Ebola outbreak: Spread of deadly disease across Europe is 'unavoidable', warns WHO chief

Four people in Spain are in hospital after a nurse tested positive for the virus on Monday

The Spanish nurse infected by Ebola is moved by ambulance to Carlos III Hospital from Alcorcon Hospital on October 8, 2014 in Alcorcon, Spain (GETTY IMAGES)

The spread of Ebola across Europe is "quite unavoidable", the World Health Organisation has warned as four people were in hospital after a Spanish nurse became the first person known to have contracted the virus outside Africa.

WHO European director Zsuzsanna Jakab has said while more cases will spread in Europe, the continent should be well prepared to control the disease.

Health officials in Spain today said four people - the nurse, her husband and two others - were being monitored in hospital in a bid to stem the spread of the virus.

"Such imported cases and similar events as have happened in Spain will happen also in the future, most likely," Ms Jakab told Reuters.

It has emerged that the nurse, who had helped treat two Spanish missionaries who died after returning from Africa with the disease, first complained of feeling ill a week before she was diagnosed with Ebola on Monday.

The 40-year-old is understood to have contacted health workers after complaining of a low fever on September 30. She was only given tests for Ebola however when she turned up at hospital with a high fever on Monday, The Telegraph has reported.

One of those hospitalised is a health worker who has diarrhoea but no fever. The other is a Spaniard who travelled from Nigeria, said Rafael Perez-Santamaria, head of the Carlos III Hospital where the infected nurse treated the two Spanish missionaries.

Health officials have said 22 people who came into contact with the nurse are also being monitored. They have not been isolated but they are having their temperature taken twice a day to check for signs of infection.

The EU has now asked Spain to explain how the nurse contracted the deadly disease, according to an AFP report.

The 40-year-old nurse, who has not been identified but is said to be in a stable condition, had up to 30 colleagues who also treated the missionaries who died of Ebola at the hospital in Madrid.

A spokesman for the European Commission said the case, the first known case of Ebola spreading within a European country, would be discussed at a Health Security Committee meeting on Wednesday.

“The priority remains to find out what actually happened,” he said.

Officials said they were still investigating how the nurse was infected. She went on holiday after the second of the missionaries she had been caring for died on September 25, although, they stressed, she had not left Madrid.

Jonathan Ball, a professor of molecular virology at the University of Nottingham, said the Spanish nurse should not have contracted the deadly disease if appropriate containment and control measures had been taken.

“It will be crucial to find out what went wrong in this case so necessary measures can be taken to ensure it doesn't happen again,” he told Reuters.

Local media in Spain yesterday reported that staff at the Madrid hospital where the nurse became infected had claimed their protective suits did not meet health and safety requirements – though this has yet to be substantiated.

Meanwhile, a Norwegian doctor infected with Ebola while working in Sierra Leone has arrived in Norway for treatment. Officials said she was in an isolation ward at Oslo University Hospital.

Additional reporting by Reuters and Press Association