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Rapid Test: “Strep Can Be Found All Over the World“
Gursharan Singh Chhatwal;
They cannot be seen with the naked eye and yet we are surrounded by them every day: Germs like strep can make us sick – urinary tract infections, tonsillitis or meningitis – and without antibiotics you can often not tackle them. Scientists have tried for many years to find effective vaccines against these germs.
MEDICA.de spoke with Professor Gursharan Singh Chhatwal, Head of Department for Medical Microbiology at the Helmholtz Research Center for infectious diseases, about the research on dangerous germs and aids that are now implemented in India for strep-infected children.
MEDICA.de: Professor Chhatwal, your task force researches germs to be able to produce vaccines for instance. How do germs become potential candidates for your research?
Gursharan Singh Chhatwal: For one, we are looking at the relevance, that is determining how often new diseases appear because of a specific germ. Here is an example: At present we are examining strep type a. Each year, more than 700 million people all over the world get infected by this type of germ. 800-900,000 people die from them. And strep is everywhere, meaning this is not a disease that just appears in developing countries, but also in Germany or the US. The second criterion raises the question concerning a vaccine. Is there already an effective vaccine available or not? The latter is the case for strep. To summarize: The germ is relevant, a vaccine is necessary – thus we analyze this virus.
MEDICA.de: If you manage to identify the bacteria‘s contact points, do you then also develop vaccines?
Chhatwal: No, this is not our job. We are working on determining whether a vaccine is safe or if it works like it should work. We test this in animal experiments. For example, we want to find out, whether a serum produces enough antibodies in the body or whether the immune response is sufficient respectively.
So far, no vaccine could be found that is effective against all strep; © PHIL
MEDICA.de: Currently, you are working on developing a rapid test that is meant to also be used in developing countries and can diagnose strep in patients. What is this test for?
Chhatwal: For 20 years, research has tried to create a vaccine against strep. We also found a few good candidates, but unfortunately they did not fulfill the requirements to be passed on to the industry. In India a large survey was now conducted, because strep can be found all over the world. But in developing countries, children much more frequently develop rheumatic fever, a disease that causes heart valve infections. This so-called Rheumatic Heart Disease can be traced back to a specific group of strep. But streptococcus is sectioned into 150 different types and of these, only three to four percent trigger this disease.
There are presently 6 million children in India between the ages of five and fifteen which are struck by this rheumatic heart disease. Approximately 400,000 die from it each year. We now have investigated why this is, because strep can also be found in the US or in Germany, where also millions of children get infected each year – however these children do not fall ill with rheumatic fever.
One reason for this distribution is that in the US or in Europe pediatricians immediately prescribe penicillin for at least 14 days, even if they merely suspect a strep infection. Then the streptococcus has disappeared. Yet this is not what happens in developing countries, even if the physician knows the child is infected with strep, because the child feels well again after taking just two penicillin pills. The medicine is no longer taken – and the streptococcus survives. It then causes the rheumatic heart disease. The reason for this insufficient drug use is that in India several hundred children come to the so-called Primary Health Centers each day. The doctors examine 30 to 40 patients per hour. That is why there is barely any time to educate patients about this disease. The physicians therefore say: Only three to four percent of all streptococcus strains cause this disease, meaning 95 percent of children are not affected. And we cannot monitor whether all children really take the penicillin for 14 days or not.
The physicians therefore need a test which indicates whether the strep is able to cause the rheumatic heart disease. And we have developed such a test. We figured out what these three percent of strains have and the others do not. We have discovered a peptide, which is specific and necessary to trigger the rheumatic heart disease. The test works just like a normal strep test – you take a swab for the specimen slide, and after two minutes you know whether the child has the type of strep that is considered among the dangerous three percent. For these affected children you can take more time, for example by having a helper go to the child’s house each day and have the child take the penicillin in his/her presence.
The interview was conducted by Simone Ernst and translated by Elena O’Meara