Transformative Change in Science Tools- Molecular Epidemiology for Bacteria and Viruses – Impl
This recent Gina Kolata article in the NYT recently highlighted transformative scientific change – molecular epidemiology for bacteria and viruses. In short, it means the ability to in just a few days (or less) actually prove the source of bacterial diseases or even a virus.
How? By using fact investigation, plus great hardware and software to sequence genomic structures, and compare them to databased genomes. Note below the stunning drops in time and price for the work.
Consequences for litigation ? Well, it’s probably not here quite yet, but think about possibilities general and specific.
On specifics, think about the next wave of illness suspected to be associated with contaminated food. (For background, see this page from the Centers for Disease Control.) Using the tools described below, the contamination perhaps will be traceable by science that may not be disputable. If that happens, the suspected source may run out of room to express doubt about the cause of an outbreak. Instead, it may face comparison of bacteria at its facility to bacteria found in sick people. When that happens and people want compensation, there may not be any causation issues left for debate.
On a large scale, think about epidemiology in general. Defendants often argue that a bad outcome is not "scientifically proven" until large scale epidemiology confirms cause and effect in a double-blinded, long term study which correlates logically to other scientific proof . That can take months, years or decades, depending on the substance and disease at issue. And, the study may be confounded by variables and may not yield a conclusion. See this defense side post for a long explanation of epidemiology and litigation tactics.
Plaintiff’s lawyers, on the other hand, will have to think about whether they can/should bring claims if a test was not run on a given person. They can argue an inference from others, but …
Think also about the act and expense of ordering testing. Should doctors order tests to determine the precise source, even if it seems obvious when the 20th patient has just been seen ? Should a heath insurer pay the bill ? Should/could the paying health insurer have a remedy against the source for all expenses of tests caused by the contamination?
Key excerpts are set out below on the exponential nature of the scientific change. Read the entire article for examples of the tools in action – the examples are powerful.
"It is the start of a new age in microbiology, Dr. Musser and others say. And the sort of molecular epidemiology he and his colleagues wanted to do is only a small part of it. New methods of quickly sequencing entire microbial genomes are revolutionizing the field.
The first bacterial genome was sequenced in 1995 — a triumph at the time, requiring 13 months of work. Today researchers can sequence the DNA that constitutes a micro-organism’s genome in a few days or even, with the latest equipment, a day. (Analyzing it takes a bit longer, though.) They can simultaneously get sequences of all the microbes on a tooth or in saliva or in a sample of sewage. And the cost has dropped to about $1,000 per genome, from more than $1 million.
In a recent review, Dr. David A. Relman, a professor of medicine, microbiology and immunology at Stanford, wrote that researchers had published 1,554 complete bacterial genome sequences and were working on 4,800 more. They have sequences of 2,675 virus species, and within those species they have sequences for tens of thousands of strains — 40,000 strains of flu viruses, more than 300,000 strains of H.I.V., for example.
With rapid genome sequencing, “we are able to look at the master blueprint of a microbe,” Dr. Relman said in a telephone interview. It is “like being given the operating manual for your car after you have been trying to trouble-shoot a problem with it for some time.”
Dr. Matthew K. Waldor of Harvard Medical School said the new technology “is changing all aspects of microbiology — it’s just transformative.”