Ebola in Europe

There was always a chance that the virus would be imported to Europe, but the fact that it was contracted by a nurse in a controlled environment was not predicted. How could this have happened?

Nobody expected it, and I simply don't understand how it could have happened. They will investigate and find out how it came to pass but it is a surprise, because in actual fact, Europe is well-prepared. And even in light of the case, we remain well-prepared. So nothing has changed in terms of the basic situation here.

One idea that has been mooted is that the nurse became infected by touching clothes that had been worn by the patient. Is that a possibility?

It is a possibility. If there were blood or other bodily fluids on the clothing, they would carry the risk of infecting someone, but everyone knows that, and I find it hard to believe that such a silly mistake could have been made.

The clothes are disposed of immediately and it's not as if people would be walking about freely with the patient's things under their arm. That would surprise me enormously. There have been precautions and standard guidelines in place for years and people are trained accordingly, so it is genuinely difficult to imagine medical staff acting in that way in Europe.

Let me reiterate that it should not have been allowed to happen and it comes as a big surprise. All we can do now is to wait to find out how the nurse became infected.

Do you think the threat is being taken seriously enough in European countries?

Absolutely. Everyone in Europe is taking it very seriously and they are well prepared to treat patients with Ebola. We have seen from other medical establishments that people can be treated without posing a threat to others.

I think what happened in Spain was the result of a mistake and of the guidelines not being strictly adhered to. But that doesn't mean we have to start doubting the way we handle or treat such cases. What is in place is right, and there will never be a way to rule out isolated errors. All you can do in the event of a case like the one in Spain is to look very carefully at what went wrong in order to prevent a repeat occurrence.

How likely are we to see Ebola appearing in other European countries?

There is always the possibility that we will see cases imported from Africa, but I don't think it's very likely. The measures now in place, which include exit controls and questionnaires at airports in affected countries, should prevent things from getting that far. Yet, if the virus continues to spread in West Africa, and passes into other countries there, it naturally increases the risk for Europe.

That said, the conditions here and in most European countries are very different to those in West Africa, so we would be unlikely to see an outbreak on the same scale here.

The exit controls you mention rely on human honesty. What if people don't tell the truth? How do you get around that?

We have to expect that there will be cases of dishonesty, where people wantonly fail to tell the truth. That in itself is a tragedy, but unfortunately it is the reality we face.

Given the three week incubation period and the degree of contact that a single individual can have with other people during that time, even in the case in Spain, there must be scope for significant damage to be done.

It is essential to remember that the virus can only be transmitted when the patient is already sick, that means that if I am infected but not actually sick during the first two weeks of the incubation period, I can't pass the virus on.

That has the effect of limiting the spread of the virus because most people who are sick go to the doctor after a couple of days and don't walk around feeling terrible for weeks.

Do you think the emergence of this case will have an impact on European and Western efforts to stem the disease in Africa?

I hope so. I think it will wake European countries up, and I hope it will lead to resources being made available more quickly, and to specialist help being sent to the affected countries. Pledges have been made, but to date, very little has actually arrived where it is needed.

Dr. Jonas Schmidt-Chanasit is head of the clinical virology unit at Germany's Bernhard Nocht Institute for Tropical Medicine in Hamburg, Germany.