It was Tuesday evening, June 7. A frightening outbreak of food-borne bacteria was killing dozens of people in Germany and sickening hundreds. And the five doctors having dinner at Da Marco Cucina e Vino, a restaurant in Houston, could not stop talking about it.
This week: The microbe hunters, candid camera for endangered animals and trying to plan a graceful exit.
Multimedia
Map
Hot Spots
Related
Hunting for a
Mass Killer in Medieval Graveyards (August 30, 2011)
RSS Feed
Get Science News From The New York Times »
Enlarge This Image
Michael Stravato for The New York Times
DETECTIVE Dr. James M. Musser, second from right, put DNA sequencing to work in a Houston case involving lethal bacteria that looked like anthrax. The culprit turned out to be a closely related
strain of Bacillus.
What would they do if something like that happened in Houston? Suppose a patient came in, dying of a rapidly progressing infection of unknown origin? How could they figure out the cause and prevent an epidemic? They talked for hours, finally agreeing on a strategy.
That night one of the doctors, James M. Musser, chairman of pathology and genomic medicine at the Methodist Hospital System, heard from a worried resident. A patient had just died from what looked like inhalation anthrax. What should she do?
“I said, ‘I know precisely what to do,’ ” Dr. Musser said. “ ‘We just spent three hours talking about it.’ ”
The questions were: Was it anthrax? If so, was it a genetically engineered bioterrorism
strain , or a
strain that normally lives in the soil? How dangerous was it?
And the answers, Dr. Musser realized, could come very quickly from newly available technology that would allow investigators to determine the entire genome sequence of the suspect micro-organism.
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.”
One group is starting to develop what it calls disease weather maps. The idea is to get swabs or samples from sewage treatment plants or places like subways or hospitals and quickly sequence the genomes of all the micro-organisms. That will tell them exactly what bacteria and viruses are present and how prevalent they are.
With those tools, investigators can create a kind of weather map of disease patterns. And they can take precautions against ones that are starting to emerge — flu or food-borne diseases or SARS, for example, or antibiotic-resistant strains of bacteria in a hospital.
Others are sequencing bacterial genomes to find where diseases originated. To study the Black Death, which swept Europe in the 14th century, researchers compared genomes of today’s bubonic plague bacteria, which are slightly different in different countries. Working backward, they were able to create a family tree that placed the microbe’s origin in China, 2,600 to 2,800 years ago.
Still others, including Dr. Relman, are examining the vast sea of micro-organisms that live peacefully on and in the human
body . He finds, for example, that the bacteria in saliva are different from those on teeth and that the bacteria on one tooth are different from those on adjacent teeth. Those mouth bacteria, researchers say, hold clues to tooth decay and gum disease, two of the most common human infections.
A Real-World Test
For Dr. Musser and his colleagues, the real-world test of what they could do came on that June evening.
The patient was a 39-year-old man who lived about 75 miles from Houston in a relatively rural area. He had been
welding at home when, suddenly, he could not catch his breath. He began coughing up
blood and vomiting. He had a headache and pain in his upper abdomen and
chest .
In the emergency room, his
blood pressure was dangerously low and his heart was beating fast. Doctors gave him an IV antibiotic and rushed him to Methodist Hospital in Houston. He arrived on Saturday night, June 4. Despite heroic efforts, he died two and a half days later, on Tuesday morning.
Now it was Tuesday night. On autopsy, the cause looked for all the world like anthrax, in the same unusual form — so-called inhalation anthrax — that terrified the nation in 2001. Even before the man died, researchers had been suspicious; washings from his lungs were teeming with the
rod -shaped bacteria characteristic of anthrax. Investigators grew the bacteria in the lab, noticing that the colonies looked like piles of ground glass, typical of anthrax but also other Bacillus microbes.
“We knew we had to get this solved in a hurry,” Dr. Musser said. “We had to know precisely what we were dealing with. That’s when we put into play a plan to sequence the genome.”
A few days later they had their answer. The bacteria were not anthrax, but were closely related. They were a different
strain of Bacillus: cereus rather than anthracis