The Untold Story of Phages By Tom Ireland — Review

An engaging book about the viruses that prey on bacteria, packed with inspirational stories of eccentric scientists, medical miracles and interwoven with how science and history affect each other

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Most people have never heard of bacteriophages, which is rather surprising considering they are the most common and diverse entities on the planet. They can be found anywhere and everywhere that bacteria or archaea occur — soil, air, and water. For example, every teaspoon of seawater contains millions upon millions of different bacteriophages. “[S]maller than the wavelength of light itself,” bacteriophages replicate themselves by targeting and invading a bacterial cell, copying itself madly, with its components spontaneously self-assembling new particles and then exiting — often explosively — often killing its bacterial host cell in the process.

Our discovery of phages (as they’re often called) is relatively recent. At the end of the 1800s, scientists discovered that when they filtered liquids to remove all bacteria, these liquids still destroyed bacterial cultures. Why? What was the cause? The researchers proposed that the filtered fluid contained entities that were “too small to see with a light microscope.”

Soon, scientists adopted the use of these filtered liquids as therapeutics, especially in the former Soviet Union, throughout Central Europe and in France until they were later displaced by the discovery of antibiotics in the 1930s.

“For a few decades in the early twentieth century, the world went mad for phages, and phage therapy was everywhere,” according to science writer, Tom Ireland.

And even today, due to the expense of producing antibiotics, “phage therapy” still persists in the Polish city of Wroclaw, in parts of Russia and especially in Georgia, as it has for many decades.

But phage therapy does not always work because these entities are tricky. Some are only weakly infectious; others are “hyper-specific, targeting only particular strains.” The technology itself is primitive, governments are lax about preclinical testing, and pharmaceutical companies cannot patent phages so they remain uninterested. Further, identifying or designing a phage to attack a specific bacterial strain is challenging, expensive and often time-consuming — and time is not something that a person who is deathly ill has much of. Nonetheless, there have been some dramatic cures.

Meanwhile, widespread abuse of antibiotics by agriculture and medicine has driven the evolution of antibiotic-resistant bacteria, some of which have evolved into monsters that are virtually unstoppable today by any means. This frightening reality is reawakening modern medicine’s dormant interest in phage therapies.

In this provocative and superbly written book, The Good Virus: The Untold Story of Phages: The Most Abundant Life Forms on Earth and What They Can Do For Us (W. W. Norton & Company / Hodder Press, 2023: Amazon US / Amazon UK), author Tom Ireland guides us through the circuitous history of bacteriophages, from the first formal description published in the scientific literature to their role in a number of Nobel Prizes, such as the discovery of DNA and their recent contribution to cutting edge technologies such as CRISPR/Cas9 — a bacterial immune system that evolved to block phage infection or replication within host cells.

This informative book is crammed with engaging stories of brilliant and eccentric scientists at the forefront of phage research who are discovering and working to understand the potential uses of phages. We learn why the Soviet Union embraced phages to fight disease, so they were recognized as the world’s first genuine antibiotic years before penicillin was discovered. We read that even today, in some isolated areas of the former Soviet Union, drinking a vial of phages to cure what ails you is as common as taking an over-the-counter drug.

Although phages are not a panacea, and the author takes pains to tell his readers this, he does describe some astonishing medical case histories and miracle cures to illustrate the promise of phage therapies when they are carefully matched to combat specific bacterial pathogens. Notably, the author summarizes the story from The Perfect Predator, a book written by epidemiologist Steffanie Strathdee about the arduous process to obtain access to phage treatment for her husband after he had been infected with Acinetobacter baumannii, known as “the worst bacteria on the planet” according to the World Health Organization.

Phages have important roles outside of medical settings, too. We learn, for example, how scientists only recently discovered the critically important role of phages to all ecosystems on Earth, from sharing genes necessary to produce oxygen, that influence the carbon cycle or that encode toxins that bacteria can use to cause disease.

One of the best books of any genre that I’ve read in 2023, this superbly-written book relies on exquisite story-telling to interweave science and history and politics into an engaging and readable account that will fascinate absolutely everyone. Whether you are looking for something unique to enthrall your book club friends, something educational to enlighten or inspire future phage hunters, supplemental reading for your university microbiology or ecology students or insights into the complex and subtle ways that politics, history, medicine, science and individual personalities all feedback on and influence each other, you will find it in this remarkable and extraordinarily readable book. Even scientists and medical doctors will find much in this book to intrigue and delight them, and non-specialists will find this eye-opening book is unlike anything they’ve ever read before.

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NOTE: the author of this book was awarded the 2021 RSL Giles St Aubyn Award for Non-Fiction, which supports writers at every stage of the writing process.

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