Ebola virus disease in Spain had become unwell and on 6 October tested positive for Ebola at her local hospital in Alcorcón, the Hospital Universitario Fundación Alcorcón. A second test confirmed the diagnosis, making this the first confirmed case of Ebola transmission outside Africa. Following testing, she was transferred to the Hospital Carlos III in Madrid for treatment. As of October 7, 50 contacts were being monitored, with 7 kept in isolation at the Hospital Carlos III, and an investigation was under way. On 7 October, Madrid's regional government got a court order to euthanize Romero's pet dog, Excalibur, concerned that it posed a risk
Ebola virus disease for a priest who had been repatriated from West Africa. This was the first transmission of the virus to occur outside Africa. Romero tested negative for the disease on 20 October, suggesting that she may have recovered from Ebola infection. On 12 October, the CDC confirmed that a nurse in Texas, Nina Pham, who had treated Duncan was found to be positive for the Ebola virus, the first known case of transmission in the United States. On 15 October, a second Texas health-care worker who had treated Duncan was confirmed to have the virus. Both of these people have since