Getting tested for COVID-19

Well, it's been a long time since my last update. Last I left you we were in Belgium when we decided the Coronavirus was putting an end to our bacteriophage efforts.

I was no longer coughing blood since I started taking the Ukrainian over the counter phages which had pseudomonas aeruginosa as one of their targeted bacteria.

We went to the Netherlands where we stayed with friends, and when the threat became too big we eventually booked an expensive hotel in my hometown of Noordwijk, seaside area of the Netherlands. We felt safe and secure for 3 nights and then decided to drive to the middle of Holland where there are lots of heaths and forests and we had another two nights in nature away from crowds before driving to Amsterdam for the final two nights prior to our flight home. In Amsterdam, we had a superb Hotel booked and paid for by sympathetic friends (!) where they served room service breakfast as by now cafes and restaurants had closed. Cindy and I rented bicycles and rode around a pretty empty Amsterdam, visiting many museums in quick succession - it's amazing how quickly you can ride past a museum if you don't go inside to look... Cindy managed to twist her ankle as she rushed off the road to make way for a police car with sirens. This was in front of the Torture Museum of all places.

Before our flight, we found the Amsterdam Bos and the Olympic rowing course where we walked for many kilometres in preparation for the long flight home.

Amsterdam airport, Schiphol, was very empty and the security still had to frisk me at very close & personal range not wearing a mask either. Pretty outraged I checked with his supervisor who said he was following protocol and that she would be doing the same in 15 minutes. I felt seriously at risk because he would have surely been infected in the past few days and could now be passing it on to anybody he was frisking like he frisked me. Apart from that, it wasn't too bad in Amsterdam and we got onto an empty flight to Abu Dhabi.

In Abu Dhabi, we went to a lounge to which one could pay for access and there I did my nebulising. The hundred-dollar access fee had scared most people and it was also in a disused terminal of the airport hence we felt very safe there. The $100 fee to get in included the towel for the shower a toothbrush a terrible razor and a very very limited choice of food and drinks, in fact not even a choice really - see below image. But we were safe.

The Abu Dhabi Sydney flight was jam-packed full with Australians returning, and arrived in Sydney at 6 in the morning we all got our flyer about 14-day self-isolation as we exited the plane. But clearly, self-isolation was not in effect until you actually got home. Forget about social distancing when exiting a crowded plane or going through customs it seems. Once at the domestic terminals where it was fairly quiet we faced cancelled and delayed flights as we made our way from Sydney to Melbourne to Devonport, arriving about 10 hours later. People in the queues were not keeping distance at all, staff and crew were also acting just as per normal as if there was no virus at all. Even in Devonport when a staff member asked if anybody had been overseas those half a dozen people were crowded around a small table filling in forms about their 14-day self-isolation...

Cindy and I had a car waiting for us and we drove to James Street where Ree had prepared the home for us and stocked it full of food. Ree had arranged with friends to stay at a beach house far away for the next 14 days to give Cindy and me a self-isolation place. Normally I live in a house with two or 3 others so this was great.

We arrived on Friday night and on Monday morning the mail brought me phage medicine from a Georgia contact.

Monday Cindy was also getting signs of a migraine, vomiting slight cough slight temperature and we eventually called the hotline who deemed us as not testable yet. Fortunately, within 24 hours we got a call to say that my cystic fibrosis was a deciding factor to get us tested. So on Wednesday, we drove out to the hospital with permission of the hotline.

Donning clean new clothing a fresh mask and plastic gloves and equipped with an antibacterial spray we headed outside the house. The testing clinic was pretty much empty and we were helped in a friendly and professional manner. Swabs were taken and we will be notified in a day or two they said.

In the meantime, I started taking the Georgian over the counter phage against pseudomonas aeruginosa and tonight I'm starting with an inhaled colistimethate sodium nebulizer antibiotic treatment as well. Wouldn't it be great if my lung function was better after 14 days of self-isolation with these new phage medications! The walks around the house certainly wouldn't have been enough to qualify as exercise, but it's the least I can do.



And just as an interesting note, on the flight between Sydney and Melbourne was a young family from overseas where the woman was crying in tears telling the crew to keep their distance from her. She was screaming and saying nobody is paying attention to the safe space requirements, not even the crew. The hostess was trying to offer her tea and asking her to calm down as she was screaming 'get away from me, step back'..., which the hostess was just not understanding until the husband sternly said please leave her alone. This is exactly how I felt for 12 hours, and I can assure you I am not fussy about a few inches here or there, and still regularly touch and scratch my face accidentally. If we caught the virus we caught it between Amsterdam and Devonport.

Fingers crossed we are all safe and I'll get back to you all when we get the results back.

Belgium phage impressions

Coming back from the Ukraine I managed to cough up blood at the border and again when walking back to the hotel in Krakow.

Reunited with Cindy we decided best course of action is to start this phage medicine from the Ukraine and catch the next flight to Brussels where I have Medicare reciprocal rights and can see doctors.

The security queue at Krakow was a mile long, a COVID19 smorgasbord where we tried to maintain distance between people... Well,... Anyways, we got to Brussels via Stockholm and a few hours delay, walked to our AirBnB near the airport and settled in and made an appointment with a local GP for the next day.

The GP and a pharmacist we spoke to had hardly heard about bacteriophages despite the new laws that say a GP can now refer to a pharmacist for Magistral Phage Preparations etc. Google that! Not a good sign. The doctor did give me a referral to a specialist.

Armed with the referral we caught bus to the Queen Astrid Military Hospital, the centre of bacteriophage studies in Belgium.

After a bit of a search in the hospital we found the team and a member took the time to speak to me. She made it clear that the legal  infrastructure may be in place in Belgium, as it is in Poland, but without major education campaigns for doctors (think pharmaceutical funded symposiums for doctors at the Gold Coast where they are sure to go to) and a major expansion in phage facilities and phage research not much is likely to happen. So as it is the team is poorly funded and has to choose carefully who to treat with the limited phage collection they have. This means serious and desperate cases with a good phage prognosis get priority and walking wounded like myself are not likely to get picked.

In the days following I did get a form for my doctors to complete but it was pretty clear I was not going to be eligible, especially given my location on the other side of the world. It is not a one shot treatment, phages are a program which requires monitoring and phage adjustments in most cases taking months.  I was not going to find people  like myself who were getting phage treatment as antibiotics were causing more sideeffects than benefits, people who prefered to try phages as a choice rather than desperacy. Mind you I'm pretty desperate with 38% lung function for the past X years and an infection that will not go away!

Other than that the unit was only a research unit and of course could not give treatment for my issues at hand. Nor could they refer me to or even suggest a GP in Belgium who was phage aware. She did urge me to get urgent help for my coughing blood episodes.

