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Phages: Bacterial Eaters From Georgia to Fight Antibiotic Resistance
By Tim Ruben Weimer
Tanja Diederen lives near Maastricht in the Netherlands. She has been suffering from Hidradenitis suppurativa for 30 years. Its a chronic skin disease in which the hair roots are inflamed under pain — often around the armpits and on the chest.
€3,900 ($4,302) for treatment in Georgia
In August 2019, the now 50-year-old made a radical decision: she discontinued the antibiotics, which were becoming less and less effective. And she traveled to Georgia for two weeks to undergo treatment with bacteriophages (or phages for short).
Such phage therapy is not yet approved in most Western European countries. She paid 3,900 euros out of her own pocket in the hope that the unconventional therapy would help her.
Bacteriophages are viruses that fight against the proliferation of their host bacteria. Therapy with bacteriophages involves the oral administration of a single, isolated type of phage. They attach themselves to their bacterial counterparts in the patient's body in order to survive.
The phages reverse the polarity of the bacterial cell in such a way that it produces further phages, filling up with more and more phages and finally bursts. Then, the released phages attach themselves to other bacteria until all of the bacteria has been destroyed.
Journey Into the Unknown
"It tastes a bit like mushrooms," Tanja Diederen remarked as she took her morning phage dose. "When I went to Georgia, I was at first very nervous and excited, but above all disappointed about the treatment here in Holland."
After antibiotics stopped working for her, her doctor suggested that she take biopharmaceuticals, i.e. genetically engineered drugs. He had never heard of bacteriophages.
Instead, Diederen decided to look for treatment options with bacteriophages on her own, which she had heard about in a television program.
The Doctor Never Heard of Phages
A phage model — phages are viruses, that multiply in bacteria and then destroy them.
She came across the Georgi-Eliava Institute in Georgia, which has been researching bacteriophages since 1923 — just a few years after their discovery. Georgia has since developed into the global center of phage therapy.
During the Cold War, antibiotics were difficult to get there or anywhere in the Soviet Union. Treatment with phages was the best way to cure infectious diseases. Today, the Eliava Institute has one of the largest therapeutic collections of bacteriophages in the world.
Tanja Diederen stayed in treatment for two weeks, after which she traveled back to the Netherlands with a large suitcase full of phage tins. Since she began taking two different phages a day and applying a cream, she feels better.
She has more energy again and the small inflammations on her chest and armpits have decreased. The large inflammations come and go, but not as severe as before.
"It Doesn't Feel Illegal to Me"
Communicating with the Georgian doctors was difficult for Tanja Diederen. She needed a translator.
Every three months Diederen travels to Belgium — 15 kilometers away — to pick up a new ration of bacteriophages sent from Georgia for 500 euros. Her health insurance doesn't pay for this. Belgium is the only Western European country where phages are allowed. In the Netherlands, as in all other countries, they can only be used in individual cases to save lives or relieve severe pain.
Her physician is solely responsible for the application.
"It doesn't feel illegal to me," said Diederen. "I am one hundred percent sure that this medicine will help many people."
Like antibiotics, bacteriophages can also lead to bacterial resistance. Their big advantage, however, is that they are always one step ahead of the bacteria and can overcome the resistance. In addition, they are always directed against a specific type of bacteria and thus leave useful bacteria undamaged, like in the intestine, for example.
Before phage treatment, it is always necessary to determine which bacteria actually trigger the disease. The phages are then produced individually for each patient — often in Georgia.
Bacteriophages Permitted in Belgium
Professor Jean-Paul Pirnay from the Queen-Astrid Military Hospital in Brussels works with bacteriophages.
Such an individual medication does not meet the applicable regulations for medicinal products in any Western European country. It would take too much effort to have each individual phage formulation approved by the authorities.
Not so in Belgium. Since last year, this process can be legally circumvented by the Scientific Health Institute, in cooperation with doctors, patients, manufacturers, pharmacists and the Belgian Federal Office for Medicinal Products, issuing a certificate for the required phage ingredients. Pharmacists will then be able to use them for the manufacture of bacteriophages, subject to certain guidelines.
"We have used the existing legal framework to insert the bacteriophages," said Dr Jean-Paul Pirnay, who works at the Queen Astrid Military Hospital in Brussels on bacteriophages.
Around 30 patients have already been treated there. Currently, the military hospital is the only place in Belgium where bacteriophages are produced.
Useful Supplement to Antibiotics
"We need pharmaceutical companies to make the phage," says Pirnay. "A hospital can't produce all phages for a growing number of patients."
But industrial production of phages would require a clearer legal framework, and research is not yet ready.
"I believe that phages will not replace antibiotics," he said. "Both will be used together to make antibiotics more effective."
