Did Spain adhere to WHO Ebola protection guidelines?

DW. Can you help us understand what could have gone wrong?

Dr Torsten Feldt: Well, let me say first we don't have any exact information about which protection measures have been used. Spanish authorities say that WHO indicated guidelines have been respected, so we have no idea and no real exact information of what went wrong.

We know that Ebola virus is only transmitted from one person to another person by direct contact or contact to infectious materials like blood, vomit or stool. So there must be some gap, but we don't know and we have no exact information on the problems with this particular case.

Could the disease spread here in Europe?

No. We are really convinced that there is no risk that the disease could really spread or there could be a larger outbreak. It is always possible like in this case that confirmed Ebola infected patient had close contacts to family members and other persons and that those persons can get infected. But once the diagnosis is made here in Europe, Germany, Spain and other European countries, there is a very well [set-up] infrastructure and the health authorities are very alert and [can] trace those contact cases and observe them very well once the infection is diagnosed.

But, what should be done to protect health workers in future?

The first important step is to really identify those infected persons very early to avoid and exclude that those persons who have symptoms and might have an Ebola infection have contact to other persons and are able to spread the infection. This is what happened in the USA with the Dallas patient who was obviously sent home in spite of reporting he was coming from an infection area.

So it's most important to really be alert, to ask those patients with fever if they have travelled to areas where Ebola infection is ongoing. The measures to prevent infection in the hospital, in healthcare, as we use them and as they are indicated by the national and international guidelines are really suitable and effective enough to exclude or minimize the risk of infection. It is never possible to really get hundred percent safety; but that is clear and that also became clear with this case and that is important.

How big a problem is the disposal of infectious waste?

In Europe it's no problem because all the units who care for those patients should have something we call an ‘Autoclave' for every waste which is disposed and which is possibly contagious is heated to a certain temperature and for a certain time to make sure there are no infectious particles or viruses in this waste and it can be discarded without any risk of infection for the environment.

Of course, in Africa, where you don't have those technical facilities, disposal often is just burnt behind the hospital and it might be incompletely burnt. This is a serious problem because definitely the waste contains infectious particles, viruses, and might pose a risk to the environment.

Is there any suggestion that Spain may have breached Europe-wide regulations on the treatment of patients with highly infectious diseases?

There is no really and exact information and one can only speculate. But as I read, Spanish authorities are really working hard on that to find out where and under which circumstances the infections might have occurred. We really can't say if there was some breach of regulations at that point.

Dr Torsten Feldt works for the Department of Infectious Diseases at Düsseldorf University Clinic.

Interviewer: Mark Caldwell