Fortunately the Ukraine phages worked enough to settle my  infection, even though they were not specifically for my infection, but still at least were for generic pseudomonas aeruginosa infections.

Also in the mean time Italy COVID19 infections started exploding and people were getting nervous everywhere.

We decided to stop calling into medical facilities and looking for sick people. Time to head for Holland and think about going back to Australia as the flu was becoming a big news story. I emailed the airline re an earlier flight and rerouting me directly home rather than via my family in Canberra.

We went to Holland, my old country of birth. Eventually we booked into a luxury hotel in my home town as we had lost confidence in small Airbnbs and budget hotels and we are now in an expensive hotel where even here we ask them not to clean the room.

I tried to call the airline a few times but hung up after 45 minutes on hold.

We spend our time doing cold beachwalks and renting bicycles and staying out of crowds. We have a rental car and do not need to get into public transport.

In one town in Holland we ran into a shop assistant who knew about phages and had seen documentaries on it and was aware people with serious infections were just.visiting former USSR countries for treatments. We got her on tape.

Waiting for the 18th. Let's hope we don't get any flu, it is the season here ... Let's hope we get on that plane home.

Phages in The Ukraine city of Lviv

I jumped on the train to Lviv in the Ukraine. Three hours to the border, changed to a wide track train, got checked for flu symptoms by soldiers and arrived about 730pm Friday night

On my way into town I enthusiastically stopped at a few pharmacies and discovered language is a major barrier here.

Long story short, I visited about 5 pharmacies who all sold phages and phage derived lysate products. Still it seems to me it is not the most common cold, cough and diarrhoea medicine that I was expecting it to be. Perhaps this is because antibiotics for the average person would still work a lot more effectively than a commercial phage preparation. Primarily because phages need to be individually matched to infections, and a random cocktail will only work for the most common infections.

I found one person who spoke good English and he explained he gets the phage based medications and sometimes they work in a matter of days, but when they don't he goes to the doctor for antibiotics etc. This indicates that without local  phage clinics and efficient specimen pathology services individualised phage treatment (Magistral Preparations) would be difficult and hence antibiotics would be more suitable.

To really understand the situation I found the Pharmacy Museum here but the old women with their painted hair were seriously unfriendly and borderline hostile. Not interested to say or do anything. Being a functional pharmacy as well they were not interested in helping me and just took my money and pushed me  into the museum. I even asked if I could see a doctor somewhere but despite understanding the word doctor just walked away from me.

In any case, I spoke to people, bought various phage preparations, really enjoyed the overnight experience. I will read the medicine inserts and labels carefully when I'm back in Poland.

As it happened I (discreetly) coughed a fair amount of blood again, just after entering Poland whilst changing trains. Phage treatment cannot come fast enough for me. I think I need to get us to Belgium sooner rather than later and see a doctor.

The only thing I took here other than my usual meds was a nasal eucalyptus spray, which I doubt caused the bleed. I've also been doing enough walking and nebs, eating healthy and I must say I feel great with little coughing even.

After the Hemoptysis episode I took the first class train back to Krakow to avoid the crowd. Fortunately it was only a fraction more expensive. I think the reason it is not popular is because the first class wagon is old fashioned and has no power points at the seats!

Moving right along...

Well, well, well. Conclusion after visiting Wroclaw. My intention was to visit a country and a clinic where I understood people were 'routinely' treated with Phages. The institute in Wroclaw has been supplying phages to Polish hospitals for almost 50 years, and from interviews, I have seen and google searches I have done I had believed that phage therapy was much more used here in Poland than it now appears. This would have been significant because it is in the European Union and operates under European medical protocols.

Visiting the Phage Therapy Unit of the Medical Centre at the Institute of Immunology and **Experimental** (!) Therapy (pictured above) I discovered that it is a bleak and empty academic feeling unit, and not a bustling medical facility as I had expected. There were no patients or people coming or going, and the receptionist I was able to speak to spoke good English but was keen not to be filmed or recorded. She confirmed that Polish people do not get phage therapy except under very special circumstances and at their own expense. The cost of treatment is about €1700 but this is, of course, a ballpark figure. She would see if I could speak to one of their doctors. A doctor did contact me, but he was wrongly informed, thinking I wanted treatment, and that a consultation meeting to explain the treatment procedure was possible in March for which cash payment was required. This is not really what I am here for, though I would love to get phage treatment for my infection. I emailed to explain. Over the past 6 months, I have also communicated with the Georgian Eliava Phage Therapy Center, and I could get nothing but treatment discussions with them and no response to interview requests.

I came to Poland to interview people about phage therapy, about commercial phage preparations, how many people they treat, what infections are they most successful with, its general use in Poland... How many Polish people are treated annually with phages in Poland etc.

In Australia no-one knows anything about phages. Just a few scientists, but not the medical world. But I now know that it is almost the same in Poland.... It is not for the average patient. It is special and experimental here too, just like in the rest of the western world. I will try travel to Ukraine later this week (across the border) and see how they use it there. But if I show people at home it is used in Ukraine it will not have the same effect as showing they use it in (EEC) Poland. Poland would have been very believable. Australians will look at Ukraine, like they would at Georgia (former USSR), that phage use is similar to say snake-bile in China... Good for them but nothing Western, in other words not believable. If I had evidence it was used in Poland we would all be more convinced!

Tomorrow we leave for Krakow, East Poland, and I will see if I can catch a train to Ukraine for a day while Cindy awaits my return in Krakow. Being so close I want to have a quick look at a pharmacy there and purchase some commercially available bacteriophage-based medicine.

Welcome to Wroclaw

Without any further problems we drove to the city of Wroclaw where the famous Ludwig Hirszfeld Institute of Immunology and Experimental Therapy is situated. The Phage Therapy Unit in their Medical Centre (IIET PAS) has been conducting research on the biological properties and the application of bacteriophages for several decades. They isolate bacteriophages and prepare phage formulations for different hospitals in Poland for their respective phage therapy since the 1970s - see their website - www.iitd.pan.wroc.pl/en/OTF

At this stage it has become clear to us that although phages appear to be commonly used in Poland since the institute has supplied hospitals since the 1970s, the three different pharmacies we visited today only know of antibiotic prescriptions and standard cough medicine. Worse still, the pharmacists themselves are very puzzled by phages, even when I show the products on the internet or the website of the institute. One pharmacist went as far to say that these are only for medical experiments by scientists and not used in the Polish medical profession. This is exactly what I get told in Australia by my doctors. Yes, I am a little disappointed and very confused. I have seen documentaries from SBS etc. where doctors from the institute in Poland were asked why this therapy is not available in other European countries to which they have no answers as they operate under the same European protocols according to the 'Declaration of Helsinki for the Medical Profession Act - 5th December 1996....

