New concern worldwide as nurse in Spain gets Ebola

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New concern worldwide as nurse in Spain gets Ebola
MADRID, SPAIN - OCTOBER 10: A group of health workers protest for the support of Teresa Romero in front door of Carlos III hospital where nurse Teresa Romero is being treated for the Ebola virus, in Madrid, Spain, on October 10, 2014. 13 people are quarantined as a precaution in hospital following the admission of Spanish nurse Teresa Romero infected with the ebola virus. (Photo by Senhan Bolelli/Anadolu Agency/Getty Images)
MADRID, SPAIN - OCTOBER 10: A group of health workers protest for the support of Teresa Romero in front door of Carlos III hospital where nurse Teresa Romero is being treated for the Ebola virus, in Madrid, Spain, on October 10, 2014. 13 people are quarantined as a precaution in hospital following the admission of Spanish nurse Teresa Romero infected with the ebola virus. (Photo by Senhan Bolelli/Anadolu Agency/Getty Images)
MADRID, SPAIN - OCTOBER 10: Nurses of Carlos III hospital, where nurse Teresa Romero is being treated for the Ebola virus, protest as Spanish Prime Minister Mariano Rajoy leaves the hospital on October 10, 2014 in Madrid, Spain. Spanish Health Minister Ana Mato confirmed nurse Teresa Romero had tested positive after treating two Ebola patients that had been brought back to the country from Africa. (Photo by Gonzalo Arroyo Moreno/Getty Images)
MADRID, SPAIN - OCTOBER 10: Nurse Teresa Romero's husband Javier Limon looks on behind the floor where medical staff operate wearing protective suits inside Carlos III hospital, where nurse Teresa Romero is being treated for the Ebola virus on October 10, 2014 in Madrid, Spain. Spanish Health Minister Ana Mato confirmed nurse Teresa Romero had tested positive after treating two Ebola patients that had been brought back to the country from Africa. (Photo by Gonzalo Arroyo Moreno/Getty Images)
Spanish Health Minister Ana Mato arrives to meet regional health advisors to reveal the government's new measures in the fights against ebola virus in Madrid on October 10, 2014. Spain said Friday it was setting up a special government committee to coordinate the national fight against Ebola after a nurse in Madrid became infected with the deadly disease. The health minister and officials from several other ministries will form a 'special committee for the management of the Ebola disease in Spain,' deputy premier Soraya Saenz de Santamaria told a news conference. AFP PHOTO / PIERRE-PHILIPPE MARCOU (Photo credit should read PIERRE-PHILIPPE MARCOU/AFP/Getty Images)
MADRID, SPAIN - OCTOBER 10: Doctors, nurses and cleaners protest against the government's handling of the Ebola virus crisis outside La Paz hospital on October 10, 2014 in Madrid, Spain. Spanish nurse Teresa Romero is being treated for the Ebola virus at the nearby Carlos III hospital after treating two Ebola patients that had been brought back to the country from Africa. (Photo by Denis Doyle/Getty Images)
A Health worker sporting a surgical mask with the words ' Government resign' stands druing a gathering outside the Carlos III hospital in Madrid on October 10, 2014 where 12 people are in quarantine as a precaution following the admission of Spanish nurse Teresa Romero infected with the ebola virus. Romero was fighting for her life Friday as fears mounted of the deadly disease spreading beyond its west Africa contagion to fuel a global pandemic. AFP PHOTO / PEDRO ARMESTRE (Photo credit should read PEDRO ARMESTRE/AFP/Getty Images)
Spanish Minister of Health, Social Services and Equality Ana Mato (C), Spanish Director of Public Health Mercedes Vinues (L) and Community of Madrid's Director General for First Aid Antonio Alemany attend a press conference at the ministry of health in Madrid on October 6, 2014 on what is believed to be the first case of Ebola contracted outside of the African continent since the latest outbreak of the virus hit West Africa this year. An assistant nurse who treated two Ebola patients at Carlos III hospital is infected with the virus herself, health officials said on October 6, 2014. AFP PHOTO / DANI POZO (Photo credit should read JAVIER SORIANO/AFP/Getty Images)
Spanish Minister of Health, Social Services and Equality Ana Mato (C), Spanish Director of Public Health Mercedes Vinues (L) and Community of Madrid's Director General for First Aid Antonio Alemany attend a press conference at the ministry of health in Madrid on October 6, 2014 on what is believed to be the first case of Ebola contracted outside of the African continent since the latest outbreak of the virus hit West Africa this year. An assistant nurse who treated two Ebola patients at Carlos III hospital is infected with the virus herself, health officials said on October 6, 2014. AFP PHOTO / DANI POZO (Photo credit should read JAVIER SORIANO/AFP/Getty Images)
(FILES) A picture taken on August 7, 2014 shows the entrance to the Carlos III hospital in Madrid where two late Ebola patients had been treated. An assistant nurse who treated two Ebola patients at a Madrid hospital is infected with the virus herself, health officials said on October 6, 2014 in what is believed to be the first time a person has contracted the disease in Europe. AFP PHOTO / GERARD JULIEN (Photo credit should read GERARD JULIEN/AFP/Getty Images)
Spanish Minister of Health, Social Services and Equality Ana Mato (L) and Community of Madrid's Director General for First Aid Antonio Alemany attend a press conference at the ministry of health in Madrid on October 6, 2014 on what is believed to be the first case of Ebola contracted outside of the African continent since the latest outbreak of the virus hit West Africa this year. An assistant nurse who treated two Ebola patients at Carlos III hospital is infected with the virus herself, health officials said on October 6, 2014. AFP PHOTO / DANI POZO (Photo credit should read JAVIER SORIANO/AFP/Getty Images)
ALCORCON, SPAIN - OCTOBER 10: A sanitation worker wearing protective clothing desinfects the hall of the apartment building, the private residence for Spanish nurse Teresa Romero several days after she was tested positive for the Ebola virus on October 10, 2014 in Alcorcon, near Madrid, Spain. Spanish Health Minister Ana Mato confirmed nurse, Teresa R. R had tested positive after treating two Ebola patients who had been brought back to the country from Africa. (Photo by Pablo Blazquez Dominguez/Getty Images)
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WASHINGTON (AP) -- Raising fresh concern around the world, a nurse in Spain on Monday became the first person known to catch Ebola outside the outbreak zone in West Africa. In the U.S., President Barack Obama said the government was considering ordering more careful screening of airline passengers arriving from the region.

