Identification and phylogenetic analysis of hepatitis C virus in forensic blood samples obtained from injecting drug users

Injecting drug users (IDUs) are a high-risk group for contracting hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections. In Japan, data on the prevalence of those blood-borne viruses among IDUs are very limited. Blood samples were obtained from 12 cadavers of IDUs sent to Nagoya City University for the purpose of judicious autopsy and two alive IDUs with hepatitis C referred to a local hospital at the same period. The viruses were detected by polymerase chain reaction and phylogenetic analysis was performed. Two (16.6%) of the 12 autopsy cases were positive for HCV, but no case was positive for either HBV or HIV. Phylogenetic analysis of the two HCV isolates revealed that one was classified into genotype 1b and another was genotype 2b. Furthermore, nucleotide sequences of two isolates recovered from IDUs with hepatitis C were identical, that indicated the transmission of HCV between them, and those HCV were phylogenetically classified into genotype 2a. The prevalence of HCV infection among IDUs in Japan, despite the case of judicious autopsy, seems to be high, but HIV infection seems to be rare. The transmission of HCV between IDUs was demonstrated, and this indicates that phylogenetic analysis would applicable to also forensic analysis. HCV isolates identified in this study did not phylogenetically segregate, thus multiple transmission route of HCV among IDUs seems be exist in Japan.     

Discriminant function sexing of the mandible of indigenous South Africans

South Africa currently has a high homicide rate. This results in a large number of unidentified bodies being recovered each year, many of which are referred to the forensic examiner. This situation has resulted in considerable growth of forensic anthropological research devoted to devising standards for specific application in South African medico-legal investigations. The standards suitable for Black South Africans now encompass a wide variety of skeletal elements (e.g. cranium, humerus, pelvis, femur, patella, talus, calcaneus), each with differing degrees of accuracy. Apart from a preliminary investigation of the Zulu local population, however, we note that there appears to be no established metric mandible discriminant function standards for sex determination in this population. The purpose of the present study is to undertake a comprehensive analysis of sexual dimorphism in the mandible of Black South Africans, incorporating individuals from a selection of the larger local population groupings; the primary aim is to produce a series of metrical standards for the determination of sex. The sample analyzed comprises 225 non-pathological mandibles of Black South African individuals drawn from the R.A. Dart Collection. Nine linear measurements, obtained from mathematically transformed three-dimensional landmark data, are analyzed using basic univariate statistics and discriminant function analyses. All of the measurements examined are found to be sexually dimorphic; the dimensions of the ramus and corpus lengths are most dimorphic. The sex classification accuracy of the discriminant functions ranged from 70.7 to 77.3% for the univariate method, 81.8% for the stepwise method, and 63.6 to 84% for the direct method. We conclude that the mandible is a very useful element for sex determination in this population.     

Forensic genetic value of 27 Y-STR loci (Y-Filer® Plus) in the South African population

South Africa has one of the highest rape statistics in the world, with an average of 117 rapes reported daily. Y-STR genotyping is becoming a popular tool in the analysis of DNA evidence collected after a crime of a sexual nature has been committed, but has yet to be implemented in South Africa’s forensic laboratories. This study aimed to investigate the forensic value of the 27 Yfiler™ Plus loci in the South African population. A total of 271 samples from the African, Asian/Indian, Mixed Ancestry¹, and Caucasian populations at the University of the Free State in Bloemfontein, South Africa were amplified and analysed using ThermoFisher Scientific’s Yfiler™ Plus PCR Amplification kit. Of the 271 samples, 261 were identified to be unique, with an overall discrimination capacity of 98.15%. Discrimination capacities ranged from 91.67% for the Asian/Indian population to 100% for the Mixed Ancestry population. The haplotype diversity across the four populations is 0.9999, with an average gene diversity across all loci of 0.717. The forensic parameters estimated in this study provide evidence for the potential use of the commercial Yfiler™ Plus PCR amplification kit in a forensic application in South Africa.     

