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
2018 Kivu Ebola outbreak 33 cases of EVD were identified, of which 24 died, in one week. On 9 November, at 319 probable and confirmed cases (not counting suspected cases) the 2018 North Kivu and Ituri province Ebola virus outbreak became the biggest in the DRC's history. On 29 November, the 2018 Kivu Ebola outbreak surpassed the total case count of each EVD outbreak that had occurred before, except the West Africa epidemic, to become the "second biggest EVD outbreak ever". The Democratic Republic of Congo declared an Ebola outbreak on 1 August, when four cases had tested positive for the Ebola virus in