In the early 1890s, Ernest Hankin studied cholera outbreaks off the banks of the Ganges. Locals dumped the dead into the waters of the sacred river, and the river in response became a poisonous source of disease, and an epidemic raged in cities and villages down the river valley. He saw it all over Europe, when the water supplies were contaminated with bacteria, but here, on the banks of the Ganges, the disease was somehow contained; new flares faded and then disappeared altogether, and did not spread like wildfire.
Hankin decided there was something mysterious in the water that killed the bacteria before they started wreaking havoc, but it took another 20 years for the French scientist to figure out that the Ganges' guardian angel was a bacteriophage virus. Harmless to humans but deadly to cholera bacteria, this virus purified water before it could infect local bathers.
For a long time, scientists ignored these "ninja viruses". But now they believe that one day these viruses will save millions of lives, far beyond the shores of the Ganges, as they offer us a new arsenal of weapons against a deadly disease.
A new approach to treating the infection will take a long time. For decades, we have relied on antibiotics like penicillin. If you are not very young, old or physically weak, you do not have to fear scratching, bruising or routine surgery. But as antibiotics proliferate, bacteria have begun to develop defense mechanisms against these drugs - and the consequences are becoming more worrying.
Today, “antibiotic-resistant,” or simply antibiotic-resistant, bacteria are already taking hundreds of thousands of lives a year - but that number could rise to 10 million by 2050, according to 2014 UK government reports.
“This is the number of people who are dying of cancer today, and it’s not just older people - it could be anyone. Trivial injuries like scratches or basic medical care - childbirth or hip surgery - could potentially expose us to these types of antibiotic-resistant infections,”says Heather Hendrickson of Massey University in Auckland, New Zealand. "We are pulled into that pre-antibiotic era when life expectancy was shorter because we could not fight infection."
If we want to avoid this bleak vision of the future, we need a radical solution - and Hendrickson thinks we must reconsider our attitude towards the bacteriophages that saved the inhabitants of the banks of the Ganges.
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Compared to more advanced organisms, a bacteriophage is surprisingly humble: a small bundle of protein that can penetrate a bacterium and take control of its engine room to create hundreds of additional copies of itself, which then explode in the bacterial dying cell. The human body is already using this process as a natural defense - our noses are full of bacteriophages that can kill bacteria in the air we breathe.
There are many reasons why bacteriophages may be a promising line of attack for doctors hoping to combat antibiotic resistance. There are many more of them than bacteria, for example: Hendrickson notes that bacteriophage viruses outnumber bacteria tenfold. There are more bacteriophages in every gram of soil than there are people on the planet.
Even more remarkable, ninja viruses only target specific targets. This is important because doctors believe that our body's microbiome may be important to our health, protect us from asthma, and maybe even balance the production of our neurotransmitters for good mental health.
Antibiotics are not very picky and can kill friendly bacteria with the crossfire. They hit our bodies like a nuclear bomb, while bacteriophages could act as trained snipers, shooting only harmful targets, leaving friendly ones untouched.
The diversity of bacteriophages, combined with their individual characteristics, may offer great potential for new therapies. But for scientists like Hendrickson, this will be serious work, as it will have to isolate the profile of each bacteriophage and identify the specific sources of infection that they can cure. We'll have to build a gigantic library of possible therapeutic agents.
Hendrickson is currently working with his students to map bacteriophages that are commonly found in soil. Once they start working on a library of bacteriophages, they will also need to find safe and reliable ways to grow, purify, and store bacteriophages - and they will have to check to see if their treatments have side effects. In this case, bacteriophages tend to be very fragile and are easily destroyed over time. Perhaps they will provoke an immune response, causing unwanted allergic reactions.
So far, most of the research on bacteriophages is being done by the countries of Eastern Europe; many continued to research bacteriophages after the West turned to antibiotics. Behind the Iron Curtain, Georgia, Russia and Poland have been using bacteriophages as medicine throughout this time. They were often used for field medicine as well.
Obviously, these studies did not see the light of day in medical journals in English and remained hidden from many scientists in the West. Hendrickson wants to solve this problem with the help of new collaborations.
One of the first major clinical trials in the West will involve the use of bandages soaked in bacteriophages to see if they can prevent infection for burn victims. Perhaps this path in medicine will really save us from the antibiotic-free apocalypse.
ILYA KHEL