Occupational exposure to bloodborne pathogens--OSHA. Final rule

The Occupational Safety and Health Administration hereby promulgates a standard under section 6(b) of the Occupational Safety and Health Act of 1970 (the Act), 29 U.S.C. 655 to eliminate or minimize occupational exposure to Hepatitis B Virus (HBV), Human Immunodeficiency Virus (HIV) and other bloodborne pathogens. Based on a review of the information in the rulemaking record, OSHA has made a determination that employees face a significant health risk as the result of occupational exposure to blood and other potentially infectious materials because they may contain bloodborne pathogens, including hepatitis B virus which causes Hepatitis B, a serious liver disease, and human immunodeficiency virus, which causes Acquired Immunodeficiency Syndrome (AIDS). The Agency further concludes that this exposure can be minimized or eliminated using a combination of engineering and work practice controls, personal protective clothing and equipment, training, medical surveillance, Hepatitis B vaccination, signs and labels, and other provisions.     

Forensic science in South Africa: Status of the profession

The forensic science profession in South Africa is currently unregulated. There is also no national body that allows for the continued development or professional interaction of forensic scientists. The above has brought about a dire need to regulate the profession, in order to achieve the specific goals listed. To attain these objectives it is envisaged that the founding of a Forensic Science Academy in South Africa is of critical importance. The creation of a Forensic Science Academy was explored as the authors believe that such an Academy will provide structure to the profession of forensic science in South Africa – as well as paving the way towards regulation of the profession.     

Postmortem Detection of Hepatitis B,C, and Human Immunodeficiency Virus Genomes in Blood Samples from Drug‐Related Deaths in Denmark*

Abstract: Blood‐borne viral infections are widespread among injecting drug users; however, it is difficult to include these patients in serological surveys. Therefore, we developed a national surveillance program based on postmortem testing of persons whose deaths were drug related. Blood collected at autopsy was tested for anti‐HBc, anti‐HBs, anti‐hepatits C virus (HCV), or anti‐human immunodeficiency virus (HIV) antibodies using commercial kits. Subsets of seropositive samples were screened for viral genomes using sensitive in‐house and commercial polymerase chain reaction (PCR) assays. Hepatitis B virus (HBV) DNA was detected in 20% (3/15) of anti‐HBc‐positive/anti‐HBs‐negative samples, HCV RNA was found in 64% (16/25) of anti‐HCV‐positive samples, and HIV RNA was detected in 40% (6/15) of anti‐HIV‐positive samples. The postmortem and antemortem prevalences of HBV DNA and HCV RNA were similar. Postmortem HIV RNA testing was less sensitive than antemortem testing. Thus, postmortem PCR analysis for HBV and HBC infection is feasible and relevant for demonstrating ongoing infections at death or for transmission analysis during outbreaks.     

Genotypic Polymorphisms of Hepatitis B Virus Provide Useful Information for Estimating Geographical Origin or Place of Long‐term Residence of Unidentified Cadavers

Increasing numbers of unidentified cadavers are a major problem. We have developed a new method for providing identification information that can determine the geographical origin or place of long‐term residence of unidentified cadavers based on genotypic polymorphisms of hepatitis B virus (HBV) known to correlate with their geographical distribution. PCR of serum samples detected HBV DNA from 4 (3.9%) of 102 randomly selected Japanese forensic cadavers. Multiplex PCR did not detect multiple HBV genotypes from any single cadaver, confirming the absence of coinfection. Phylogenetic tree analysis based on a 485‐bp mutant region of the HBV S gene successfully classified the HBV genotypes into A to J. Among 10 HBV‐infected cadavers, 8 had genotype Ce/C2, a genotype prevalent in East Asia, and 2 had genotype Bj/B1, a Japanese‐specific genotype. HBV genotypic polymorphisms correlate with the geographical distribution of the virus and thus provide important information for identifying unidentified cadavers infected with HBV.     

Genetic landscape of the mitochondrial DNA control region in South African populations

A high-quality dataset of the mitochondrial DNA control region sequences was generated with Sanger and next-generation sequencing. The study was aimed at characterizing the maternal genetic ancestry and analyzing the haplogroup distribution of 246 individuals residing in South Africa. The study presents mtDNA sequences in South Africa for forensic applications.     

