A teenager given a one per cent chance of surviving a dangerous infection has been saved by an experimental cocktail of viruses.

Scientists have hailed the “remarkable” recovery of 17-year-old Isabelle Carnell-Holdaway, who came down with a bug related to tuberculosis following a lung transplant at Great Ormond Street Hospital.

No previous transplant patient to have been infected with Mycobacterium abscessus at the hospital has survived.

However, Isabelle, who was born with cystic fibrosis, is now out of grave danger after being given untested “phage therapy”.

Also known as bacteriophages, phages are a naturally occurring virus that attacks bacteria rather than the body’s own cells.

Yes, excellent.

The Great Ormond Street team obtained phages from the Howard Hughes Medical Institute in the US after Isabelle’s mother Jo read about the treatment on the internet.

Whut?

49 thoughts on “Dr Google”

  1. No previous transplant patient to have been infected with Mycobacterium abscessus at the hospital has survived.

    I wonder how the rate of infection compares with decent (or even average) healthcare systems.

  2. I heard somewhere that much of the early research into medical uses of phages was done in the USSR as they were shut out of the antibiotic research being done in the West after the commercial exploitation of penicillin. Can someone with real knowledge comment?

  3. Bloke in North Dorset

    Have I got this right – genetically modified crops from the USA are a no-no, but genetically modified humans are OK?

  4. How do we select doctors? We pick the kids who are really good at learning by rote (because that’s what biology and chemistry are) and then teach them medicine, which is also mostly learning by rote.

    I beat 2 GPs, a locum and an ENT with 2 hours and the internet. No chemistry, no biology. Just me, and my general skills at diagnosis and reading up on stuff. And the key, single thing they missed was that I’d had medical work done just before it happened. They also said that had no effect (and anyone who does diagnosis knows that 95% of the time the last change is the problem). A quick trip to the dentist and I was right as rain.

    Never, ever believe a GP who tells you nothing more can be done. They don’t know much and haven’t taken even a cursory glance of what is out there. I’d rather trust the cunts that work the front desk of Currys for computer advice than these overpaid motherfuckers.

  5. BoM4, given that you seem to talk in riddles, you should not be so quick to blame the doctors for not having a clue what was wrong with you. If the problem was with your teeth, why visit a doctor?

  6. Let’s face it, most of us view our local GP as the gatekeeper to someone that can (hopefully) read and write – a consultant with a modicum of expertise. Unfortunately even in our hospitals it’s often a question of potluck, given medics are no different to most other trades and professions: a limited pool of outstanding talent, a fair proportion of the reasonably competent, lots of makeweights and a good percentage of incompetents. We probably expect too much from our medics and often endow them with ‘magic wand’ properties. All of us have friends in the business and appreciate it’s a tough old job. Just don’t take what they tell you as gospel.

  7. Diogenes
    “The ease of production of antibiotics, the relatively broad spectrum of action of antibiotics, and the stability of the preparations were advantages over phages. In the Soviet Union, however, phages continued to be used, probably for economic reasons, and perhaps even for ideological reasons: The State Serum and Vaccine Institute in Tbilisi, Georgia, was a major source of phages and could be held up as a success of Soviet science against the capitalist West. Conversely, in the postwar period, maintaining a distance from anything Soviet, be it ideas, politics, or even medicine, was important in the United States. Thus, to some extent, phage therapy became politically tainted as well.”

    https://www.annualreviews.org/doi/full/10.1146/annurev.micro.55.1.437
    Bacteriophage therapy

  8. Confused,

    Because the problem manifested itself in my ear. But was related to my teeth.

  9. BOM4
    “Never, ever believe a GP who tells you nothing more can be done. They don’t know much and haven’t taken even a cursory glance of what is out there. I’d rather trust the cunts that work the front desk of Currys for computer advice than these overpaid motherfuckers.”
    A big hoorah for this. What I don’t understand is why we seem prepared to shovel huge money at them for their downright incompetence. Other countries treat medicine much more as a vocation with pay that is far more middle range than us.

    Frankly, to borrow from the appendix blog, I’d expect to get as least as good an outcome from following Monty Python’s instructions on how to take my appendix out on the Piccadilly line, than relying on most doctors in NHS hospitals.

  10. Bernie G,

    It’s also about barriers to entry.

    GPs remind me of some of the programmers I worked with in the mid-80s, in the mainframe days. Real jobsworth journeymen and incompetents. Then home computers and PCs came along and anyone could have a go at programming.

  11. As part of why phage therapy hasn’t been intensively studied in the west: you cannot patent and receive royalties from marketing naturally occurring viruses.

  12. So they are celebrating–call it–that they have saved someone from their own incompetence and the unsanitary conditions of the NHS? After already failing to save God knows how many others?
    .