Tanja Diederen wants to continue her treatment in Brussels in the future. Communication with the Georgian doctors was difficult for her, she always needed a translator.
"I really hope that phages will soon be allowed in Europe," she said. "Going to Georgia is quite difficult and expensive."
Germany and the Netherlands are currently conducting pilot studies to see whether an individual prescription of bacteriophages would be possible. France has already imported Belgian phages and agreed to their use.
Reposted with permission from Deutsche Welle.
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EcoWatch Daily Newsletter
By Tara Lohan
The Santa Fe River starts high in the forests of New Mexico's Sangre de Cristo mountains and flows 46 miles to the Rio Grande. Along the way it plays important roles for wildlife, irrigation, recreation and other cultural uses, and provides 40 percent of the water supply for the city of Santa Fe's 85,000 residents.
By Julia Conley
Climate campaigners on Friday expressed hope that policymakers who are stalling on taking decisive climate action would reconsider their stance in light of new warnings from an unlikely source: two economists at J.P. Morgan Chase.
Tensions are continuing to rise in Canada over a controversial pipeline project as protesters enter their 12th day blockading railways, demonstrating on streets and highways, and paralyzing the nation's rail system
Colorado River Has Lost 1.5 Billion Tons of Water to the Climate Crisis, 'Severe Water Shortages' May Follow
California is headed toward drought conditions as February, typically the state's wettest month, passes without a drop of rain. The lack of rainfall could lead to early fire conditions. With no rain predicted for the next week, it looks as if this month will be only the second time in 170 years that San Francisco has not had a drop of rain in February, according to The Weather Channel.
The last time San Francisco did not record a drop of rain in February was in 1864 as the Civil War raged.
"This hasn't happened in 150 years or more," said Daniel Swain, a climate scientist at UCLA's Institute of the Environment and Sustainability to The Guardian. "There have even been a couple [of] wildfires – which is definitely not something you typically hear about in the middle of winter."
While the Pacific Northwest has flooded from heavy rains, the southern part of the West Coast has seen one storm after another pass by. Last week, the U.S. Drought Monitor said more Californians are in drought conditions than at any time during 2019, as The Weather Channel reported.
The dry winter has included areas that have seen devastating fires recently, including Sonoma, Napa, Lake and Mendocino counties. If the dry conditions continue, those areas will once again have dangerously high fire conditions, according to The Mercury News.
"Given what we've seen so far this year and the forecast for the next few weeks, I do think it's pretty likely we'll end up in some degree of drought by this summer," said Swain, as The Mercury News reported.
Another alarming sign of an impending drought is the decreased snowpack in the Sierra Nevada Mountain range. The National Weather Service posted to Twitter a side-by-side comparison of snowpack from February 2019 and from this year, illustrating the puny snowpack this year. The snow accumulated in the Sierra Nevadas provides water to roughly 30 percent of the state, according to NBC Los Angeles.
Right now, the snowpack is at 53 percent of its normal volume after two warm and dry months to start the year. It is a remarkable decline, considering that the snowpack started 2020 at 90 percent of its historical average, as The Guardian reported.
"Those numbers are going to continue to go down," said Swain. "I would guess that the 1 March number is going to be less than 50 percent."
The National Oceanic and Atmospheric Administration (NOAA) Climate Prediction Center forecast that the drier-than-average conditions may last through April.
NOAA said Northern California will continue deeper into drought through the end of April, citing that the "persistent high pressure over the North Pacific Ocean is expected to continue, diverting storm systems to the north and south and away from California and parts of the Southwest," as The Weather Channel reported.
As the climate crisis escalates and the world continues to heat up, California should expect to see water drawn out of its ecosystem, making the state warmer and drier. Increased heat will lead to further loss of snow, both as less falls and as more of it melts quickly, according to The Guardian.
"We aren't going to necessarily see less rain, it's just that that rain goes less far. That's a future where the flood risk extends, with bigger wetter storms in a warming world," said Swain, as The Guardian reported.
The Guardian noted that while California's reservoirs are currently near capacity, the more immediate impact of the warm, dry winter will be how it raises the fire danger as trees and grasslands dry out.
"The plants and the forests don't benefit from the water storage reservoirs," said Swain, as The Mercury News reported. "If conditions remain very dry heading into summer, the landscape and vegetation is definitely going to feel it this year. From a wildfire perspective, the dry years do tend to be the bad fire years, especially in Northern California."
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A warm day in winter used to be a rare and uplifting relief.
Now such days are routine reminders of climate change – all the more foreboding when they coincide with news stories about unprecedented wildfires, record-breaking "rain bombs," or the accelerated melting of polar ice sheets.
Where, then, can one turn for hope in these dark months of the year?