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Virologists may not be publicly talking about the possibility that the Ebola virus could someday mutate into an airborne strain, writes Michael T Osterholm in the New York Times, but it's something they are "definitely considering in private".
The director of the Center for Infectious Disease Research and Policy at the University of Minnesota says that the virus - which currently can only be transmitted through contact with bodily fluids - has proven to be "notoriously sloppy in replicating", which increases the chances that it could turn into something more contagious.
"Why are public officials afraid to discuss this?" he asks. "They don't want to be accused of screaming 'fire!' in a crowded theatre - 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."
The second disturbing scenario he envisions is if the Ebola virus is brought to a more densely populated area of the world, where it would be more difficult to contain.
According to the World Health Organisation, the virus has already infected almost 4,800 people and killed around 2,400. It is now predicting that more than 20,000 may contract the virus before the current outbreak is over.
"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?" he asks. The more people who get infected, he says, the greater the opportunities for mutation.
"The current Ebola virus' 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," he writes.
To prevent this, Osterholm says, the United Nations should be put in charge of overseeing containment of the outbreak by managing air supply chains, providing hospital beds and training medical staff.
Waiting for a vaccine isn't a realistic solution, he concludes. By the time one is developed, the disease could be in "our own backyards".
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