EBOLA IN THE AIR? A NIGHTMARE THAT COULD HAPPEN

Ebola in the air? A nightmare that could happen

By Elizabeth Cohen, Senior Medical Correspondant

September 13, 2014 -- Updated 0104 GMT (0904 HKT)

A child stops to look at a man who is suspected of suffering from the Ebola virus on a main street in Monrovia, Liberia, on Friday, September 12. Health officials say the current Ebola outbreak in West Africa is the deadliest ever. More than 4,700 cases have been reported since December, with more than 2,400 of them ending in fatalities, according to the World Health Organization.

Health workers on Wednesday, September 10, carry the body of a woman who they suspect died from the Ebola virus in Monrovia.

A woman in Monrovia carries the belongings of her husband, who died after he was infected by the Ebola virus.

Five ambulances that were donated by the United States to help combat the Ebola virus are lined up in Freetown, Sierra Leone, on September 10 following a ceremony that was attended by Sierra Leone President Ernest Bai Koroma.

A health worker wears protective gear Sunday, September 7, at ELWA Hospital in Monrovia.

An ambulance transporting Dr. Rick Sacra, an American missionary who was infected with Ebola in Liberia, arrives at the Nebraska Medical Center in Omaha, Nebraska, on Friday, September 5. Sacra was being treated in the hospital's special isolation unit.

Medical workers from the Liberian Red Cross carry the body of an Ebola victim Thursday, September 4, in Banjol, Liberia.

Health workers in Monrovia place a corpse into a body bag on September 4.

A rally against the Ebola virus is held in Abidjan, Ivory Coast, on September 4.

After an Ebola case was confirmed in Senegal, people load cars with household items as they prepare to cross into Guinea from the border town of Diaobe, Senegal, on Wednesday, September 3. Senegal has since closed its borders.

Crowds cheer and celebrate in the streets Saturday, August 30, after Liberian authorities reopened the West Point slum in Monrovia. The military had been enforcing a quarantine on West Point, fearing a spread of the Ebola virus.

A ambulance leaves the University Hospital Fann in Dakar, Senegal, were a man was being treated for symptoms of the Ebola virus on Friday, August 29.

A health worker wearing a protective suit conducts an Ebola prevention drill at the port in Monrovia on August 29.

Senegalese Health Minister Awa Marie Coll-Seck gives a news conference August 29 to confirm the first case of Ebola in Senegal. She announced that a young Guinean had tested positive for the deadly virus.

Volunteers working with the bodies of Ebola victims in Kenema, Sierra Leone, sterilize their uniforms on Sunday, August 24.

A Liberian health worker checks people for symptoms of Ebola at a checkpoint near the international airport in Dolo Town, Liberia, on August 24.

A guard stands at a checkpoint Saturday, August 23, between the quarantined cities of Kenema and Kailahun in Sierra Leone.

A burial team from the Liberian Ministry of Health unloads bodies of Ebola victims onto a funeral pyre at a crematorium in Marshall, Liberia, on Friday, August 22.

A humanitarian group worker, right, throws water in a small bag to West Point residents behind the fence of a holding area on August 22. Residents of the quarantined Monrovia slum were waiting for a second consignment of food from the Liberian government.

Dr. Kent Brantly leaves Emory University Hospital on Thursday, August 21, after being declared no longer infectious from the Ebola virus. Brantly was one of two American missionaries brought to Emory for treatment of the deadly virus.

Ebola outbreak in West Africa


   Experts fear that Ebola will mutate and become spreadable via cough or sneeze
   Ebola is an RNA virus, meaning every time it copies itself, it mutates
   Most mutations mean nothing, but some could change the way the virus behaves

(CNN) -- Today, the Ebola virus spreads only through direct contact with bodily fluids, such as blood and vomit. But some of the nation's top infectious disease experts worry that this deadly virus could mutate and be transmitted just by a cough or a sneeze.

"It's the single greatest concern I've ever had in my 40-year public health career," said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "I can't imagine anything in my career -- and this includes HIV -- that would be more devastating to the world than a respiratory transmissible Ebola virus."

Osterholm and other experts couldn't think of another virus that has made the transition from non-airborne to airborne in humans. They say the chances are relatively small that Ebola will make that jump. But as the virus spreads, they warned, the likelihood increases.

Every time a new person gets Ebola, the virus gets another chance to mutate and develop new capabilities. Osterholm calls it "genetic roulette."


As of Friday, there have been 4,784 cases of Ebola, with 2,400 deaths, according to the World Health Organization, which says the virus is spreading at a much faster rate now than it was earlier in the outbreak.

Ebola is an RNA virus, which means every time it copies itself, it makes one or two mutations. Many of those mutations mean nothing, but some of them might be able to change the way the virus behaves inside the human body.

"Imagine every time you copy an essay, you change a word or two. Eventually, it's going to change the meaning of the essay," said Dr. C.J. Peters, one of the heroes featured in "The Hot Zone."

That book chronicles the 1989 outbreak of Ebola Reston, which was transmitted among monkeys by breathing. In 2012, Canadian researchers found that Ebola Zaire, which is involved in the current outbreak, was passed from pigs to monkeys in the air.

Dr. James Le Duc, the director of the Galveston National Laboratory at the University of Texas, said the problem is that no one is keeping track of the mutations happening across West Africa, so no one really knows what the virus has become.

One group of researchers looked at how Ebola changed over a short period of time in just one area in Sierra Leone early on in the outbreak, before it was spreading as fast as it is now. They found more than 300 genetic changes in the virus.

"It's frightening to look at how much this virus mutated within just three weeks," said Dr. Pardis Sabeti, an associate professor at Harvard and senior associate member of the Broad Institute, where the research was done.

Even without becoming airborne, the virus has overwhelmed efforts to stop it.

The group Doctors Without Borders says Monrovia, Liberia, needs 1,000 beds for Ebola patients but has only 240, and it has had to turn patients away, sending them back to neighborhoods where they could infect more people.

This week, a Pentagon spokesman said the United States is sending a 25-bed field hospital to Monrovia.

"A 25-bed hospital with nobody to staff it? That's not the scale we need to be thinking about," Le Duc said. "It's an absolute embarrassment. When there was a typhoon in the Philippines, the Navy was there in 48 hours and had billions of dollars in resources."

Osterholm commended groups like Doctors Without Borders but said uncoordinated efforts by individual organizations are no match for Ebola spreading swiftly through urban areas.

"This is largely dysfunctional. Nobody's in command, and nobody's in charge," he said. "It's like not having air traffic control at an airport. The planes would just crash into each other."

Funerals, ghost towns and haunted health workers

The roots of our Ebola fears

CNN's John Bonifield contributed to this story.