A doctor has revealed that the Spanish nurse who was infected with Ebola may have been caught the virus after accidentally touching her face with an infected glove after treating a missionary who had been infected with the virus.
Health officials say Teresa Romero twice entered the room of Spanish missionary Manual Garcia Viejo -- once to clean him and the second time to tidy up after he died on September 25, just days after he was repatriated from Sierra Leone.
Doctor German Ramirez of Madrid's La Paz-Carlos III hospital said Romero told him she had touched her face with her gloves as she removed her protective suit after leaving the quarantine room where the missionary was being treated.
"It seems like it was the gloves. The gloves touched the face," Ramirez told reporters gathered outside the hospital.
"It is possible that this was not a mistake as such. It could simply be an accident and logically, probably, she could not remember at the beginning because of the state of her health."
Romero herself said in an interview Wednesday in the online edition of El Pais newspaper that the point when she removed her protective suit was "the most critical moment in which it could have happened, but I am not sure".
- 'Mistake' or 'accident' -
Romero's is the first case of Ebola being transmitted outside of West Africa, where an outbreak which began at the start of the year has killed nearly 3,900 people and infected at least twice as many, according to the World Health Organization.
Romero was one of five people still in isolation in the hospital on Wednesday. Officials there said another case, a nursing assistant who had been admitted on Tuesday, was discharged after testing negative for Ebola.
The Madrid regional health minister Javier Gonzalez said he thought the infection had been due to a "mistake" on the part of the nurse or an "accident".
"She has said herself that she probably made a mistake. That reassures us because the safety protocol were observed correctly. If a mistake was made, we will have to find out why," he told reporters.
"We are not trying to blame her," he added. "I think it was an accident on the part of the patient."
Gonzalez earlier told regional lawmakers in a hearing that Romero had visited her family doctor shortly after feeling ill on September 29 and "concealed from the doctor the fact that she was a nurse who had been in direct contact with a patient infected with Ebola".
She then called a medical helpline for hospital staff on October 2 and told them she had a fever, but was not admitted to hospital until October 6.
- Hairdressers under observation -
Safety protocol dictated that a fever of 38.6 degrees Celsius (101.5 Fahrenheit) or higher could be a symptom of Ebola, but Gonzalez said the nurse's temperature had never been recorded as having reached that level.
"One of the things we have now done is to change the protocol so that anyone with a temperature of a few tenths of a degree will be considered at risk," he said.
He rejected claims that medical staff were not adequately trained to treat Ebola patients safely, but admitted that "something clearly did not work" and the safety protocol may have to be "modified" further.
Gonzalez said that among the people who were being monitored after coming in contact with the nurse before she was hospitalised were "two hairdressers".
"After going to the family doctor she went to the hairdresser to get her legs waxed," he explained.