In any case, we may need to visit ex-Soviet countries such as the Ukraine next door... This was not part of the original plan but maybe worthwhile as I really want to see how phage-based medicine is dispensed in some countries, and we are so close here.

Cindy and I did an introduction to Poland session with Marta, a young professional (an Airbnb event) in a local cafe for 2 hours and have established a good contact to help us in case we run into trouble or need some translation help.

My health is holding out although I am coughing up more blood. I would love to try some phage options ASAP. Just to recap my expectations, a commercial phage preparation for my pseudomonas aeruginosa is likely to lessen my infection temporarily, but to eradicate my infection I will need specific targeted phage therapy in conjunction with antibiotics over a period of weeks or months which is not something I'm expecting to get on this trip. I am however expecting to get some phage treatment and obtain a lot of relief, including an albeit temporary but significant increase in lung function.

Here is me coughing blood...
https://youtu.be/zpO87_Uzvdg

And PS, yes there was an incredible military parade in the old town here in Wroclaw. No idea why...

Arrival in Warsaw

Yesterday late afternoon we arrived in Warsaw. When we picked up the rental car we were given a fancy Mercedes instead of the budget choice we had arranged. This is normally wonderful, but... We got the keys in the airport terminal and headed down to an attendant-less dark garage. It took us 20 minutes to find out how to change seat position and controls and acquire the bare minimum car knowledge required to drive. Not easy amongst all the buttons, switches and digital displays. Even the steering wheel is on the wrong side of the car. Easiest of all was putting on our fancy magnetic phage or fail magnetic door sign.

By now it was probably 6 p.m. and we headed into Warsaw City, (www.booking.com/hotel/pl/prudentia-apartment-wars.pl.html) to find the hotel we had booked through the airline. The navigation took us to an obscure set of buildings in the city, none of which looked anything even remotely like a hotel. The phone number we had had an answering machine in Polish, and the friendly local people trying to help us were also unable to find it. we tried a few nearby addresses and drove aimlessly for about an hour looking everywhere before we decided that this city was too much for our tired brains. The reason we had a City hotel was so we could have a few hours in the historic Old City before driving to Wroclaw in the morning. We headed off West at about 8 p.m.

Amazingly the highway here has 140 km per hour speed limit and so in no time we were clear of the City and stopped at a roadside McDonald's. There we used our phone to book a nearby Hotel.

The nearest one, 2 km away spoke English and we booked a room there. Due to the 8 lane motorway we had to drive 30kms around to get there but that was no problem. The hotel was palatial, complete  with white marble stairs but no elevator. We happily carried our heavy suitcases to the second floor and crashed out exhausted.

The day before in Amsterdam I had to cough up blood (freaking out supermarket staff and everybody around me) so I have to make sure I do my meds/therapy/exercise seriously and not cut any corners. Can't wait to go into a pharmacy today and see what they've got for phages

STEP 1 - Leaving for Canberra

Today is the day!

Cindy and I are flying to Canberra on Frequent flyer points and I have relatives and friends there. Two nights in Canberra will ensure I have everything with me that I need. Currently, my luggage weighs 28kg, most of which is medical equipment and medicine. My nebuliser, my oxygen concentrator (the red bag), and enough medicine to see me through 6 weeks, just in case we need to be quarantined for 2019-nCoV - the Corona Virus. Cindy hasn't got that much so we can even out the suitcases at some point.

In Canberra, I will find out what I have forgotten... Hopefully nothing. I have made lists and been methodical and careful, just like the other 20 times when I did forget things. There will be a day in Canberra to sort out any issues.

Next stop will be AbuDhabi, via Melbourne. There we plan to catch our breath for 2 nights at a complimentary free stopover hotel before flying to Amsterdam, Two nights with my cousin Mike there making sure I am healthy and have no flu symptoms before flying to Poland where the work begins! It seems a silly way to do it but when you have fickle lungs it is the safest way to go I think, and as it happened with Etihad it was also a most affordable option from Canberra, and don't forget we are doing this on a shoestring budget!



Just a reminder, I am paying my own airfares and treatment costs if applicable, and fundraising documentary funds I use to help subsidise Cindy and incidentals and travel for the documentary and then on our return, we need the big bucks ($10-30k to get professionals to help us assemble the documentary from our clips and recordings. Please help us make the documentary and tell the world about our investigation into Bacteriophages to help fight antibiotic-resistant infections!

https://www.gofundme.com/f/phage-or-fail-with-antibiotics

And STOP PRESS listen to this informative easy to understand podcast to understand Phages.

• Htttp://drmikehutchinson.com/bacteriophages-with-dr-sulakvelidze.php

Just do it!

https://phage.directory/capsid/raising-awareness-among-doctors



Well, it has come to this. I really will just go with a friend and go in search of Bacteriophages and film the experience and see who we meet along the way. February 2020 (whoops, I had incorrectly typed 2019 before) seems a good time!

All my efforts trying to organise a planned visit/treatment have been in vain, so I will invite one of my besties to come along with me and fly to Europe in search of a cure.

The reason it is difficult is that there are many people desperate to try phage therapy and the three most famous centres of phage research and treatment are overwhelmed with requests from foreign patients. The world is not short of sick people affected by antibiotic-resistant infections, which is exactly why the World  Health Organisation is so concerned about it; https://www.who.int/antimicrobial-resistance/global-action-plan/en/

I would have thought myself to be a perfect patient for scientists and doctors wishing to treat people with antibiotic-resistant infections. I am relatively healthy, mobile, have an infection that is easily accessible (through inhalation), easily monitored, and am not likely to die overnight from my infection and have a good chance of returning for follow up treatment or testing. Plus I am guaranteed to culture other antibiotic-resistant infections regularly over time giving treatment centres a reliable guinea pig that is known to them which surely has its advantages. But, there are many people in the world with Cystic Fibrosis like me.

Why do I still want to go with no guarantee for treatment? I will film and document my search for treatment and on my return discuss with doctors and scientists and prepare footage and material for the documentary.  What's in it for me? I want phage therapy to be available to me just like medicinal marihuana, and raising awareness about it is very important. Even if I were to be successfully treated there is a great chance I will be reinfected with the same or other strains of antibiotic-resistant lung infection within months. Hopefully, the next infection I get can be treated more effectively with standard antibiotic treatment. What makes me survive this hardy strain of pseudomonas aeruginosa is my alternative health supplements like Indrepta C: http://cysticfibrosis.com/indrepta-c-now-available-nonsense-mutations/ which helps me tremendously, and my adherence to what I believe to be a healthy and sustainable diet and lifestyle.