In dealing with potential Ebola cases, Obama said, "we don't have a lot of margin for error."

Already hospitalized in the U.S., a critically ill Liberian man, Thomas Duncan, began receiving an experimental drug in Dallas. But there were encouraging signs for an American video journalist who returned from Liberia for treatment. Ashoka Mukpo, 33, was able to walk off the plane before being loaded on a stretcher and taken to an ambulance, and his father said his symptoms of fever and nausea appeared mild.

"It was really wonderful to see his face," said Dr. Mitchell Levy, who talked to his son over a video chat system at Nebraska Medical Center.

In Spain, the stricken nurse had been part of a team that treated two missionaries flown home to Spain after becoming infected with Ebola in West Africa. The nurse's only symptom was a fever, but the infection was confirmed by two tests, Spanish health officials said. She was being treated in isolation, while authorities drew up a list of people she had had contact with.

Medical workers in Texas were among Americans waiting to find out whether they had been infected by Duncan, the African traveler.

In Washington, the White House continued to rule out any blanket ban on travel from West Africa.

People leaving the outbreak zone are checked for fevers before they're allowed to board airplanes, but the disease's incubation period is 21 days and symptoms could arise later.

Airline crews and border agents already watch for obviously sick passengers, and in a high-level meeting at the White House, officials discussed potential options for screening passengers when they arrive in the U.S. as well.

Nancy Castles, a spokeswoman for Los Angeles International Airport, said the Centers for Disease Control and Prevention has had employees on site at more than a dozen major international airports in the U.S. like LAX for many years. Screening of passengers starts with Customs and Border Protection agents, who work with CDC when they have a case they are concerned about.

Obama said the U.S. will be "working on protocols to do additional passenger screening both at the source and here in the United States." He did not outline any details or offer a timeline for when new measures might begin.

Additional screening would not have caught Duncan because he wasn't exhibiting any Ebola symptoms when he arrived in the U.S.

The Obama administration maintains that the best way to protect Americans is to end the outbreak in Africa. To that end, the U.S. military was working Monday on the first of 17 promised medical centers in Liberia and training up to 4,000 soldiers this week to help with the Ebola crisis.

The U.S. is equipped to stop any further cases that reach this country, said White House spokesman Josh Earnest.

"The tragedy of this situation is that Ebola is rapidly spreading among populations in West African who don't have that kind of medical infrastructure," Earnest said.

About 350 U.S. troops are already in Liberia, the Pentagon said, to begin building a 25-bed field hospital for medical workers infected with Ebola. A torrential rain delayed the start of the job on Monday.

The virus has taken an especially devastating toll on health care workers, sickening or killing more than 370 in the hardest-hit countries of Liberia, Guinea and Sierra Leone - places that already were short on doctors and nurses before Ebola.

Texas Gov. Rick Perry urged the U.S. government to begin screening air passengers arriving from Ebola-affected nations, including taking their temperatures.

Perry stopped short, however, of joining some conservatives who have backed bans on travel from those countries.

Federal health officials say a travel ban could make the desperate situation worse in the afflicted countries, and White House spokesman Earnest said it was not currently under consideration.

Southwest Airlines CEO Gary Kelly said he saw no need for additional screening at airports and noted that airlines already carefully clean planes.

Airlines have dealt with previous epidemics, such as the 2003 outbreak in Asia of SARS, or severe acute respiratory syndrome.

"Now it's Ebola," Kelly said. "We are always on the alert for any kind of infectious disease."

The U.S. didn't ban flights or impose extra screening on passengers during the SARS outbreak or the 2009 swine flu pandemic. Both of those were airborne diseases that spread more easily than the Ebola virus, which is spread by contact with bodily fluids.

The CDC did meet many direct flights arriving from SARS-affected countries, to distribute health notices advising travelers that they might have been exposed, how they could monitor their health and when to call a doctor.

Canadian health authorities attempted various methods of screening arriving passengers for SARS, including sometimes checking for fever. Authorities later reported that five SARS patients entered Canada in three months, but none had symptoms while traveling through airports.

General airport fever checks aren't very effective, especially as flu season begins, said Lawrence Gostin, a prominent health law professor at Georgetown University. But checking and questioning only passengers from the outbreak zone "might reassure the public. I don't think there would be a big downside."

The SARS death rate was about 10 percent, higher for older patients. Its new relative MERS, now spreading in the Middle East, appears to be more deadly, about 40 percent. About half of people infected with Ebola have died in this outbreak.

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Associated Press writers Jorge Sainz in Spain, David Koenig in Dallas, Josh Funk in Omaha, Matthew Perrone, Lolita Baldor and Joan Lowy in Washington, and Krista Larson and Sarah DiLorenzo in Liberia contributed to this report.

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