Extracts from an Amazing Book on Bacteriophages
Viruses vs. Superbugs
A solution
to the antibiotics crisis?
Thomas
Häusler
Translated
by Karen Leube
Macmillan
London New York Melbourne Hong Kong
© Thomas
Häusler 2006
First published 2006 by
Macmillan
Houndmills,
ISBN-13:
978–1–4039–8764–8
ISBN-10:
1–4039–8764–5
contents
list of
figures vi
foreword viii
preface xi
chapter 1
at the limits of
medicine 1
chapter 2
invincible microbes 15
chapter 3
the wild pioneer era
48
chapter 4
the renaissance of
phages during the war 105
chapter 5
a parallel universe 126
chapter 6
keepers of the grail
in peril 175
chapter 7
resurrection 203
chapter 8
what’s the future of
phage therapy? 248
appendix
1 a short list of
bacteria 252
appendix
2 the advantages and
disadvantages
of phage therapy 257
notes 261
figure
sources 283
index 284
v
14039_87645_01_prels
foreword
Just
imagine life without antibiotics. It would be like it was 100
years ago,
when pneumonia and tuberculosis were the most
frequent
causes of death, and the risk of infection turned a
simple
appendectomy into a dangerous operation.
Luckily we
do have antibiotics. However, they are becoming
increasingly
ineffective. Doctors are more and more frequently
confronted
with infections they can’t do anything about
because the
bacteria have become resistant. This has dire
consequences
for patients. Many end up living with a chronic
infection
for years on end, some are forced to become
amputees
and yet others succumb to the infections.
The crisis
affects people in both industrialized and devel-
oping
countries. In the
aureus is wreaking havoc. Forty to fifty
per cent of infections
that people
contract in hospitals are resistant to more than one
antibiotic.
The developing countries are groaning under the
burden of
tuberculosis, which claims the lives of 2 million
victims
throughout the world every year. The increase in multi-
resistant
TB is especially alarming. Treating it costs 100 times
more than
treating the regular form, making a cure unafford-
able for
many people in impoverished countries. And these are
only two
examples.
Despite
this, many pharmaceutical companies have stopped
developing
antibiotics. They see the financial risk as too big
and
potential profits too skimpy. This has led to very few new
drugs for
fighting bacterial infections being launched in recent
years. A
survey of 11 large pharmaceutical companies revealed
that of 400
substances they were developing, only 5 were anti-
bacterial drugs.
What can be
done about the resistance crisis? One thing
is needed
for sure: new drugs. One of them could be bacterio-
phages,
viruses that attack bacteria without harming people.
So-called bacteriophage therapy had its
heyday from 1920
to 1940,
before it was pushed aside by penicillin. The former
today. Most
Western doctors do not even know that this
method exists.
However,
there are some scientists who have resumed
research on
bacteriophage
therapy, and that’s a good thing.
We need to
pursue any and every approach that can
contribute
to solving the resistance crisis. Bacteriophage
therapy may prove to be a particularly worthwhile area of
that is
freely accessible. Determined researchers now need to
use this as
a starting point and work out how to turn bacterio-
phages into
drugs that meet today’s standards. This would be
best
carried out in cooperation with science departments at
universities,
along with private companies and non-profit
foundations
that support the projects. This is exactly the goal
of the
Foundation for Fatal Rare Diseases. The foundation
supports
the development of drugs for neglected infectious
and
pulmonary diseases and is especially committed to
helping
affected patients who have not been in the public eye,
particularly
those in
Thomas
Häusler’s remarkable book plays a central part in this
scheme,
because it acquaints the public, researchers and deci-
sion makers
with a therapy that has the potential to someday
heal many
patients who cannot be helped at the moment.
This is why
the Foundation for Fatal Rare Diseases is supporting
the
realization of this English edition. The fact that the author
writes
about bacteriophage
therapy in the form of such a
gripping
story makes reading it all the more exciting.
Vera
Cavalli, Dorian Bevec and Fabio Cavalli
Founders of
the Foundation for Fatal Rare Diseases
preface
Why should
anyone be interested in an old cure that hasn’t
been used
in the West for 50 years? It’s a method that many
doctors
aren’t even aware of today. The most telling answer to
this
question came when I received a call in my office from a
man one Friday
morning in January 2001. It was the day after
my article
on the Eliava Institute in
the German
weekly newspaper Die Zeit. In the article I had
described
how this old remedy – phage therapy – had survived
in the
impoverished country.
Phages are
viruses that attack and kill bacteria but not
people.
Since Stalin’s days, doctors in
been using
phages to cure bacterial infections. In the West this
method was
also once popular but, in contrast to the Soviet
here after
1940. The Eliava Institute in
where phage
therapy survived even after the collapse of the
However, because
of
precarious
situation, it is experiencing a gloomy present. From
the point
of view of today’s science, it is unclear how effective
phages are
in fighting infection. This is because the studies
carried out
by early pioneers and Soviet researchers do not
meet
today’s standards. All this was in my article in Die Zeit.
