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Four more people have been quarantined in Spain’s Ebola outbreak and a pet dog has been ordered killed, and health officials in the United States and other first-world countries need to react quickly to prevent the continued spread of the deadly disease, according to an expert.

“What Dallas and Spain illustrate is that this disease is not contained in West Africa. It’s spreading, and it will continue to spread. It’s a regional epidemic turning into a global epidemic,” said Andrew Price-Smith, a former biosecurity advisor to the U.S. director of National Intelligence. “I’m worried about other travelers getting off in major cities like Boston, New York and Los Angeles. I’m worried about the cases we haven’t screened.”

Health officials yesterday were trying to figure out how Ebola got past Europe’s screening defenses and quarantined four people at a Madrid hospital where a nursing assistant was infected while caring for a Spanish priest who died of Ebola last month after being evacuated from Sierra Leone. Officials said they would kill the woman’s pet dog, Excalibur, because it could transmit the virus to humans.

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Price-Smith said air traffic screening procedures are inadequate, and travelers trying to fly undetected could take simple steps — including taking ibuprofen — to get past security.

“If they aren’t symptomatic, they can get on planes and arrive in other countries, and that’s a problem,” he said. “They game the system, and people can lie on the form.”

In Dallas, Thomas Eric Duncan remained in critical condition, on a breathing machine and kidney dialysis. His liver function, which declined over the weekend, has improved, though doctors say it may not stay that way. His family visited the hospital but declined to see him on a video feed, saying it was too disturbing last time.

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