Is the 'poor man's atomic bomb' about to explode?

• Position: Your Life

Is a worldwide breakout from the African epidemic of Ebola a realistic possibility? Viral hemorrhagic fevers, of which Ebola is one example, have killed fewer than 3,000 people over 40 years. So, why the high level of concern now?, wonders Jane M. Orient, executive director of the Association of American Physicians and Surgeons, Tucson, Ariz., and author of Your Doctor Is Not In: Healthy Skepticism About National Health Care and Sapira's Art and Science of Bedside Diagnosis.

Orient points out that Thomas Frieden--director of the Centers for Disease Control and Prevention, Atlanta, Ga.--maintained in early August that an Ebola outbreak in the U.S. is "not in the cards," though six days later he stated that the disease "inevitably" would reach the U.S.

The CDC has issued guidelines for commercial aircraft and hospitals, all the while insisting that Ebola is not spread through air, food, or water. When transporting Ebola patients, however, CDC personnel don pressurized suits and self-contained breathing apparatus--a level of precaution well beyond the gloves, mask, and hand-washing used by hospitals or emergency medical response teams. Is this just excessive caution?, asks Orient.

The usual, natural mode of transmission requires direct contact, although there is evidence that air-borne transmission can occur in some circumstances, as noted in a Pathogen Safety Data Sheet from the Public Health Agency of Canada, explains Orient. In Africa, families handle corpses extensively in preparing them for burial, and medical workers often lack the most rudimentary protective gear. In rural areas, people live close to--and often eat--infected animals such as fruit bats and monkeys, she adds.

Unlike previous outbreaks, this one is occurring in major cities, with potentially devastating consequences, as discussed in a hearing before the U.S. House Foreign Affairs Subcommittee on Africa, Global Health, Global Human Rights.

Some fears are based on concerns about potential deliberate use of deadly pathogens in biological warfare. Marburg virus, a relative of Ebola, was weaponized by the Soviet Union for aerosol distribution, as was smallpox. (Soviet efforts to weaponize Ebola were not successful.)

"While chemical weapons have been called the 'poor man's atomic bomb,' biological agents are far more effective--and, once released, they keep proliferating, unlike radioactivity or...