Ella Barasa is On the 26th, she found that the regular treatments that had sustained her were no longer working. The slender lab assistant has lived with the side effects of cystic fibrosis since childhood. Cystic fibrosis is a genetic disease that turns the mucus in the lungs and other organs into a sticky mucus that gives pathogens a place to grow. To keep the infection under control, she followed a regimen of swallowing and inhaling antibiotics, but by early 2019, antibiotic-resistant bacteria were lodging in her lungs, making her worse than ever.
Balasa’s lung function had dropped to 18%. She had a fever and was so weak that she could not raise her arms above her head. Even an intravenous dose of colistin, a brutal last-resort antibiotic, gave no dents. I asked if it would be possible to voluntarily receive a virus that attacks bacteria known as a phage.
That January, Balasa moved from her home in Virginia to New Haven. Every day of her week, she breathed in a mist of the virus that biologist Benjamin Chan, scientific director of the Yale Center for Phage Biology and Therapeutics, isolated for her offensive capabilities. Pseudomonas aeruginosaa multi-drug resistant bug that clogs Balasa’s lungs.
And it worked. The virus penetrated the goo, attacked the bacteria, and killed some of the bacteria. The remaining bacteria were weakened to the point that antibiotics could knock them out.
Today Baratha is 30 years old. She continues to suffer from cystic fibrosis, but two more rounds of phage and drug changes have prevented her from reliving the crisis that phage treatment has quelled. We are consulting with drug development companies and working to visualize new treatments, including phages. “I see them very much as a new way of treating infections,” she says.
Her success has an asterisk. Phages are unapproved drugs not only in the United States, but also in the United Kingdom and Western Europe. In these countries, no companies manufacture it commercially, and hospitals and pharmacies do not have it in stock. To administer them, doctors must seek compassionate use approval from government regulators (the U.S. Food and Drug Administration in the case of Balasa), indicating patients have no other choice.
That process is inefficient and inherently unfair. Yet, journal articles and researchers report well over 100 people in the United States. Patients have undergone acute phage therapy, most of which has not been published. Researchers believe that more lives could be saved if phages were legally available.
And finally, it can become a fact. In 2021, the US National Institutes of Health gave her $2.5 million to 12 US agencies to study phage therapy.Last year, the NIH initiated the first federally funded clinical trial of a beneficial virus, supporting 16 centers to test safety and possible dose levels. Pseudomonas, the pathogen that made Balasa sick. Other academic centers and private companies have initiated about 20 trials in the US and about 30 in the UK and Europe. And in January, a UK parliamentary committee launched an investigation into whether the phage could be marketed in the UK.
