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The newspaper of The Johns Hopkins University April 3, 2006 | Vol. 35 No. 28
Tutored By 9/11 Experience, Genetics Experts ID Katrina Victims

By David March
Johns Hopkins Medicine

Experts at Johns Hopkins are joining efforts to provide names for more than 70 still unidentified bodies recovered after Hurricane Katrina, which struck last Aug. 29, killing more than 1,200 in Louisiana and Mississippi. Most of the dead have already been identified and buried by their families.

Using experience gained in DNA analysis of human remains after the terrorist attacks on Sept. 11, 2001, Johns Hopkins epidemiologists and genetic counselors are helping Louisiana state officials with the difficult task of collecting data on family history, a key step in the complex system of DNA testing that state officials must use to match the dead to some of the families of more than 2,000 people still listed as missing from the disaster.

"Both disasters, the attack on the World Trade Center and Hurricane Katrina, have challenged the nation's abilities to handle mass-fatality identification beyond anything ever experienced before," said statistical geneticist Joan Bailey-Wilson, an adjunct professor at Johns Hopkins. Bailey-Wilson, also co-chief of the Inherited Disease Research Branch of the National Human Genome Research Institute, a member of the National Institutes of Health, has been coordinating national efforts of other geneticists who have volunteered from across the country to assist with victim identification in the Gulf region. She sits on an expert panel, along with Johns Hopkins' Elizabeth Pugh, a genetic epidemiologist, to advise crime lab staff and the coroners' offices in both states responsible for identifying the dead and missing. It is a repeat role for the two, who also served on a panel for the Medical Examiner's Office in New York City after the World Trade Center attacks.

Bailey-Wilson and Pugh have each visited the Gulf region in the last few months to assist the Louisiana State Police Crime Laboratory with its efforts to manage the identification process and collection of buccal swabs (of the mouth cavity) from family members of the missing, almost all of whom are from Louisiana.

"Pulling together the infrastructure — from experts in various disciplines and from medical centers across the country — is a skill that forensics experts learned from 9/11, but most of us hoped it was a once-in-a-lifetime event," Bailey-Wilson said.

According to the Johns Hopkins experts, the DNA identification process following Katrina is a more complex job than initially thought for several reasons.

Many of the victims lost their identifying personal effects in the disaster; items such as toothbrushes and hairbrushes, which could contain hair and saliva samples useful in DNA testing, were often contaminated or destroyed by the flooding; and many medical and dental records normally used to match dead bodies with names of the missing were destroyed, leaving behind few clues as to whose remains were found. All of these factors make identification difficult without the aid of DNA testing. Making matters worse, family members whose DNA is required to make a match were often displaced by the hurricane, making contact difficult and adding delays to scheduling interviews and appointments for genetic testing.

"One of the lessons learned from 9/11 was that talking to the families about the missing is skilled detective work that can best be done by qualified genetics clinicians and genetic counselors who know the right questions to ask based on what information is needed to fill in the family pedigree," said Pugh, an assistant professor at the Johns Hopkins School of Medicine and head of statistical genetics at the Center for Inherited Disease Research, an NIH-funded initiative based at Johns Hopkins. CIDR is a high-tech facility dedicated to helping scientists at the NIH, Johns Hopkins and elsewhere get a first fix on the regions of the human genetic code containing genes that contribute to complex diseases.

"In today's world of blended families and multiple marriages, not all siblings are biologically related to one another, and trained interview techniques are needed to separate the correct blood relationships involving DNA from the correct social relationships that do not involve any genetic material," she said.

Bailey-Wilson, an adjunct professor at the Bloomberg School of Public Health, said that since September 2005 she has fielded several hundred inquiries from health professionals wanting to help. Of these, more than 70 geneticists from at least 30 medical institutions and private practices have agreed to serve as volunteers in efforts to collect information on family history.

Genetic counselor Julie Albertus was the first Johns Hopkins counselor to join the effort, having left for the Gulf region on March 12. Nicole Johnson of the School of Medicine and the Kennedy Krieger Institute's Rebecca Kern were next, departing on March 19. They, like Albertus, worked for one week at the Louisiana Family Assistance Center, formerly called the Find Family National Call Center, in Baton Rouge, La., where investigative operations are based. Plans are under way to send another counselor in June. While there, counselors interview relatives by phone to help construct complex family trees of those presumed lost, a necessary first step in the identification of the dead using DNA testing.

In DNA-marker testing, a person's unique genetic makeup is matched against other previously known samples or, if none exist, samples taken from family members, looking for genetic traits or markers specific to the individual or family. The results from the DNA analysis can be used alone or combined with other information, such as body location and distinguishing features, for the state coroner to make an official identification.

Compiling a genetic picture requires an accurate construction of the family tree so that the minimum amount of genetic information needed can be obtained from siblings or parents, or from cousins and grandparents.

"If a missing aunt, for example, has no children and only one sibling, taking a family history can be simple. However, if a missing aunt has eight children and five siblings, taking down the correct information and determining which relatives are willing to donate DNA samples can be a sensitive and time-consuming task," said Bailey-Wilson, noting that family interviews can last from 15 minutes to two hours. The process, she said, is made more difficult by the fact that many of the relatives may have moved several times since the hurricane.

Tracking this process for each missing person and casualty involves tremendous attention to detail, said Pugh, who helped the Louisiana State Police Crime Laboratory's DNA unit set up one of the computer systems and protocols that will guide the identification process. She points out that the whole identification effort follows strict confidentiality rules to protect people's privacy.

A person's DNA contains all the genetic information passed down from their parents, but slightly different — though mostly similar — combinations are passed along to siblings. Recognizable but distinct patterns can be seen in cousins but with greater difficulty and often requiring specialized tests. Statistical methods are used to compare and match DNA samples to determine how likely it is that genetic markers for an unidentified deceased person fit into the pattern of genetic markers observed in relatives of someone reported missing.

Genetic testing is made easier, Pugh said, by the existence of commercially available computer software programs to analyze DNA results. These programs can statistically match any individual with genetic material from the same person or with that of family members using as few as 16 unique genetic markers.


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