Metric analysis of sex differences in South African black and white pelves

Sex determination of unknown skeletal material is one of the most vital determinations made by forensic anthropologists. Numerous studies have focussed on the differences, both osteometric and morphological, between the sexes of a particular racial phenotype and population. Previous work by a variety of researchers has underscored the necessity of population specific standards. The purpose of this research is to metrically assess sex differences in the pelvis of South African whites and blacks and develop standards tailored to these groups. Data were collected from 400 known sex/race skeletons from the Pretoria and Dart Collections. Nine measurements (traditional and newly developed) were taken and subjected to SPSS stepwise and direct discriminant analysis. Results indicated that there are significant differences (p < or = 0.001) between the sexes of both races for most measurements. Discriminant function analysis selected ischial length as the most sexually dimorphic dimension in whites (averaged 86% accuracy), while acetabulum diameter was most diagnostic in blacks (averaged 84% accuracy). Six functions were developed from the pelvic dimensions. Highest accuracy was achieved from Function 1 (including all dimensions) which averaged 95.5% correct classification in whites and 94% in blacks. Functions based on selected parts of the pelvis were not as effective and ranged from 73-86% in whites and 72-84% in blacks. This research provided evidence of the significant sex differences that exist between the pelves of South African whites and blacks whilst measurements used here for discriminant function analysis gave classifications with high accuracies. These results can be used to aid in the identification of human skeletal remains in South Africa.     

Quantification of the subpubic angle in South Africans

Due to the high crime rate in South Africa, forensic anthropologists are increasingly approached to aid in the identification of skeletonized remains, with sex and population affinity assignment being some of the most critical tasks they face. For over a century, the pelvis has been known to be one of the most sexually dimorphic bones of the human body and the subpubic angle is one of the most accurate, albeit scarcely quantified, features thereof. Hence, the aim of this study was to quantify the size of the subpubic angle and compare it between male and female South Africans of African (black) and European (white) descent. One hundred and forty five (145) pelves were selected, consisting of 68 white (43 male and 25 female) and 77 black South Africans (44 male and 33 female), from the Raymond A. Dart Collection of Human Skeletons housed at the University of the Witwatersrand, Johannesburg, South Africa. Each of the pelves were articulated and placed into a custom built stand for photographing. Measures of the subpubic angle from these digital images were subjected to numerous statistical analyses. Results indicated that significant differences exist between the sexes, as well as between the two population groups. For black individuals it was found that males generally possessed a subpubic angle of 74.9° or less, with larger values being indicative of the female sex. For white individuals, subpubic angles of 81.4° and less indicated males whilst larger values indicated females, with an average accuracy of 86% for both population groups. These results illustrate the advantages of using the subpubic angle to assist in the estimation of sex and population affinity and also reinforce the need for population specific parameters to be applied.     

Nine-locus Y-chromosome STR profiling of Caucasian and Xhosa populations from Cape Town, South Africa

Y-chromosome STR markers are not widely used in forensic case work in South Africa. To begin assessing the forensic value of these markers in South Africa, samples were collected from 100 English-speaking Caucasian males and 99 Xhosa males, living in the Cape Town metropolitan area. Allele and haplotype frequencies were determined for nine Y-chromosome STR loci (DYS19, DYS389-I, DYS389-II, DYS390, DYS391, DYS392, DYS393, and the duplicated locus DYS385). Unique haplotypes were obtained for 47 Xhosa males and 66 Caucasians.     

