MADRID (MarketWatch) — In the capital and largest city of Spain, alarm and questions were growing among its 3 million–plus inhabitants over how a country with a modern, reputable health-care system has found itself in crisis over a deadly disease previously associated almost exclusively with West Africa.

“I am totally panicked,” said Isabel Alonso Paloma, a retiree who lives near Plaza España, one of the city’s largest and most popular plazas.

Spaniards went to bed Monday with the shocking news that a nurse’s aide in Madrid had become infected with Ebola after attending to an African-based missionary who died in hospital. Hers is the first known case of Ebola infection outside of West Africa. Tuesday hasn’t brought much better news, as the aide’s husband is now quarantined amid a stream of reports about additional potential cases of the disease in Spain.

Paloma’s husband, Roberto Acuña, a self-employed 67-year-old Madrid native, was angry as well as panicking, saying the country’s health minister, Ana Mato, should resign. “The least bit of negligence in any process is deadly. Today we have the news — this is negligence. The first responsibility lies with the minister.”

Acuña’s anger was echoed in social media via #MatoDimisión, a hashtag calling for Mato’s resignation from her cabinet post, while the online newspaper El Confidencial had nearly 20,000 votes — 88% of its straw poll — calling on her to step down. Some media outlets reported that the medical team caring for the missionary and a priest who had been brought back from Africa and eventually died used gloves held together by adhesive tape and carried waste out of rooms via elevators used by other personnel.

In an assessment of risk by researchers at Northeastern University in Boston, Spain was ranked 19th out of 30 — that is to say, among countries least likely to suffer an outbreak of Ebola. The U.S., where much attention in recent days has been focused on an Ebola patient in Texas, along with France and the U.K., ranked well ahead of Spain in risk levels.

First Ebola case outside West Africa

Acuña said the worst aspect of the current situation in Spain is not knowing how much worse the crisis might get. “Have you read about what happened in the 14th century here? Boats in Italy infected by the Bubonic Plague? And millions of people died in Europe.”

“Of course I’m panicked,” he said. “There is no cure [for Ebola].”

A different view came from Manuel, a 33-year-old immigrant from Ghana, where Ebola has not been diagnosed since the West Africa outbreak began. He’s been in Madrid for four years, soliciting change and food outside a grocery store in the center of town in exchange for dog sitting or looking after shopper’s belongings. ”I don’t worry about that,” he said. “I just worry about getting work.”

Ionel Catama, a 62-year-old from Romania who has lived in Spain for 10 years, said he was more afraid of a terrorist using Ebola as a biological weapon, gesturing toward the historic Mercado de San Miguel, a popular market that’s packed day and night with tourists and Madrileños.

“When there are more cases, it will be time to panic,” said Catama, who distributes advertising fliers for local businesses and also works as a massage therapist. Unlike others, though, he appeared to have total faith in the health system of Spain.

“In Spain the hospitals are very prepared. There are many cures and vaccines for whatever illness you have,” he said. “Spain is ready to face anything.”

That view wasn’t shared by six Spanish friends traveling across the city on the bus, who agreed the flow of news about Ebola was more than a little unsettling. Rosalia, 65, who declined to provide her last name, said she has one big question for the Spanish government. “Why did they bring these two sick men to Spain in the first place? I just don’t understand it.”