To cut the costs down I think it is best to just do the simplest thing, and that is to fly to Wroclaw in Poland, see how phages are used in practice by visiting a  few pharmacies, maybe see a doctor, and visit the Ludwik Hirszfeld institute, and then travel by rental car to Krakow in Poland where due to the enormous demand for phage therapy the L.Hirszfeld Institute recently opened an experimental phage therapy branch as well. Next stop is Brussels where phage therapy has been legally allowed as a treatment option where I will visit a doctor and seek help for my current infection and try visit the Queen Astrid Military Hospital where the national phage library is maintained.

On my return, I will discuss my findings with doctors and relevant scientists and doctors at the Royal Hobart Hospital, Monash University and the University of Tasmania. Then I will seek professional help in putting the documentary together!

Any feedback or suggestions always welcome by emailing me at suggestions@coughing4cf.com !


GREAT SHORT VIDEOS TO WATCH

• https://www.yalemedicine.org/stories/phage-therapy/ See Profesor J.Koff and B.Chan in action, the team I had the biggest hope for to help me.
• https://youtu.be/YI3tsmFsrOg How phages work...

Interesting new articles;

• https://phage.directory/capsid/raising-awareness-among-doctors
• Here is a typical case where phage therapy was started when the CF patient was in a critical condition, as this is the point where experimental methods can be used if legal permission is obtained in time. Often this is too late, here it was just in time. I like to be treated before I get to a critical stage: https://cysticfibrosisnewstoday.com/2019/06/04/armatas-phage-therapy-resolves-multidrug-resistant-pseudomonas-airway-infections-case-report/

To help with the project please show your support by donating to the fundraiser at https://www.gofundme.com/f/phage-or-fail-with-antibiotics. 

New Plan for 2020

Finally! Another update. I am sure you are all worried about what is happening with this documentary...

Appendicitis!

I had an Appendicitis Scare in the past few months. Because my lungs are so sensitive/awkward an appendectomy was not performed. Instead, I was first admitted to a regional hospital but eventually went for admission at the Canberra Hospital.  The final outcome; I was twice treated with large doses of IV antibiotics and the appendicitis is gone for now. It is expected to come back, which is totally normal, so they wish for my gut to fully recover and get over the infection before removing it later this year or in January through a laparoscopic procedure.  This means full intubation will not be required if all goes to plan.

I was hoping this situation would perhaps qualify for an emergency TGA approval to improve my lungs with Phage Therapy before the procedure, but due to hesitance of my health providers to fully commit themselves to phage therapy, and the dim outlook of getting TGA approval by the medicos involved, this opportunity has now kind of passed.

NEW PLAN

But we NEVER GIVE UP! Even though the preferred option of Yale treating me for the documentary seems to have gone out the window, I have formulated a new plan:

In Search of a Phage - The fight against Antibiotic Resistant Infections gets on the road.

Early

In early 2020 I hope to travel to Tbilisi in Georgia. I will go to a pharmacy and ask for a phage preparation to treat my Pseudomonas Aeruginosa lung infection. They may or may not give me something suitable. Chances are they will refer me to the Eliava Institute of Bacteriophages or to a local doctor. I will see what happens and go with the flow for a week, during which I may also visit this legendary institute where the world's largest phage library exists.

Next, I will travel to Wroclaw in Poland, where the next most famous bacteriophage institute is, the Hirszfeld Institute of Immunology and Experimental Therapy.
Here I will do the same, spend a week or so in search of Phage treatment.

Jean-Paul Pirnay
Qn. Astrid Military Hospital

And then my last destination is in Brussels where the 'Koningin Astrid Military Hospital' has made leaps and bounds in phage therapy. In Belgium they now allow Phage therapy. My strategy here is to go to a GP and explain what I have done to get rid of my pseudomonas infection. They will do a sputum test and see what is happening with my infection and will prescribe a  magistral preparation and ensure that the infection will definitely be treated and I can go home with an ongoing treatment plan.

I now envisage the documentary as follows:

• Start with my CF team explaining my infection (futile hospitalisation and ABX treatments)
• Switch to scientists at the University of Tasmania and Monash University explaining bacteriophages a bit better*.
• Get on the road and in Georgia hear a little about the history of phages* before proceeding to me making an attempt to get treated with phages. 
• Travel to Poland where we will hear about the successful application of phages in WWII on the battlefield and why there was perhaps not a 100% success rate there, hear how many people visit the Ludwik Hirszfeld Institute from abroad, and briefly discuss why Phage therapy is not accepted in other countries***.
• Travel to Brussels where we will speak to scientists and medical professionals, such as Jean-Paul Pimay pictured above, at the Queen Astrid  Hospital who will explain why it is now permitted in Belgium and how it was approved for public use, and explain why in Australia and other countries it is still not accepted.
• Back in Tasmania I will see my CF clinic, get a sputum test and lung function test and ask why we can not do this in Australia yet and when will it be possible. With my daring trip, taking the phage preparations in foreign countries, not one side effect was noted or warned against,. It was much cheaper compared to any hospitalisation for IV antibiotics and there are no serious side-effects noted over the 80+ years of use in  Eastern Europe or in the rest of the world over the last decade or more.

Hopefully, this documentary will make a big difference to the acceptance of Phages.

Thank you for your patience, hanging in there with me, and please pass to anyone who may be battling Antibiotic-Resistant infections!

Remember the Fundraiser to fund the Documentary is here: https://www.gofundme.com/f/phage-or-fail-with-antibiotics


* "Since time immemorial, phages—the viral parasites of bacteria—have been protecting Earth’s biosphere against bacterial overgrowth. Today, phages could help address the antibiotic resistance crisis that affects all of society"... 

** Discovered early 1900s and was replaced by the easier to use Antibiotics except in Russia and Eastbloc countries where Antibiotics were hard to get, hence phage therapy successfully continued there till today. 

*** Phage therapy does not fit the western clinical trial model as billions of phages exist naturally and each one is only effective against a very specific bacteria. Clinical trials will not work for trials that demand one medicine to be tested on multiple patients. Phages are a tailor-made (often per case) medicine.

Waiting on FDA approval

Hi everyone,

We are anxiously awaiting word from the FDA to approve my bacteriophage treatment at Yale.

Because phage therapy is still not officially cleared as an official treatment on humans in the western world, use of them must be applied for before researchers or doctors can use them on a patient, and that includes research.

Just to recap. Phages are the millions of natural enemies of bacteria. They are viruses that cull bacteria populations. If it wasn't for bacteriophages our sewers and compost bins would be overflowing with green ooze :)  Like any overpopulation, disease/viruses ensure population numbers are kept in check.

Bacteriophages are highly specific (hence minimal side-effects), and one phage cocktail that may kill the pseudomonas infection in my lung, but not the pseudomonas infection in someone else's lung which may require another combination of phages because the bacteria came from another source, and is, therefore, a different genotype.  Because phages are all unique they cannot easily be classified as a medicine because they really are a family of bacterial agents. For every patient, a unique phage cocktail has to be prepared from a Phage Bank. Exceptions are of course if it is the same bacteria that has infected many, say with a hospital infection.