The caller
explained that he had read the article. He was
calling
directly from the hospital and appeared to be under a
great deal
of pressure. Not mincing words, he explained that
he had been
suffering from an infection in his foot for two
years.
Doctors couldn’t get it under control because the
bacteria
were resistant to all antibiotics. He was scheduled to
have his
foot operated on a fourth time the next day. Could I
put him in
touch with someone in
before long
he would lose his foot.
More than
any research I have done, his call hit me between
the eyes.
Never before had I been so aware of the power that
bacteria
continue to wield over us. We have grown up with the
certainty
that every bacterial infection can be cured by antibi-
otics. Most
of us have no idea of the destruction that bacteria
are capable
of rendering, because our doctors prescribe drugs
at the
slightest symptom.
One year
after I received this call, I accompanied an expedi-
tion of
botanists and fragrance researchers to a rain forest in
and my
right foot was hot, red and swollen. The next morning
I could
hardly walk. Bacteria must have entered places where
my sandals
had rubbed against my skin while we were hiking.
The doctor
accompanying the expedition gave me some
antibiotics
that he found in his first-aid kit. The effect was hit
or
miss – more
miss than hit, in fact. Four days later, I arrived
home – with
my foot still swollen. My GP prescribed some
other
antibiotics and luckily they worked. He cut to the chase:
‘That could
have been the end of you.’
At that
point, however, I no longer needed that kind of
graphic
demonstration of the power of bacteria, since I had
already
started doing research for this book. The 80-year-old
history of
the tiny phages and their potential role in reining in
the
antibiotic resistance crisis were constantly on my mind.
The
fascination produced by phage therapy is particularly
striking as
I write these lines. In
and doctors
are combating bird flu. A pandemic is in the
making.
This was only just averted in the case of SARS, a new
atypical kind
of pneumonia. These health crises show viruses in
their
familiar role – as lethal villains. Phage therapy takes this
image and
turns it upside down, turning the bad guys into
unexpected
allies.
This book
is not a health manual whose purpose is to testify
to the
efficacy of phages. First,
it’s too early to reach a clear
conclusion
about their effectiveness. Researchers are still
working on
this. Second, I found the detective work on the
origins of
the captivating idea that bacteria can be fought with
their
natural enemies at least as interesting as the analysis of
phages’
curative powers. I hope that this has led to a book that
sheds some
light on the sometimes winding paths of medical
research
and in turn provides some insight into an area of our
society
that is becoming increasingly significant. Never has so
much
medical research been undertaken as at the present time,
nor has so
much money ever been spent to cure us of diseases.
This
English edition came about some three years after the
German
edition was published. I have taken great pains to
update the
material in the book. As I did so, I saw that some
companies
had been confronted with scientific or financial
obstacles,
leading them to abandon their projects altogether.
On the
other hand, other companies and university
researchers
have joined the ranks of phage therapy research,
contributing
good ideas. What they require is support from
public and
private sponsors in order to produce drugs from
phages.
They are desperately needed.
I could not
have written this book without the help of many
researchers,
doctors, patients, librarians and helpers. They
provided me
with information, books and photos, gave me
accommodation,
told me about their lives, interpreted or
handed out
advice. I extend my gratitude to all of them.
I would
specifically like to thank Elizabeth Kutter, Hans-
Wolfgang
Ackermann and Harald Brüssow for sharing their
expertise.
Zemphira Alavidze, Nino Chanishvili, Liana Gache-
chiladze,
David Gamrekeli and Mzia Kutateladze not only
provided me
with exhaustive information, but made my
research in
forget
their hospitality.
Reto
Schneider, Elizabeth Kutter and my wife Susanne read
the entire
manuscript. I thank them for their countless sug-
gestions
for improvement in style and content. I also express
my thanks
to my translator Karen Leube, my editors Sara
Abdulla
(Macmillan) and Wolfgang Gartmann (Piper), and the
team at
Aardvark Editorial. Without the support of Tamedia
AG, the
publisher of Facts news magazine, this book would not
have been
possible. Facts, my employer, continued my salary
while I
worked on this book, and Tamedia’s media forum paid
for the
research expenses. I would like to thank my colleagues
at Facts,
Odette Frey, Beate Kittl and Rainer Klose, for their will-
ingness to
put up with the additional work and reorganization
brought
about by my absence. The English translation was
generously
funded by the Foundation for Fatal Rare Diseases.
Thomas
Fritschi and Rich Weber drew the graphics for Figures
3.4 and
3.5. I thank Susanne and Julia for putting up with a
husband and
father who was more of a phantom for a year
and, at
times, an overworked, nervous one at that.
Thomas
Häusler
