Bacteriophage therapies: exciting but not new

Bacteriophage viruses don’t make us ill. But they do kill bacteria. Little wonder there is so much about them in the news. We are faced with virulent new strains of bacteria that have developed resistance to our current range of antibiotics, and now there are viruses at hand which can kill the pathogens outright. You can see why people are so excited.

Except for one thing: this is all a century out of date. Phage therapy was introduced by an arrogant, inflexible and opinionated French Canadian named Félix Hubert d’Hérelle. He was a single-minded solo investigator who gained modest qualifications at school, and never even went to university. The journal Nature says he studied medicine, and the Encyclopaedia Britannica even grants him an MD degree from Montreal, but neither is true. Yet in 1922, at the age of 49, he had completed so much research that he published a major textbook on the subject called The Bacteriophage, its Role in Immunity. It became a standard text.

The Ganges was known to be a major source of epidemics ... less widely known is a fact that only the Indians knew – drinking water from that same river could cure cholera too

It is widely known that, in 1884, the pioneering microbiologist Robert Koch had demonstrated that cholera was caused by drinking water that contained bacteria. The river Ganges was known to be a major source of epidemics in India. Much less widely known is a fact that only the Indians knew – drinking water from that same river could cure cholera too. One of Koch’s co-workers was an English bacteriologist, Ernest Hanbury Hankin, who went to India to find out why. He knew that it was easy enough to culture the cholera organisms on agar, but you could never grow the bacteria in water from the river Ganges. Something killed them all.

In 1896 he published a book on the mysterious bactericidal nature of water from the Ganges and his findings became famous, indeed Mark Twain included in account in his 1897 travelogue More Tramps Abroad. D’Herelle was fascinated by it all, and in 1917 he carried out a crucial experiment. He cultured Shigella bacteria from the stool of a soldier with dysentery, but then took a sample of the contaminated fluid and forced it through a porcelain filter to provide a clear liquid that was free of bacteria. When he added this to the bacteria culture, it became clear overnight. All the Shigella had been killed. D’Herelle gave some of the clear filtrate to the soldier to drink, and the man recovered. There was something else in the water; something that killed bacteria.

Félix d’Hérelle embarked upon an exhaustive series of experiments, and eventually came up with extracts that could cure a range of diseases: cholera, typhoid, septicaemia, even staphylococcal skin infections. He called his invisible agent bacteriophage. It was to be his life’s work. His treatment for dysentery was used in Arabia and Africa, trials were launched in Greece and Italy and China soon followed. Phage preparations were produced in Michigan and at Stanford University. D’Hérelle was appointed Director of Bacteriological Services for the League of Nations and was even made a professor at Yale.

In 1940 a “phage group” had been established in Caltech, but came to nothing; no one wanted anything to do with a communist idea

D’Herelle was often met with opposition, and in 1934 he emigrated to Tbilisi, Georgia, where an institute was set up for him to expand his work. It was a huge success, and during the communist era phage preparations became widely available throughout the USSR. There was interest in the West, though the era of antibiotics had captured everyone’s attention. In 1940 a “phage group” had been established in Caltech, but came to nothing; no one wanted anything to do with a communist idea. Phage therapy, meanwhile, became a mainstay of treatment throughout the USSR. It still is – you can buy phage medicines and ointments in all the former communist countries. The Tbilisi institute even sells them online.

At last we are catching up, proclaiming this as something new and exciting, and a triumph of Western medicine. It’s unfortunate that the new generation of researchers doesn’t know what work went on before. And we know they don’t because they all say phage to rhyme with page. It doesn’t – properly pronounced, phage rhymes with the Taj in Taj Mahal. Not only have they lost sight of the backstory of the phage, but they can’t even say it correctly.

Pic: CDC