As a result, germs have made a comeback. So-called superbugs, bacteria that are resistant to one or more antibiotics, are on the rise across the United States. These bacteria used to be confined to hospital wards, but they are increasingly seeping out into the environment, where they infect otherwise healthy adults and children. From 1999 to 2008, the rate of children admitted to hospitals with methicillin-resistant Staphylococcus aureus (MRSA), one of the strains that infected Bledsoe, has grown tenfold At the moment, there are still drugs to fight MRSA, but a growing number of bacteria are impervious to every antibiotic available. In a January, 2009 report, "Bad Bugs, No Drugs," the Infectious Diseases Society of America wrote, "There is an urgent, immediate need for new agents with activity against these panresistant organisms. There is no evidence that this need will be met in the foreseeable future."
Phage therapy holds potential as an important new weapon in the fight against superbugs. Rediscovered in the West in the mid-1990s, the treatment has brought a steady stream of venture capitalists, entrepreneurs and physicians through the Eliava Institute's derelict halls. Independently and with the help of specialists there, Western biotechnology companies are exploring ways of using phage to battle these deadly infections.
Once dismissed as a backward treatment, phage therapy has gained important ground in the last several years. In 2009, British company Biocontrol Limited completed the first double-blind clinical trials showing that phage therapy is safe and effective for the treatment of chronic, antibiotic resistant ear infections. The United States Army has funded research into whether phages can heal some of the hardest to treat wound infections in Iraq war veterans. Meat and seafood companies are spraying the viruses on their equipment to protect consumers from foodborne illness. And researchers are exploring ways that phages can treat illnesses as diverse as lung infections in cystic fibrosis patients, breast infections in nursing mothers, sinusitis and urinary tract infections. In some ways, phages fit perfectly with the current conventional wisdom that simple and natural products can sometimes top artificial and chemically enhanced ones; one company has had its phages certified organic, Kosher and Halal.
Phages are no magic bullet. Critics point out that they can cause disease as well as cure it. By mingling their own genes with those of bacteria, phages have given rise to some of our deadliest pathogens, including toxin-producing Corynebacterium diphtheriae, which cause diphtheria; and E. coli 0157, which causes severe food poisoning. Proponents counter that they have the technology to screen out these rogue phages. Like antibiotics, phages breed resistance, though isolating a new phage can be faster and cheaper than synthesizing a new antibiotic. Finally, some see phage therapy as a cultish phenomenon backed by weak science. But the current crop of biotech startups is beginning to prove them wrong.
"The Forgotten Cure" traces the story of phages from Paris, where they were discovered in 1917; to Tbilisi, Georgia, where one of phage therapy's earliest proponents died at the hands of Stalin; to the Nobel podium, where prominent scientists have been recognized for breakthroughs stemming from phage research. In the present day, the book closely follows the founders of two biotechnology companies specializing in phage therapy as they navigate the difficult path to FDA approval.
The treatment stands at the crossroads of two vastly different medical cultures. To the East: the former Soviet Union, which long provided free but substandard medical care. To the West: the United States, which offers superior medical care that not everyone can afford. Americans are accustomed to high-tech treatments and rapid-fire cures, which phage therapy won't necessarily deliver. Pharmaceutical and biotech companies, in order to keep the flow of innovation coming, expect vast profits.