Ken Isaacs, a vice-president of Christian charitable organization Samaritan’s Purse, has said that the actual number of Ebola cases is 25 to 50 percent higher than has been reported to the World Health Organization. Isaacs appeared before a subcommittee of the House Committee on Foreign Affairs. He warned that the situation in Liberia is out of control, and that elements of the local medical community are ignoring the disease or pretending that it doesn’t exist.

He described a situation in which a prominent local doctor attempted to enter a ward full of Ebola patients without any protective clothing, mocking the existence of the disease. A man who was with him died of Ebola within five days. For the most part, the West African medical establishment is co-operating with health organizations, but victims are often hiding in order to avoid having their families quarantined.

As of Thursday, WHO reported that Ebola had killed 932 people in West Africa, with 1,711 confirmed and suspected cases. If Isaacs is right, this represents a serious undercount of the actual cases. Ebola spreads through contact, not through the air. However, all bodily fluids spread infection, including debris from a sneeze. The infection remains asymptomatic from 8 to 10 days after infection, and during this time the victim is not contagious. Victims can become contagious before they are too sick to function, and in a healthy person, the first few days of symptoms can be subtle, with fever being the only initial sign. Thus contagious victims may spread the disease before they become unable to function.

Judging from comments on Twitter, there is significant public fear that Ebola will spread to the US and Europe, but at present it is not anticipated that the outbreak will affect the developed world, but it could spread much more widely in Africa. There is an Ebola vaccine in development, but it is not expected that it will be deployed in a public context before next year. Some infected health workers have been treated with it, but no African patients.
A Twitter rumor that there is an outbreak in Atlanta has been denied by officials. An internet-fueled outbreak of hysteria is far more likely than a serious Ebola crisis in Europe or the US.