New Delhi- A second Ebola case on US soil has raised the alarm in India's health establishment and many experts believe the country is ill-prepared to tackle a possible outbreak, Indian media reported today.

As in other countries, India has been screening passengers arriving from West Africa, checking for fever and other signs of illness at Delhi's international airport and others. It is unclear how effective this screenings drive is proving.

The country's state of public health is reason for concern. If the killer virus breaks through the barriers, Ebola could well become a pandemic with the combined problems of an overstretched health system and inadequate monitoring and tracking mechanisms.

India has one nurse per 1,000 people, according to the 2010 World Bank data compared to 10 nurses for every 1,000 in the US. Health experts say doctors and nurses seldom wear protective gloves as a mandatory practice which could lead to immediate infection and spread of the virus. The prevalence of malaria, dengue and other fever-inducing diseases makes it tough to isolate people displaying symptoms of early onset of Ebola.

In a densely-populated country the task of monitoring and tracking cases can be difficult. So far the country has only two laboratories — the National Institute for Communicable Diseases in Delhi and the National Institute of Virology in Pune — to test the virus.

Conceding that controlling and containing a possible outbreak would be an enormous task, Union health minister Harsh Vardhan said there was no room for complacency. "We should be prepared for the worst. We are aggressively monitoring all entry points and passengers from affected countries. Our surveillance begins from the embassies of the infected countries right up to the destination.

Guidelines have been issued to states and hospitals and we are holding daily reviews," he said. The ministry said all suspected cases had tested negative so far.

The rising concern comes a day after WHO said the Ebola outbreak could grow to 10,000 new cases a week within two months. Death toll from the virus has reached 4,447, nearly all of them in West Africa. Dr Bruce Aylward, WHO assistant director-general, said the number of new cases was likely to be between 5,000 and 10,000 a week by early December.