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
West African Ebola virus epidemic much of sub-Saharan Africa, prior to the outbreak Ebola was mistakenly thought by the international community to not be endemic to West Africa. Thus, these early cases were diagnosed as other conditions more common to the area and the disease had several months to spread before it became recognized as Ebola. On 25 March 2014, the WHO indicated that Guinea's Ministry of Health had reported an outbreak of Ebola virus disease in four southeastern districts, and that suspected cases in the neighbouring countries of Liberia and Sierra Leone were being investigated. In Guinea, a total of 86 suspected cases, including