With phages not exactly qualifying as medicine and one phage cocktail not curing all infections as similar as they may seem, it is very difficult to conduct clinical trials where historically one medicine is tested on a number of patients. Even if you had a collection of 30 people with Cystic Fibrosis and with Pseudomonas lung infections, each infection is likely a different genotype and requires a  different phage cocktail to treat. Biochemists test each person's bacteria with a range of phages and narrow down phages that are effective specific to each case. As bacteria mutate and gain resistance, the phage cocktail needs adjusting periodically. It is not one pill for all solution. It is a tailored treatment. Companies like AmpliPhi in the USA and others are working on creating more universally applicable cocktails which may get annual 'updates' just like annual flu shots do. Other researchers are trying to engineer artificial phages to gain optimal results for more infections.

Just a reminder, bacteriophages are not a recent invention,...Cocktails of phages were used therapeutically in Europe and the United States during the early 1900s pre-antibiotic era, used in the fight against the bubonic plague in Southeast Asia, dysentery in France, and cholera in India. Phage use is still prevalent in Russia and Central and Eastern Europe today. In the West, phage therapy was abandoned after broad-spectrum antibiotics came on the scene.

https://www.nature.com/articles/s41587-019-0133-z

Lets hope I get the call soon so that I will still be healthy enough to fly the 15000 kilometres to the USA! I would hate to have another 2 week hospitalisation to get pumped full of antibiotics which hardly addresses my Pseudomonas aeruginosa infection and which are starting to give me nasty side-effects!

As soon as I get the call with a date I will contact the press and we will need to scramble for the $$$ to make up the target figure required for the documentary!

If you hear of anyone who has antibiotic-resistant infections, Cystic Fibrosis or anyone who may be interested please pass this website to them!

Thanks for your patience and support!

Walter----

If you have anything to do with Microbiology in Australia you would have seen the March edition of Microbiology Australia, a CSIRO publication. They have dedicated their entire quarterly magazine to Bacteriophages!

Have a read if you are interested! http://microbiology.publish.csiro.au/nid/206/issue/9721.htm

Too much for most people to read, but I will refer to its content over the next few weeks on my Facebook page www.facebook.com/Coughing4Cf and on the blog https://www.coughing4cf.com.

One paragraph from the Microbiology Australia magazine;

Phages are natural organisms, arguably the most abundant life-form on Earth. They have evolved closely and dynamically with their bacterial host and are therefore specific and effective in selectively eliminating their target. They have a low environmental impact and have shown to have no serious side effects on bystander microorganisms. They are self-replicating in the presence of their target, facilitating dosing regimens, and have been successfully employed to treat even MDR infections, Only recently (2006) the FDA has recognised the designation of phages as ‘generally regarded as safe’, allowing for the use of phage in clinical practice and opening the road towards the implementation of bona fide clinical trials.

Complete article here: http://microbiology.publish.csiro.au/?paper=MA19005

We now have an incredible film producer tentatively working with me ( www.deansaffron.com) to make the documentary a reality, but I do need more finance to help make this a reality. Once we have a finite date with Yale I will engage the media and hopefully, we can then reach our goal! In the meantime keep on drumming up interested parties, and ask your friends to support with small donations so they can stay up to date with progress and experience phage therapy through my journey!

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REMEMBER WE NEED $$$ TO MAKE THIS DOCUMENTARY of my treatment so that other people learn about Bacteriophages and recognise their potential in the fight against antibiotic-resistant infections. PHAGE or FAIL. I invite you to be part of this revolution and donate :)  In return, you will get regular updates about my journey/lesson and you will get to see the 15-minute documentary once completed!  CLICK HERE: www.gofundme.com/phage-or-fail-with-antibiotics

Phages don't fit traditional clinical trial format

Antibiotics are failing us and bacteriophages are there waiting to be used.

With decades of proven effectiveness against bacteria, as used in WWI and WWII and now continuing to save lives in a few countries where clinical trials are not required why can't we get clinical trials that allow it? Because phages are personalised medicine, and clinical trial formats do not fit the mould for it. Belgium, USA, Poland and a few other countries now allow it, most under special rules and regulations  It is time we all learn about phages' effectiveness in our fight against antibiotic-resistant bacteria!

More info: www.scienceabc.com/…/what-is-bacteriophage-biology-therapy.…

A CSIRO publication, Micro Biology Australia, has dedicated their March 2019 issue to Bacteriophages, this is how important phages are in today's world.

So what is really blocking them from being used? 

Bacteriophages are not currently classified in medicinal legislation since they are neither living nor chemical agents. Therefore, it is complicated to regulate and perform clinical trials and commercialisation. To ensure the efficiency of phage preparations, their effectiveness and host range towards currently circulating pathogenic strains must be monitored. This might explain why the phage preparations approved in the Russian Federation and Georgia are not static but are continuously updated to target newly emerging pathogenic strains. Legislation to allow these updates is necessary to circumvent repeated registration procedures.  

The Belgian Minister of Health has formally acknowledged that it is difficult to define the status of therapeutic phage preparations: should they be considered as industrially-prepared medicinal products (subjected to constraints related to marketing authorisation) or as magistral preparations (prepared in pharmacies’ officina). Magistral preparations (compounded prescription drug products in the US) are made by a pharmacist from the constituent ingredients to meet the specific patient needs. On 26 October 2016, it was formally agreed that natural bacteriophages and their products, which are not fully compliant with the European Directive requirements for medicinal products for human use and for which there is no monograph in an official pharmacopoeia can be processed by a pharmacist as raw materials (active ingredients) in magistral preparations, providing compliance to several logical provisions.

What this means in simpler terms; Clinical trials require ONE preparation to be tested. This is not how phage therapy works. There are millions of bacteriophages and a lab determines which ones are put into the preparation on an individual basis. Even if you had 30 burn infections it is highly unlikely the same phage preparation would be effective for all, and even during treatment the infection needs regular monitoring and phage preparations may need adjusting. Current clinical standards do not allow for any such variations!

Examples of occasions when the same phage cocktail would be effective is in a hospital where a hospital-acquired infection is spreading to patients. The same phage preparation can be given to all suspected patients, or in a nursing home where gastro is doing the rounds, a single phage preparation can clear most cases without causing harm to patients. Keep in mind that each time there is an outbreak typically a new preparation is required. But this is what we want, we want a pharmacy to be able to make the preparations as is now happening in Belgium; Magistral preparations (compounded prescription drug products in the US)!!

Progress Everywhere

Time for another update!