Assessing zygomatic shape and size for estimating sex and ancestry in a South African sample

Unidentified, decomposed and skeletonised human remains are frequently found in South Africa, therefore, standardised, reliable and relevant sex and ancestry estimation methods are required for forensic identification. This study assessed sex and ancestral variation in zygomatic size and shape in a South African population using geometric morphometric analyses. The zygoma of 158 South African individuals were sampled. Eight zygomatic landmarks were captured in 3-dimensions using a Microscribe G2 digitiser and assessed using procrustean geometric morphometrics. Shape and size differences were analysed using multivariate linear regression, discriminant function and canonical variate analyses. Males had significantly larger zygomas than females. Significant shape variation was found between ancestral groups. Bantu-speaking and Mixed ancestry individuals had narrower, shorter and more anteriorly projecting orbital margins, whilst Europeans had vertically elongated and receded orbital margins. European ancestral groups were most discernible from Bantu-speakers and Mixed ancestral groups. Ancestry estimation accuracies improved when ancestry was aggregated with sex. Pairwise ancestry-linked comparisons in females were as follows; Bantu-speakers (76%) from Europeans (72%), Bantu-speakers (71%) from Mixed ancestry (59%) and European (72%) from Mixed ancestry (63%). Similarly, ancestry-linked comparisons in males were as follows; Bantu-speakers (77%) from Europeans (81%), Bantu-speakers (53%) from Mixed ancestry (59%) and European (72%) from Mixed ancestry (82%). Size differences are putatively linked to variations in hormone-regulated growth and muscular robusticity between males and females. Shape variations between ancestral groups are likely attributable to the heterogenous genetic and ancestral origins of the South African population. It is challenging to distinguish between South Africa Bantu speakers and Mixed ancestry people due to Mixed ancestry individuals having variable genetic contributions from Khoesan, Bantu-speakers, Europeans and Asians. Bantu-speaking and Mixed ancestry people had zygomatic morphologies consistent with historical thermoregulatory adaptations to sub-Saharan climates, reported in African-descendants. Zygomatic morphology in European descendants suggests ancestral origins from colder climatic regions. This study demonstrated the utility of the zygoma in distinguishing between ancestral groups in South Africa, but further research is required to develop population-specific standards to distinguish between South African populations with shared African ancestry. The zygoma shows a promising ability to estimate sex and ancestry in South Africans, suggesting population specific standards for this bone may be of forensic interest.     

Forensic medical examination in cases of sexual abuse

The article presents the analysis of forensic medical expert practice in the field of sexual abuse. Drawbacks in expert examinations, official decisions on such examinations, low expertise of forensic medical personnel in sexual crime, lack of tools for genital and anal examination are analysed and methods of correction of this situation are proposed.     

歧视还是合理差异？—医学专业限招乙肝病毒携带者的跨学科研究

本文以医学科学为基础，通过分析携带乙肝病毒的医务人员是否具有传染性，将乙肝病毒携带者的医学受教育权与公众健康之间的法益博弈进行论证，为医学专业是否应当限招乙肝病毒携带者进行科学解读。     

论输血及血液制品感染的侵权责任——基于日本法上的经验

在医学界,血液被称为"生命的源泉"。然而,近年来,随着临床用血和血液制品使用的大量增加,患者感染梅毒、肝炎、甚至艾滋病的案例已屡见不鲜。而上世纪末,我们的邻国日本也曾遭遇过同样的"血液之殇",日本司法实践在处理诸如"东大梅毒事件"、"药害肝炎事件"、"药害艾滋事件"上的成功经验会带给我国怎样的启示,以下将对日本法上血液的法律属性、医疗过失的判断标准、因果关系的证明以及医药产品责任主体的责任分配等进行分析,并结合我国《侵权责任法》相关规定,从法解释学的角度出发,针对我国司法现状,探讨日本法对我国在法律解释适用方面的借鉴意义。     

Histopathological findings in 851 autopsies of drug addicts, with toxicologic and virologic correlations

