SAN FRANCISCO — It has been four years since a spate of anthrax poisonings killed five people, and the murderer is still on the loose.
Many investigative missteps occurred in the first days when those packages of anthrax began showing up in the mail — including the federal government's refusal to immediately acknowledge that a crime had been committed.
Combining lessons from such missteps with advances in microbiology like gene sequencing, scientists and law enforcement authorities are now working together to make "microbial forensics" as potent an investigative tool as DNA evidence.
Each microbe, whether anthrax, HIV or E. coli, has its own genetic signature, which can be used to trace the source of a disease outbreak.
Virus hunters have been doing this for years to track naturally occurring outbreaks: SARS investigators two years ago were able to track that disease's origins in its first human victim, who spread it to others staying at a Hong Kong hotel.
Last year, the FBI created an elite committee of scientists and law enforcement officials to develop ways to bring such virus hunting skills to crime investigations. One goal is to train more doctors and other first responders to be able to identify when a bioterrorism attack has occurred and sound the alarm.
A big lesson learned from the anthrax attacks is that simply watching emergency rooms for disease outbreaks — the government's chief surveillance strategy — isn't effective, said Dr. Larry Bush, the Atlantis, Fla., doctor who diagnosed the first anthrax case in October 2001 and had no doubt his patient, American Media Inc. photo editor Bob Stevens, was purposely infected. Stevens died days later.
"By the time you start seeing dozens of people walking around with a rash, the smallpox is already out of the box," said Bush.
A paper published this past week in the Public Library of Science's Biology journal details the first extensive evidence-gathering guidelines for doctors to follow when they suspect a biological crime.
Doctors are urged to preserve not only tissue samples but other more traditional pieces of evidence, such as clothing, that can be later examined for fingerprints. They are also urged to keep detailed medical records.
The goal is to develop consistent and valid scientific processes that can be used as evidence in court, just as DNA evidence can identify culprits or exonerate the innocent.
During the 2001 anthrax attacks, Bush ordered all blood and tissue samples taken from Stevens to be saved, a decision for which he was later applauded because those specimens will be vital if a criminal case ever gets filed.
Because inhaled anthrax infections are so rare, Bush extensively questioned his comatose patient's family, leading him to conclude that a crime had been committed.
Four years later, microbial evidence has become even more important, because an increasing number of microbes have had their entire genetic makeup mapped and their DNA blueprints published.
Though biological crimes are rare, they do occur and they aren't limited to terrorist attacks.
Microbial evidence was first introduced in a U.S. court in 1998 to convict a Lafayette, La., doctor of attempted murder for injecting an estranged lover with HIV taken from one of his patients. He had told her it was a vitamin B-12 injection. But the HIV from the doctor's patient and his victim were identical enough to persuade a judge to sentence him to 50 years in prison.
The conviction was upheld in appellate court and the U.S. Supreme Court refused to hear the case, validating the use of microbial evidence.
But getting that case to court in the first place was tough — the local police officers and prosecutors initially didn't believe the victim's accusations about a well-respected doctor in a small town.
Recognizing that a disease has resulted from a crime is a big challenge, and doctors don't want to sound a false alarm for an illness that occurred naturally.
"I'm not sure our law enforcement is sophisticated enough to recognize a (microbial) crime," said Rock Harmon, an Alameda County prosecutor who is a member of the FBI committee. "They probably just dump the evidence in the drain."
Harmon was invited to the FBI committee because of his extensive work in helping create legal protocols that have made DNA the routine investigative tool it is today.
Now Harmon and others hope to translate the scientific and legal success DNA has had in court to the world of microbes.
Still, bringing DNA expertise to the world of microbes is daunting, according to Dr. Steven Schutzer of the University of Medicine and Dentistry New Jersey and his co-authors in the Public Library of Science piece.
"Because of the sheer number of potential pathogens that could be employed as a weapon, identifying genetic markers for microbes is a more daunting task than identifying human DNA," the authors concluded. "In the case of human identification, only one species is involved, and it is often possible to identify an individual person."
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