  13. UK GPs and NHS doctors are not dependent on customer satisfaction for their pay but upon compliance with bureaucracy.

  14. I’d like to second BoM4 by saying that the bulk of GPs are thick, lazy, useless, overpaid cunts who couldn’t diagnose their way out of a paper bag.

    Such is the cult of the NHS is that it is getting praised for managing to solve its own fuck-ups, with the aid of google and a pushy Mum.

    I bet substantial numbers die each year because either they don’t have family support or the family is too deferential to the state religion.

  15. LJH said: “As part of why phage therapy hasn’t been intensively studied in the west: you cannot patent and receive royalties from marketing naturally occurring viruses”

    Well, that’s complete and utter c*ckrot right there… Of course you can.

    The first one I came across, which took all of 30 seconds of looking:

    EP3130669 B1, granted independent claim: “. A bacteriophage FCJ28 (KCCM11466P) having a specific ability to kill enterotoxigenic Escherichia coli. “.

    European grant was published yesterday. Not granted in the US yet.

    There are over 3000 patent families in the Patbase database with the word “bacteriophage” in the claims.

  16. Further to last: that one there is a basic claim to the phage itself.

    There are other more clever ways of claiming, so-called “first medical use” and “second medical use” -type claims, where if you discover that some naturally-occurring substance has therapeutic properties you can get a patent for its use as such, “method of manufacturing a medicinal preparation”, “medicinal preparation comprising…” claims and other exotics.

    But that’s nowhere near as morally satisfying as falsely accusing Big Pharma of lack of interest due to a false belief that they can’t patent phages and profit from licensing revenues, am I right? 😀

  17. Abacab: I stand corrected if cleverer patenting has evolved but that was not the case thirty years ago when this was a real obstacle. I suspect progress is due to the recently acquired ability to tweak viruses into new “synthetic” forms which can be patented. I repeat pre the genetic engineering revolution no one was interested in funding research into them, despite the potential therapeutic value.

  18. Who paid for it? Was it men-only fundraising?
    What is the use of treatment if the money is contaminated?

  19. ” I suspect progress is due to the recently acquired ability to tweak viruses into new “synthetic” forms which can be patented.”

    Wut? Inventions based around isolating naturally-occurring microorganisms were foreseen already in the original 1973 text of the European Patent Convention, decades before genetic engineering. See e.g. EPC’73 Rule 28, which provides the rules for the deposit of biological material not otherwise available to the public.

    Anyway, I literally just explained to you how to patent new uses of naturally-occuring things… Whether it’s synthetic or not is a red herring. And this is nothing new.

    For instance, if you discover that rock salt from a particular cave in Outer Mongolia has a theraputic benefit for the treatment of headlice (or whatever), you can patent this.

  20. Just looked – there’s bacteriophage-related patents going back to the 1920’s and 30’s…

  21. Bernie G

    ” ………given medics are no different to most other trades and professions: a limited pool of outstanding talent, a fair proportion of the reasonably competent, lots of makeweights and a good percentage of incompetents.”

    Same as everywhere else: only the Square Root of the number of employees actually does anything to achieve the stated purpose of the organisation.

  22. Ljh

    “….you cannot patent and receive royalties from marketing naturally occurring viruses.”

    One of the curses of modern parmaceutical research. There are plenty of substances out there – Co-Enzyme Q10, Vitamin D, Milk Thistle, etc, etc – which have large anecdotal health benefits, but no one is going to fund a proper trial if they can’t make money off of them.

  23. “no one is going to fund a proper trial if they can’t make money off of them.” Oh I don’t know: isn’t that the sort of thing the NHS should fund, using money saved by sacking all the puritan propagandists it employs?

  24. “Ljh

    UK GPs and NHS doctors are not dependent on customer satisfaction for their pay but upon compliance with bureaucracy.”

    Although even if they were so dependent, it might not help. Very few of Harold Shipman’s patients complained.

  25. Off-topic but I see the PC SJW’s have claimed another victim in the sacking of Danny Baker.

  26. Andrew C, indeed. BBC are fucking wankers cancelling the Danny Baker show. No more sausage sandwich game – utter utter cunts

  27. Dennis the Peasant

    All this talk about GPs misses the point. She’d just had a lung transplant. Her mom wasn’t dealing with GPs. She was dealing with specialists… supposedly the best of the best.

  28. “no one is going to fund a proper trial if they can’t make money off of them.”

    Err, health insurance companies? State-run systems like the NHS?

    It would be a massive boon for health insurers, NHS etc. if e.g. Vit D could be used to cure expensive-to-treat cases.

    Occam’s Razor, however, indicates rather that the “anecdotal evidence” around such thing is entirely beaulocks…

  29. In the current climate and given his public persona, Danny Boy has either been missing on another planet this past year or two; never reads the papers or listens to the news; was pissed as a newt when he tweeted; or is just about the dumbest shit employed by the BBC (and that’s saying something).