DEAN SAFFRON, a friend in Queensland, who has been involved with CF projects in which I have been part of, has offered to help me make a 15 minute documentary of my journey into Phage Therapy! Dean, https://www.deansaffron.com/, is an accomplished and award-winning photographer and filmmaker and has offered his time and skills for a minimal cost. This is the first concrete offer I have had and one I am super happy with. We do need to raise significantly more $$$ to make it a reality, but we have figures on the table and complete with Dean's travel cost we are looking at needing about $10k, which is half my estimate of $20k. Currently, we are at the $4k mark.

Dean's latest successes;
"Salt of the Earth " Winner Best Short Film , Anglet, France.
"Still Swell at 85 " Winner Best International Short Film London.
"Still Swell at 85 " Winner Best Short Film ASMF, Australia"
"The Spokesman" 2nd prize Velo Best Short Film Berlin, Germany.
"The Spokesman" The Auteur Award Best Short Film , Australia
"Phage or Fail" Winner Best Short .......   :)

One other issue I am pleased to have solved was that a standard USA Tourism B2 tourist visa, or in our case an ESTA visa exemption, covers medical treatment: https://travel.state.gov/content/travel/en/us-visas/tourism-visit/visitor.html.

As soon as we have a definite date for phage therapy at Yale University I will engage the press and hope to attract more funding.

CONFERENCE CALL with YALE! Last week key players from Yale University, their Cystic Fibrosis team, Dr. Benjamin Chan, myself, some of my  Tasmanian CF team, and my wonderful GP Jane Cooper from the Don Medical Clinic had a conference call detailing the process. Discussed were issues with initial treatment logistics, ongoing care, mailing of further phages, repeat visits, current status quo of bacteriophage treatment wrt Cystic Fibrosis, possible ramifications for a future lung transplant and if the phage treatment will affect my current treatment plan. The specialists involved in my care still have no time or interest in this treatment because it is seen as experimental and not permitted on humans in Australia YET.

IT IS UP TO US TO CHANGE THIS VIEW in Australia. The USA and Europe are slowly adopting phage therapy despite the usual required clinical guidelines for its use have not been completed, similar to those for medicinal marijuana. With Marijuana, there are two hurdles, the illegal status as a drug as well as the lack of substantial pharmaceutical profits. Phage therapy only has the latter, which is perhaps why the world is slowly adopting phage therapy quicker than we are medicinal use of marijuana.

Emily's Entourage

'Emily’s Entourage' accelerates research and drug development for nonsense mutations of Cystic Fibrosis and awards grants to research. A significant amount has been awarded to Dr. Benjamin Chan from Yale for research on Eliminating Resistance in Multi-Drug-Resistant Bacteria Using Phage Therapy.  This is where I am going for treatment!

TIME MAGAZINE article:
http://time.com/5068513/superbugs-are-nearly-impossible-to-fight/

quote:

Phage therapy has some unique benefits over antibiotics. For one, bacteriophages can be found everywhere on earth, even in sewage. Second, it attacks only the targeted bacteria, not the so-called good bugs in the host. Third, it can be done quickly: scientists can create a phage cocktail and provide it to patients within 48 hours of a superbug-infection diagnosis in some cases. And even though bacteria can become resistant to phage, there are an infinite number of strains of the viruses–not so with antibiotics. During Patterson’s treatment, the bacteria grew resistant to his initial phages, but the doctors were able to tweak the treatment with new strains until he cleared the infection.

FORBES MAGAZINE
(May 2019);
https://www.forbes.com/sites/madhukarpai/2019/05/08/fighting-fire-with-fire-can-we-kill-super-resistant-mycobacteria-with-viruses/#7236157556e5

quote:

In general, the field of phage therapy has to evolve from a series of case reports of compassionate use among desperately ill patients, to an evidence-base that demonstrates that phage therapy is safe, effective, and can become a part of routine clinical practice. Thankfully, such randomized trials are emerging. More are needed, and need to be funded.

REMEMBER OUR FUNDRAISING PAGE IS HERE:
https://www.gofundme.com/phage-or-fail-with-antibiotics

Clinical Trials for Phage Therapy!!

GREAT INTRO VIDEO in case you do not know about Bacteriophages. Watch this little 6-minute presentation, and pay extra attention at the 5-minute mark: https://youtu.be/YI3tsmFsrOg

My chronic lung infection...

UPDATE ON MY PHAGE THERAPY:

We are now at the stage where my GP and my Tasmanian Adult CF Clinic, Dr. Benjamin Chan (the researcher intending to treat me) and the director of the Yale University Adult Cystic Fibrosis Program are all getting together to formulate a plan.

I have also been talking to a Melbourne Film Producer who is keen to work out the logistics to make a documentary about the experience, and how to raise enough funds to make it possible. Please share our fundraiser: https://gofundme.com/manage/phage-or-fail-with-antibiotics. This filmmaker has also worked with Coen Ashton, a young man with Cystic Fibrosis who was a brilliant motivator and strong advocate for Organ Donations, a recipient of transplanted lungs himself but unfortunately succumbed to kidney failure as a result of the strong pharmaceuticals he received during his short life.

And as for my health, I just spend 10 days in the Royal Hobart Hospital getting strong IV Antibiotic treatment for my current lung infection which rendered my lung function to be 31% of expected (FEV1) for my age. A very worrying figure. It has since recovered to 39% and I am now on home IVs in Devonport. All these antibiotics take a toll on my organs, unlike Phage Therapy which only targets one bacteria.

I expect to go to Yale in June... at this stage.

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NOW LETS TALK PHAGE UPDATE!

Clinical Trials

To date I have been led to believe that because there is little money to be made by pharmaceutical companies there have been no clinical trials organised for phage therapy.  Who would pay for clinical trials of acupuncture, for instance. A needle maker who sells $300 acupuncture needle kits? There just isn't the money to justify the expense of a clinical trial involving dozens of scientists and lab workers, patients,...  And phages are also quite cheap.

BUT, it appears I was wrong! Was reading Time Magazine;  http://time.com/5068513/superbugs-are-nearly-impossible-to-fight/ ;

In 2018, two small biotech companies in the U.S.–AmpliPhi Biosciences and Adaptive Phage Therapeutics (APT)–will launch clinical trials that will attempt to answer some of the key questions about phage.

This to me indicates that there is movement in the works!

In fact after checking up on AmpliPhi (pronounce Amplifie!) I found that a Phase I-II clinical trial European Research & Development (R&D) Project funded by the European Commission had already been completed; Project  PHAGOBURN. It involved E-Coli and Pseudomonas Aeruginosa burn wound infections. In its Executive Summary it said:

In the context of a worldwide growing antibiotic resistance threat, notably the emergence of multi-drug resistant bacterial strains, PhagoBurn was launched to evaluate the clinical potential of bacteriophages (phages) as a novel and innovative strategy to fight this critical issue. Launched in 2013 and completed in 2017, PhagoBurn was the world first prospective multicentric, randomised, single blind and controlled clinical trial of phage therapy ever performed according to both Good Manufacturing (GMP) and Good Clinical Practices (GCP).

