Evolution: Crime Fighting Machine

I know I give physicians crap sometimes on my blag, but I really do appreciate what they–along with nurses, physical and respiratory therapists, and other health professionals– do.

They interact with people when they are at their ‘worst’– a normally cheerful, charming person is sick, scared, in pain, frustrated, worried, hurt, angry, drugged up when they are at the hospital.  They are not themselves.  And when patients are in this ‘altered’ state, they are helpless, relying on these professionals for help.  I dont just mean ‘helpless’ in the sense most of us have no idea how to remove a lung tumor– I mean literally completely helpless– Sometimes patients are naked, unconscious, and relying on medical professionals to keep them alive.

I have no doubt that medical professionals are even more repulsed by stories like this than I am:

‘Serial infector’ hospital worker charged in NH hepatitis C outbreak that sickened at least 30

N.H. Hepatitis C Outbreak: Technician Was Fired in Ariz.

A hospital technician, David Kwiatkowski, has been accused of stealing pain medication (100 times as potent at morphine) and sterile needles from surgical patients.  Not only did patients not get the pain medication they needed, Kwiatkowski also exposed them to Hepatitis C, which he knew he was infected with for several years.

As an HIV researcher, I will tell you that I would be MUCH more upset about being exposed to HepC than I would HIV.  Weve got drugs for HIV.  Weve got jack shit for HepC (actually, I think its worse than jack shit).

And now people who went to the hospital for help are infected with Hepatitis C.  At least 30 people.  Apparently, Kwiatkowski has a loooooooong employment history behind him:

Twenty-five former patients at St. Francis Hospital in Poughkeepsie, N.Y., where Kwiatkowski worked for three months in late 2007 and early 2008, have been asked to get tested. In Kansas, state health officials are sending letters to about 460 patients who were treated at the cardiac catheterization lab at Hays Medical Center from May 24, 2010, to Sept. 22, 2010. The state also is setting up an informational website, and the hospital has set up a telephone hotline.

In Maryland, hundreds of patients are being contacted by the four hospitals where Kwiatkowski worked between May 2008 and March 2010. None of the four, which include The Johns Hopkins Hospital and a Veterans Affairs hospital in Baltimore, reported that Kwiatkowski was fired or that his behavior raised red flags.

Officials have identified 270 patients at Maryvale and fewer than 200 at the heart hospital who could have been exposed to Kwiatkowski.

At Houston Medical Center in Warner Robins, Ga., CEO Cary Martin the identification process hasn’t been completed yet. Kwiatkowski worked in the cardiac cath lab there from October 2010 to March 2011 but did not have access to the hospital’s medication system, he said.

Kwiatkowski didn’t have direct access to Exeter Hospital’s medication system, either, but investigators believe he was able to steal medication that other employees were in the process of preparing for patients and switch it with syringes he had filled with another liquid, possibly saline. Former co-workers reported that he sometimes came in on his days off and attended procedures he wasn’t assigned to.

Testing originally was recommended only for patients who had been treated at Exeter’s cardiac lab, but state officials have expanded the recommendation to include anyone who underwent surgery or was admitted to the intensive care unit because Kwiatkowski sometimes took patients to those areas.

You might think I am writing about this story because of the virus angle.  Well, yes, but thats not it– Im writing about this because this is exactly one of those instances when medical professionals and PhDs, though we often fight, can use our powers together For Good.

Science, Evolution, can determine whether Kwiatkowski is guilty or innocent.

When the medical professionals are testing everyone for HepC, they need to get some PhDs some blood samples.  We would then extract the viral genome and sequence it.  Hepatitis C is an RNA virus.  That is PERFECT!  See, a DNA virus wouldnt change very much, but RNA viruses mutate quite a bit.  PERFECT!  We can use that change, that evolution, to determine who (if anyone) Kwiatkowski infected!
Lets say we have viral sequences from 5 people and Kwiatkowski, and a basic consensus/reference sequence.  IF Kwiatkowski had nothing to do with their HepC infection, the phylogenetic tree would look like a squished spider:

le expertly drawn phylogenetic tree

If Kwiatkowski infected three of the five, the phylogenetic tree would look like this:

K, 1, 3, and 4 are obviously related sequences

Even if Kwiatkowski infected someone a long time ago, a person he infected would be grouped with his viruses:

K, 1, 3, and 4 are still related, but 3 was infected earlier, and the sequence has drifted further away from K

I hope, in addition to testing patients, the medical professionals in charge of this case get PhDs to do this.  For the patients, and for justice.

Comments

  1. #1 Bob Powers
    July 30, 2012

    Science: it’s not just for geeks anymore.

    Too cool, ERV

  2. #2 Poodle Stomper
    July 30, 2012

    Hey ERV, did you see the latest ebola thing? I thought you might be interested in it if you hadn’t heard of it already:
    http://www.newscientist.com/article/dn22120-ugandans-urged-to-avoid-contact-as-ebola-spreads.html

  3. #3 KiwiInOz
    July 30, 2012

    There has got to be a tv show in this. NCIS crossover with House, or something.

  4. #4 Fkurban
    Baltimore
    September 11, 2012

    I was wondering if there is any way to get sequence of Kwiatkowski’s HCV isolate…?