I've written almost three dozen posts about the Ebola epidemic in Western Africa in the last six months, as we've watched the death toll and total number of cases rise exponentially to over 2,300 out of 4,300 cases. Last week, the World Health Organization warned us to brace for several thousand new cases in the next three weeks and that the total number of cases may exceed 20,000 before the epidemic can be brought under control.

In all this time the basic message has been, 'as tragic as this is for Western African nations, the epidemic will be controlled and the rest of the world should not be worried about broader spread.' Tonight, I've just read two reports by respected virologists that challenge these assumptions.

Remember, the following scenarios are the opinions of doctors not affiliated with the World Health Organization, but sufficiently respectable that I feel they are worthy of bringing to your attention. But, please keep these reports in the context of a heads up that this Ebola epidemic seems to have the potential to become vastly more dire than we've heard professional discussion of so far.

In our first article, What We’re Afraid to Say About Ebola, Michael T. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, warns that that the potential of mutation of Ebola to an airborne spread vector is greater than we've been led to believe.



What is not getting said publicly, despite briefings and discussions in the inner circles of the world’s public health agencies, is that we are in totally uncharted waters and that Mother Nature is the only force in charge of the crisis at this time. The first possibility is that the Ebola virus spreads from West Africa to megacities in other regions of the developing world. This outbreak is very different from the 19 that have occurred in Africa over the past 40 years. It is much easier to control Ebola infections in isolated villages. But there has been a 300 percent increase in Africa’s population over the last four decades, much of it in large city slums. What happens when an infected person yet to become ill travels by plane to Lagos, Nairobi, Kinshasa or Mogadishu — or even Karachi, Jakarta, Mexico City or Dhaka? The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air. You can now get Ebola only through direct contact with bodily fluids. But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus’s hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years. Each new infection represents trillions of throws of the genetic dice.



Osterholm warns that if the virus mutates to develop the capacity to be spread by air infections would spread quickly to every part of the globe.



Why are public officials afraid to discuss this? They don’t want to be accused of screaming “Fire!” in a crowded theater — as I’m sure some will accuse me of doing. But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.



I have now read several times this week that "(in) 2012, a team of Canadian researchers proved that Ebola Zaire, the same virus that is causing the West Africa outbreak, could be transmitted by the respiratory route from pigs to monkeys, both of whose lungs are very similar to those of humans.

In a second frightening report which is stirring controversy among the international health communities, Virologist: Fight against Ebola in Sierra Leone and Liberia is lost, a German virologist, Jonas Schmidt-Chanasit of the Bernhard Nocht Institute for Tropical Medicine in Hamburg "told DW that he and his colleagues are losing hope for Sierra Leone and Liberia, two of the countries worst hit by the recent Ebola epidemic."



"The right time to get this epidemic under control in these countries has been missed," he said. That time was May and June. "Now it is too late." ... Schmidt-Chanasit expects the virus will "burn itself out" in this part of the world. With other words: It will more or less infect everybody and half of the population - in total about five million people - could die. For Sierra Leone and Liberia, though, he thinks "it is far from reality to bring enough help there to get a grip on the epidemic." According to the virologist, the most important thing to do now is to prevent the virus from spreading to other countries, "and to help where it is still possible, in Nigeria and Senegal for example."



Schmidt-Chanasit comments are making many representatives of organizations fighting the spread of the Ebola virus angry and one has said his comments "are not very constructive."





Jochen Moninger, Sierra Leone based coordinator of Welthungerhilfe, told DW, Schmidt-Chanasit's statement is "dangerous and moreover, not correct."



The W.H.O. is refusing to comment on Schmidt-Chanasit's comments and a spokesperson says there is still hope for Liberia and Sierra Leone.

Moninger believes the epidemic can still be contained in Sierra Leone. She says she is not as familiar with Liberia, where things "do not look good."