This investigation was carried out on 851 consecutive judicial autopsies of drug addicts who died mostly of heroin overdose from 1977 to 1996. Research of anti-HIV/HBV/HCV antibodies was performed, and histologic sections were retrospectively reviewed. More than 65% were HBV/HCV-positive and about 17% HIV-positive; females were HIV-positive more often than males. Intracranial microhemorrhages were frequently found; cerebral infectious diseases were rare. Inflammatory heart lesions, myocardial fibrosis, and acute ischemia were common. Interstitial nephritis (found in about 8%) was more frequent in females, in older patients, and in those carrying HIV infection; glomerular sclerosis was detected in about 12%. Acute bronchitis and/or pneumonia was demonstrated in 12%, without significant association with HIV infection; pulmonary hemorrhages, foreign body granulomas, and food aspiration were also commonly seen; hyperplasia of pulmonary perivascular lymphatic tissue was rather characteristic. Liver was carrying steatosis in 66.3% and/or hepatitis in 64.5%; acute hepatitis was more frequent in females, chronic hepatitis in older subjects and in those proven positive for hepatotropic viruses; cirrhosis occurred more often in older patients, in those carrying virus infection, and in consumers of nonnarcotics drugs such as ethanol. No pathologic finding was clearly related to drug abuse; therefore, during autopsy, drug addiction can be suspected, but anamnestic and circumstantial data are needed to lead pathologists to request toxicologic analysis to ascertain the cause of death. The present investigation emphasizes that, in addition to the risk of death by overdose, the high incidence of acute and chronic diseases could seriously undermine the health status of heroin and/or other drug consumers.     

Biosafety considerations for autopsy

An autopsy may subject prosectors and others to a wide variety of infectious agents, including bloodborne and aerosolized pathogens such as human immunodeficiency virus, hepatitis B and C viruses, and Mycobacterium tuberculosis. Other hazards include toxic chemicals (e.g., formalin, cyanide, and organophosphates) and radiation from radionuclides used for patient therapy and diagnosis. These risks can be substantially mitigated through proper assessment, personal protective equipment, appropriate autopsy procedures, and facility design.     

A case study on the application of isotope ratio mass spectrometry (IRMS) in determining the provenance of a rock used in an alleged nickel switching incident

The application of isotope ratio mass spectrometry (IRMS) in forensic science to establish the provenance of a range of questioned substances including soils, drugs, explosives, currency, ivory and rhino horn has been widely documented. The present study wishes to highlight the applicability of IRMS and specifically stable carbon IRMS in determining the provenance of a carbonate rock that was switched for nickel metal exported from South Africa to Israel. The technique employed effectively argued against a South African origin for the rock whilst simultaneously supporting an Israeli origin, enabling investigators to focus their attention accordingly. The study represents the first documented instance known to the authors where IRMS has been employed in the forensic geo-location of a rock.     

传染病疫情下法医学尸体解剖检验室建设展望

人群对新型冠状病毒肺炎普遍易感,在国内已造成数万人感染。由于现有的尸体解剖检验室不具备传染病患者或疑似传染病患者尸体解剖检验条件,公安机关法医人员在处理感染状态不清、疫情接触时不明的未知名尸体案事件时,面临着严峻的感染风险。为满足传染病患者或疑似传染病患者尸体解剖工作需要,确保法医人员身体健康安全,了解传染病患者的病理生理改变,完善法医学解剖检验室的建设十分必要。     

Training of legal professionals in DNA evidence

The South African Criminal Legal System is based on Roman Dutch law. Court proceedings are led by a single presiding officer of the court. Prosecutors and defence advocates present the court with evidence in an adversarial manner. This system has inherent advantages and disadvantages and therefore the training of legal professionals in handling DNA evidence in court is important. The prosecutors resort under the National Prosecuting Authority and the defence advocates act independently or e.g. under the auspices of Legal Aid South Africa.Education curricula of legal professional do not include forensic science evidence. Principles such as evidential value in the forensic context are not addressed. Training of legal professionals with our Essential DNA Evidence™ Course has been a multiplier of forensic science knowledge in the legal profession in South Africa. We present prosecution and defence perspectives in an unbiased manner, compensating for the possible subjective interpretations of evidence that may be presented in court. Forensic evidence is subsequently carefully evaluated prior to being court presentation thus improving court efficiency, and allowing for a more focussed approach to the presentation of evidence. Approaches to the customisation of course content that adds value has been identified via evaluation of training programmes.Experience has shown that legal professionals have the ability to incorporate relatively complex scientific concepts into their legal arguments if provided with the appropriate training opportunity. Appropriate training in DNA evidence has made the court process more effective, both in terms of time and costs, and ultimately serves justice.