In the New York Times, Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, lays out his two biggest worries about the Ebola outbreak. First, that the virus could reach a large urban area where it will spread more quickly than it has in isolated villages. Second, and far more worrisome, that Ebola could mutate and be transmissable 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.
If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico.
Osterhom goes on to lay out how the world should be planning. You can read his recommendations here.