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Bacteriophages - Genesis.

Like most discoveries, it happen quietly and without much fuss. A British chemist, E. H. Hankin, noticed that water from the sewage-infested Ganges & Jumma rivers seemed to be able to kill cholera bacteria. In 1915, simultaneous discoveries by British bacteriologist Frederick W. Tort and Felix d'Herelle, of the Pasteur Institute, Paris found that a 'microbe' found in the faeces of a dysentery patient could kill Shigella bacteria. He called this microbe a 'bacteriophage' from the Latin 'phage' meaning 'to eat', although until the advent of the electron microscope the method by which this phage destroyed bacteria was just speculation.

Along with his colleagues at the Institute, they were the first to realise the therapeutic implications of this new discovery and in 1919 they set about treating a 12 year old boy, suffering with severe dysentery. First giving themselves a trial dose 100-times the planned dose, to check the preparation's safety, they treated the boy, who made a full recovery in a few days. At the time, this must have seemed like a miracle!

D'Herelle and his team travelled all over the world, setting up phage therapy trials by observing who recovered naturally from various diseases and isolating the phages to be grown on in labs. The initial enthusiasm was, forgive the pun, infectious! The American drug company Eli Lilly, amongs others who sensed a Gold Rush and wanted to be in the vanguard, became involved in the 1930s. However, the basic science was patchy and not enough was known about the therapeutic action; why did some people recover and others did not? Quality of preparations was poor, there were few controls or regard to testing phages for suitability to deal with a disease, or indeed if they were still alive before being administered!

Due to its erratic performance, phage therapy was slated by the American Medical Association in 1934 and, with the discovery of the wonder-drug antibiotics, phage therapy fizzled out in the West to be replaced by antibiotics, which seemed infallible. Little did they know....

Phage work continued by Russians.

Giorgi Eliava, a scientist from Georgia, worked with d'Herelle for 5 years and returned to his homneland to start a bacteriological research institute, with the blessing (and funding) of fellow Georgian, Joseph Stalin. D'Herelle himself left Yale University in 1933 to come and work in Georgia, much to the delight of the Soviets, who saw this as a political coup for the Soviet system against the expensive, capitalistic Western drug companies and their monopolistic patents. However, disaster struck the Institute when Eliava fell foul of Beria, boss of the dreaded KGB, who had him executed. Some say it was because Eliava went over Beria's head when refused phage funding, others say it was because they shared a common love interest. We can never be sure - those were turbulent times and personal rivalries often resulted in imprisonment in the Gulags and almost certain death; the lucky ones were executed immediately after their "show" trial.

Although the Institute foundered briefly, following Eliava's death, it eventually recovered, due to the selfless work done by dedicated staff, on very little pay. They believed in what they were doing, continuing researching and producing phage tablets by the million, mainly for the Soviet army. The tablets overcame the practical limitations of the original fragile glass vials. During the Soviet period, money was no object at the Eliava Institute however, after 1996, when Gorbachev started 'Peristroika', funding dried up. The Georgians were on their own, having their own political problems to contend with; during the civil war in Abkhazia, Georgian soldiers carried sprays of phages for application to battlefield wounds, resulting in relatively few deaths by infection.

The Glimmer of Hope...

With the ever increasing resistance of bacteria to antibiotics, despite doctors having known about this as far back as the 1940s, the West started to search for alternatives; the hunted was fast becoming the hunter! When antibiotics attempt to kill resistant strains of bacteria, all that happens is that other non-resistant bacteria are killed, leaving the field clear for resistant types to thrive without competition. Friendly bacteria are killed, often resulting in a weakened immune system, resulting in more infection, resulting in more antibiotics, resulting in.......etc.

The old stories of mysterious viruses which only, killed bacteria were re-investigated. People started to contact the Eliava Institute in Tbilisi, the capital city of Georgia where Felix d'Herelle had worked with Giorgi Eliava to develop phage therapy, wanting to know more. Some came with a genuine desire to help, others to plagiarise that knowledge and take advantage of the Georgians' expertise, for free. Others however, like Fred Bledsoe of Fort Wayne, Indiana, and musician Alfred Gertler, had heard of the benefits of phage therapy and came simply to be cured of life threatening MRSA; something that doctors, using current medications, had not managed to do. The next step for them would have been amputation.

It now just remains to be seen which government is prepared to swallow its pride, introduce new guidlines to encompass the unique way that phage therapy works, and actually do something now to alleviate the suffering of thousands of MRSA sufferers. Although more research is always needed, that is no excuse for not using the experience and knowledge gained by the Tbilisi experts. How much reinvention is enough? Someone with chronic, life-threathening MRSA will tell you the answer.