And the FDA in the USA has now also approved two other Clinical Trials which target Pseudomonas lung infections: https://cysticfibrosisnewstoday.com/2018/09/20/fda-oks-2-trials-investigational-ab-pa01-targeting-pseudomonas-aeruginosa/:

• A Phase 1/2 randomized, controlled clinical trial to evaluate the safety and efficacy of AB-PA01, administered intravenously in approximately 100 patients with hospital-acquired and ventilator-associated pneumonia (HAP/VAP) due to Pseudomonas aeruginosa. 
• A Phase 1/2 randomized, controlled clinical trial as above, in approximately 100 patients with Pseudomonas Aeruginosa bacteremia. 

"Pseudomonas aeruginosa is not only a challenging infection to treat, but one that represents a serious threat to the cystic fibrosis community as well as to lung transplant patients,”

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The easiest way to get bacteriophage treatment to infections is where the infections are easily accessible, ie. on the skin or in the lungs. Infections found in burn victims are much more numerous than lung infections and burn infections tend to be more homogenous infections whereas lungs tend to have multiple infections. This is why burn-related skin infections are most ideal for clinical trials.

Phage Therapy Centre in San Diego, USA.

Despite many countries not ready for human phage applications, with human trials supposedly 20 years away, in the USA patients now seeking phage therapy can submit an Emergency Investigational New Drug (eIND) application with the FDA. This process allows for use of 'as yet unapproved treatments' on a case-by-case basis. On this basis, IPATH Phage Centre was created in San Diego:  Center for Innovative Phage Applications and Therapeutics.) to treat patients with multidrug-resistant infections.

The aim of IPATH will be to make phage therapy more widely available as a clinical option for patients with life-threatening infections that aren't responding to antibiotics. Currently, IPATH is prioritizing serious multi-drug resistant bacterial infections that are associated with the following conditions: cystic fibrosis, complicated urinary tract infections, organ transplantation and implantable hardware (infected joints, pacemakers,...).

PLEASE DONATE!

So this concludes this update on my Phage Therapy mission!

Thank you again for your donation, and please spread the fundraiser so we can make a small documentary out of my experience going to Yale University for treatment of my Pseudomonas Aeruginosa lung infection, a very common infection for people living with Cystic Fibrosis:

https://www.gofundme.com/phage-or-fail-with-antibiotics
and follow me on https://www.facebook.com/Coughing4Cf

Urinology cures Cancer

image from https://www.frontiersin.org/articles/10.3389/fmicb.2016.01631/full
Modular Approach to Select Bacteriophages Targeting Pseudomonas aeruginosa for Their Application to Children Suffering With Cystic Fibrosis

Do a quick Google Search again to verify the above title. Tell me what websites you see. Recognise them? Probably not. Is this because no pharmaceutical company is willing to spend several million dollars into doing the clinical trials? Same can be said about Phage Therapy, but there is as much money for Pharmaceutical organisations as there is in Phage Therapy as there is in urinolgy or cannabis for that matter. But if you Google Bacteriophage with your favourite infection you will get credible websites covering its virtues.

In fact, just driving in my car someone alerted me to a radio program on phages, and I tuned in to listen: https://www.bbc.co.uk/programmes/w3cswvsm

Like most press coverages it was overall super positive and makes you scratch our head why we can't find a way to use phages in fighting infections that antibiotics have trouble with.

In the next week or so I am due to go into hospital to have a 'tune-up', tens of thousands of dollars will be thrown towards me to pump me full of antibiotics and get my lungs cleared a little, but only temporarily. In my analogy of rabbits in my carrot field, this is now akin to paying the army to come in with a battalion to shoot as many as they can. We all know the rabbits will be back within weeks of the battalion leaving. Rediscovering the calicivirus (that virtually stopped the rabbit plague and is still killing domestic rabbits today) is probably a better option.

At a nearby Film Festival in the mountains (Cradle Mountain Film Festival), where I was scouting for documentary makers willing to cover my experience with Phages at Yale University, I was at altitude, about 800m perhaps. I could hardly function. Parked next to the disabled spot at cradle Hotel I was exhausted by the time I got to the cafe inside. Trying to do my nebs and cough up a cup of phlegm too two hours that night as each and every step was torturous. It was too cold for my oxygen concentrator to work properly. I need to kill this pseudomonas infection in my lungs. And I am not the only one suffering. And people with Cystic Fibrosis are also not the only people suffering from such infections.

So anyway, the journalist on the radio explained how she went to the pharmacist and bought phage medicine over the counter. It was designed to kill the 3 most common bacteria circulating in the country that made people sick. Bacteria jump from host to host as you know, so it is quite normal for an infection in a group of people to be exactly the same. Hence an annual update of the phage medicine ensures it stays effective to the particular genotype of the bacteria. That is right, the phage will only kill the exact one genotype of the targeted bacteria. This means not one phage to kill just one bacteria, it has to be really specific. Hence phage therapy often falls under individualised medicine, where a phage is found for each individual case.

How about the annual flu injection. Every year there is a new cocktail of antivenin to combat the worst flues expected to dominate the country. Are millions of dollars and decades of clinical trials required to get them through the medical authorities to be allowed for human use? How do they get away with it? Why can't we do it with phages? Anyone who wants to get a flu shot can buy one, those who are at highest risk are given them for free.  Why? Because it is proven to work, keep flu numbers down and prevent epidemics. It is in the government's interest to keep us out of hospital and dying. When I walk in the street, go into a pharmacist or doctor surgery, a hospital, or a plane, I am afraid someone with a nasty bacteria infects me. They wouldn't infect healthy people, but my CF lungs most certainly will, and can cause me to be counting daisies within weeks. And yes, many with Cystic Fibrosis wear masks and keep distance, and all of us avoid crowds. I live in Tasmania where crowds are rare and fresh air is prevalent.

Take a hospital infection where a superbug has gone out of control infecting dozens and killing several patients, it is often just the one bacteria to blame. A bacteriophage can be isolated and given to all patients which will in most cases kill the infection without side effects. Of course, this presumption is just merely a presumption, but that is theoretically how bacteriophages work, they are highly targeted enemies of our enemies, they are our friends!

