Tom Ireland (Hodder & Stoughton)
EVERY so often I remember that I should be scared, not just of climate change and creeping authoritarianism, but also of antibiotic resistance. As bacteria acquire the ability to fend off ever more antibiotics, we risk returning to a time when a simple bacterial infection could mean death.
To tackle the threat, some researchers are developing new antibiotics to replace the old ones that no longer work. It is expensive and time-consuming. What if there was a simpler solution? What if we could use viruses to cure bacterial infections?
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That is the premise of science journalist debut book, The Good Virus: The untold story of phages: The most abundant life forms on Earth and what they can do for us. (Full disclosure: Ireland and I are represented by the .) Many of us are still feeling the impacts of covid-19, which was caused by a virus, but this book is a reminder that not all viruses are dangerous to our health.
The good viruses of the title are called bacteriophages, or simply phages. They can only reproduce by infecting bacteria, injecting their own genetic material into the cells and taking over their internal machinery. Ireland explains that 鈥渁 never-ending microbial war between viruses and bacteria is going on in the world around us, every minute of every day鈥�. This even happens in our bodies, every bacterium on our skin and in our guts is under attack from phages.
The notion of using phages to cure bacterial infections goes back decades. Ireland begins his book, arrestingly, in 1942 during the siege of Stalingrad, in the then Soviet Union. He writes: 鈥淪oviet scouts were crossing the front line daringly to steal certain German corpses, before squirrelling them back down into a secret laboratory hidden deep beneath the city.鈥� These raids were part of a project led by Soviet researcher Zinaida Yermolyeva to treat outbreaks of cholera, a bacterial infection, by harnessing the phages that attack the cholera bacteria. These phages were most readily found in the corpses of those who had recently died from cholera.
Stories like this reflect the excitement many microbiologists felt after the discovery of phages in the early 20th century. However, the research from that time was largely ignored, and phages have been neglected. The core premise of The Good Virus is that medical and virological research has paid too little attention to phages, despite their enormous promise.
Ireland鈥檚 account of the early history of phage research is richly detailed and absorbing, and well balanced between the biological details and the personalities and scientific politics involved.
He argues that phage medicine came to be associated with the crank ideas pushed by Soviet pseudoscientist Trofim Lysenko, among others, explaining why it has been little studied in the West. For many years, almost the only place to get phage therapy was at the Eliava Institute in Tbilisi, Georgia 鈥� and many people with chronic bacterial infections made the journey to receive treatment.
The tables finally turned in 2016, when epidemiologist used phage therapy to save her husband鈥檚 life. Tom Patterson had a bacterial infection that had resisted all known antibiotics. In desperation, Strathdee recruited a team to develop a phage therapy after reading about the idea online. The pair tell their story in their book, . Ireland retells it, setting it in its full context.
Readers may be wondering why phages aren鈥檛 regularly prescribed. The difficulties are largely procedural. Phage therapies typically involve a cocktail of phages, freshly sourced for each infection, ruling out conventional controlled studies in which the same treatment is given to many patients. This could surely be overcome by ingenious experimental design, but the stigma attached to the idea means regulators have been slow to act.
A later section of the book explores the role of phages in ecosystems. Fascinating as this is 鈥� it turns out phages kill about half the bacteria in oceans 鈥� it interrupts the narrative and might have been better as an epilogue. But this is a minor complaint. The Good Virus is original, eye-opening and grippingly told.
Michael Marshall is a writer based聽in聽Devon, UK