  30. @Henry Crun

    And I bet the cunts who complained are anti-royalists anyway. They aren’t interested in any real offence, just revel in bringing anyone down for anyone saying or doing anything that they can look at obliquely squinting with one eye shut and see something they can misconstrue as not SJW approved PC blandspeak.

    IIRC Baker used to do an imaginary skit on his show (on the radio) which consisted of a procession of chimps supposedly dressed as historical and famous figures.

    I can’t stand watching or listening to the BBC news anymore. A non-stop deluge of multi-cultural men-bashing shyte.

  31. Wife did an Advanced Life Support Course recently, it was 6 doctors and her (nurse with over a decade of ICU experience).
    She breezes through it and scored 100% on the final test, they all struggled, she was shocked at the basic stuff the missed and when she handed her test in and left they were mostly only half way through and most looking worried.
    Of course in a situation that called for using these skills she would be expected to defer to the doctor

  32. Bnic, surely she’d be expected to let the doctor take the lead but call out anything she was unhappy about?

  33. @Confused May 9, 2019 at 9:31 am

    Yep, everything between lips and uvula is dentist territory

    .
    @Bloke on M4 May 9, 2019 at 10:06 am

    What was the diagnosis – upper molar abscess pressure on nerve?

  34. “I bet substantial numbers die each year because either they don’t have family support or the family is too deferential to the state religion.”

    A little known report was compiled by one of the largest NHS Trusts (possible Leicester but don’t quote me) whereby they took the medical records of every patient who died with a certain period of being admitted to one of their hospitals (maybe a month) and then gamed those cases with a panel of experts – ie gave them the initial facts, let them make a diagnosis and course of action, then compared what actually happened, at each stage of the patients treatment. They discovered that 25% of deaths contained significant errors in treatment and diagnosis that could well have either caused or hastened the patients demise.

    Edit: found the article, its actually about a doctor who made an serious error causing a boys death, and was struck off but then reinstated:

    https://www.bbc.co.uk/news/resources/idt-sh/the_struck_off_doctor

    Quote In 2013, Leicester GPs had started to become concerned about the University Hospitals of Leicester Trust’s SHMI. It had been higher than it should have been since the SHMI was introduced in 2010.

    After deliberating with the Trust, they asked Dr Ron Hsu, then a public health consultant and now associate professor at the University of Leicester, to investigate further.

    He met representatives from the local Clinical Commissioning Groups, the hospital and NHS England to devise and agree a plan.

    Teams of doctors and nurses were tasked with going through the records of patients who had either unexpectedly died in hospital or died within 30 days of leaving between 1 April 2012 and 31 March 2013. It didn’t look at paediatrics.

    They focused on a sample that would help them identify systematic clinical issues. This is where you learn the most, Dr Hsu says.

    In large rooms set aside in the hospital, the teams pored over patients’ notes looking at the kind of care they were receiving and identifying things they thought had gone wrong.

    The bar was set high – a team of doctors or nurses had to be unanimous before they agreed a patient had received poor care, Dr Hsu says.

    When Dr Hsu came to tally the results, he did not believe what he saw. “It was shocking. Based on what I read I was expecting around 10% of patients to have received unacceptable care,” he says.

    But in fact nearly a quarter of patients in the report had received “unacceptable care” – serious errors had been made that would have increased the risk of harm.

    So there you go, if you go into hospital and die, there’s a 25% chance the ‘wonder of the world’ NHS will have killed you through negligence.

  35. Well thanks Jim, that’s an article that could be the canonical reference for “ignorance is bliss”: having read it, I’m going to steer clear of hospitals for everything up to and including limb amputation

  36. Oh well, Hopper, if you want a horror story: I had an NHS operation where the anaesthetic wore off too early. I can tell you that’s bloody painful.

  37. Bloke in North Dorset

    Surprised Jim’s link was the BBC, must have been buried quite deep.

    Isn’t one of the major complaints against the US healthcare system that its too expensive because doctors are incentivised to carry out expensive tests that might not be necessary? Maybe they’re on to something?

  38. So… Big proviso.. If the USSR were big on phage research while the West built antibiotics, as reported by El señor Ken, Maybe we should cosy up to Putin

  39. “Surprised Jim’s link was the BBC, must have been buried quite deep”

    The article was mostly about the travails of a suitably ethnic female doctor who misdiagnosed a young boy who arrived in hospital and he died as a result. The section that I quoted was only a very small part of the whole article, and the implications of it were never discussed. I suspect it would never have been published on the BBC as a stand alone article.

  40. Was that the doctor that was reinstated following appeals despite a conviction for negligence.
    I think she also was just suspended for most of it and took maternity leave during the suspension

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