And is it just one bacteriophage that exists to kill that one particular infection? No, shock horror, it is more like real life biology where say us humans are able to get thousands of viruses that could harm or kill us without affecting our goldfish or hamster, as can rabbits get thousands of viruses without harming their fleas and other parasites, or us humans trying to grow carrots in the same fields these rabbits are dying of the various viruses they could potentially catch. Some viruses are more virulent than others. This means the microbiologists need to isolate a cocktail of effective phages for the bacteria they are targeting. It's not rocket science, but will take a lot of biochemists and lab workers to be employed. The alternative our capitalist society seems to prefer is to find a pharmaceutical solution that spends the same or more on a handful of CEOs and investors instead of creating employment for scientists! Win-win for Phages again.

In the Eliava Institue in Georgia, former Russia, 800 scientists used to work there to isolate and distribute phages for all of the USSR, today still 80 or so remain, to help treat people from their country and desperate visitors who come from overseas to seek treatment after the western system has failed for years.

Thank you for reading this far and if you enjoy these regular updates and are interested to see how I go in my quest for killing my Pseudomonas aeruginosa infection with Phage Therapy please share this page and my fundraiser with other people interested in fighting antibiotic resistance in our world! Donations are not for my travel or treatment, they are intended to cover film and media costs etc to let the world know about Bacteriophages.



--
Cheers,

Walter van Praag

Phage Therapy? Please explain again....

I decided to write an analogy of how I see phages, and how I explain it to other people.

Many people still think I am going to get cured, but really I am going for treatment that should be simple and available for anyone around the world, or at least doctors ought to have bacteriophage options in hospitals when treating infections that do not respond to traditional medicine.

So here is my analogy:

The RABBIT PLAGUES

I liken my lungs to a farmers field of rabbits. I cannot use my green paddock anymore as the rabbits eat everything and dig everything up. A little after European Settlers in Australia decided to release 24 rabbits this turned into a nationwide plague within 50 years.  Poisons used to kill the rabbits also killed farm animals and left dangerous residues on crops, and shooting, baiting and trapping seemed pointless. Like the bacteria growing in Cystic Fibrosis lungs, the usual methods of healthy diet, exercise etc is not enough to get rid of my 'rabbits' (infection), so 'poisons' are used; antibiotics. The poisons also affect good bacteria and cause harm, plus eventually, my rabbits don't even care about the poison and the poison is rendered useless. Like in my lungs, the 'rabbits' in the paddock have become very resistant to the rabbit poisons, like the bacterial infection in my lungs has become resistant to the antibiotics.

Now we all know that any overpopulation tends to get diseases, like too many fish in a fishbowl, too many chickens in a hatchery, pigs in a piggery, people in a hospital... or rabbits in a field. This led to excessive use of antibiotics to be used on animal farms to keep the populations healthy. This overuse also contributed to global bacterial infections becoming more resistant to antibiotics. Humans too have been squeezed full of antibiotics, with antibiotics being the most often prescribed medicine of the Century. This has led to more superbugs in society, bacteria that are resistant to most antibiotics.  

So why isn't our world covered in a bacterial ooze growing out of control? For the same reason, overpopulation is stopped by disease, which also happens on a bacterial level. Bacteria are also susceptible to viruses that kill them. Like most viruses, they generally do not travel across the 'species'. Antibiotics are very indiscriminate, affecting all species and all sorts of bacteria, but these natural bacteriophages, viruses, are highly targeted. Scientists found viruses that killed rabbits and isolated them. In Australia that controlled the rabbit numbers very effectively without affecting other species; the Calicivirus.

When people discovered that bacteria have viral enemies, bacteriophages (phage is the Greek word for kill) we started isolating them and using them to heal infections in humans. In the early 1900s this was revolutionary, but when antibiotics were invented in the 1930s phage research stopped as antibiotics could kill a range of bacteria, instead of looking for individual cures (phages) for specific bacterial infections. Many East Bloc countries did not have access to antibiotics and they continued using phage therapy, hence you can find phage-based medicine and prescriptions against common bacteria on pharmacy shelves in Poland, Russia, Georgia, etc. They have not stopped their research in phages, and have hundreds of academic studies and trials in half a dozen or more languages published over the past decades.

Slowly our Western Scientists are waking up to phages: www.phageguard.com. All they need to do is look in dirty places, places where a person with Cystic Fibrosis (or anyone for that matter) can easily contract lung infections; compost bins, soils, garbage tips, sewerages, polluted rivers...  There they can find the bacteria that might be causing my infection in great numbers. Great numbers also mean scientists (biochemists) can also find the bacteriophages killing them. Next, the scientists isolate these phages. They may find several phages for similar genotypes of the same bacteria, and they can formulate and administer tailored phage cocktail to infected people. In combination with antibiotics, this has had enormous success. Like the Calicivirus which killed the majority of rabbits (but not all!). Now bacteria can still become resistant to phages, but for now we have a hugely as yet untapped successful weapon against antibiotic-resistant bacteria, one that is totally underutilised in Western Society. Why aren't we using them more? 

If they are so good,... then why aren't pharmaceutical companies excited about this? Well, as was mentioned, these phages are not artificially synthesised or manufactured in a lab, they are found in nature within the city limits, and they merely need isolating. This means phages are very common and no patents can be claimed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821673; 

success of phage therapy may be hampered by a lack of investment support from large pharmaceutical companies, due to their narrow spectrum of activity in antibiotics, very large costs associated with clinical trials of the variety of phages needed, and regulatory requirements remaining unclear. Intellectual property is difficult to secure for therapeutic phage products for a variety of reasons, and patenting procedures vary widely between the US and the EU. Consequently, companies are more likely to invest in phage products for decontamination or veterinary use, rather than clinical use in humans....  

In Holland, a government official was recently claiming that human trials could be as far away as 20 years before being allowed to be trialled on human subjects in Holland, yet the European Medicines Agency has allowances for phage therapy treatment on humans. In response, the Dutch have submitted a 40,000 signature asking for an explanation of why they have to travel to Poland for phage therapy.

* in the USA the FDA approves phage therapy in individual cases where all conventional drugs have been tired and the situation is serious or life-threatening.
* in Belgium a 'magistral phage regulatory framework' has been introduced where phage products can be prepared by a pharmacist on a doctors authority.

* in Poland and Georgia it is regarded as another medicine and available by prescription for tailored phages or at pharmacies for common infections.

* in the European Union (EU) phages are allowed under approved protocols as outlined by the European Medicines Agency (EMA) - a decentralised agency of the European Union (EU) responsible for the scientific evaluation, supervision and safety monitoring of medicines in the EU. Without the EMA's approval phages would not be available in Belgium or Poland, both EU members.

Some good references; 

American Society for Microbiology: https://jvi.asm.org/content/89/15/7449

We need phage therapy now: https://www.mdpi.com/1999-4915/10/12/688/htm



OH, to help in this noble quest (😅) please donate here; www.facebook.com/donate/390637581737170/

or here; www.gofundme.com/phage-or-fail-with-antibiotics