Thanks to research by Lee Gehrke, a professor of health sciences and technology, and other researchers at Harvard and MIT, viruses like Ebola may be more rapidly detected and tracked than ever before. The rapid diagnostic, which can detect deadly pathogens in under 30 minutes, is part of an interdisciplinary project supported by the National Institutes of Health.
This invention has grown out years of research at Gehrke’s lab on RNA viruses, viruses that have one-stranded RNA rather than DNA as their genome. Ebola is an example of an RNA virus. The researchers are pairing the rapid diagnostic with a phone application to allow the spread of the viruses to be tracked via real-time maps.
30 MINUTES OR LESS
Gehrke said that the goal of the researchers was to develop a rapid diagnostic test that can perform in under 30 minutes and can be used as a point-of-care device to evaluate patients with fevers, which can indicate many different underlying diseases.
“If a patient comes into a clinic and has a fever, you want to be able to rule out some pathogens,” he said. “In West Africa, there are a number of viruses that would present as fever, including Ebola, Lassa, and Marburg, so it is very useful to get a very quick idea of what the patient is suffering from.”
While the Ebola outbreak in West Africa has ascended to international media headlines in recent months, Gehrke warned against ignoring other dangerous viruses.
“Ebola is a terrible disease, but it is not the only one that I think we should be prepared for,” Gehrke added. “There are other emerging viruses that we also need to have a great sense of preparedness for.”
The device is specific for several viruses, including Ebola and dengue fever, and it can detect more than one pathogen at once, according to Gehrke.
“By detecting whether a person’s fever is in fact a symptom of Ebola, the rapid diagnostic can help better quarantine people,” said Kimberly Hamad-Schifferli, MIT professor and senior collaborator on this project.
Gehrke also attested to the value of rapid detection of the virus.
“Being able to detect the virus and identify the people or environments that are contaminated is very important for reducing or stopping the spread. Early detection is important for treatment,” he said.
NUTS AND BOLTS
Unlike other diagnostic tools, the Harvard and MIT-developed device can be operated cheaply by personnel with little training in a variety of settings. Competing approaches, like polymerase chain reaction, require more time and expensive equipment.
“This approach gives much greater flexibility, cost control, and adaptability in responding to outbreaks of different emerging pathogens in different parts of the world,” Gehrke wrote in an email.
Gehrke attributed this flexibility in part to the ability of the device to operate without power or refrigeration. The device does not require specialized chemicals, equipment, or training, researchers said.
“We are interested in making something that can detect disease rapidly and can be operated by an end user, or someone who is not medically trained or a technician,” Hamad-Schifferli said.
The device uses a sample of a body fluid, such as blood, serum, or saliva, to test a patient, Gehrke said. The test operates by diverting the sample in a maze-like structure and making it run into chemicals, said José Gómez-Márquez, director of the Little Devices Lab at MIT and senior collaborator on this research.
According to MIT postdoctoral fellow Justina Tam, who is working on visual markers, or detection agents, for the rapid diagnostic, “the detection agents are agents that have some visible color if they accumulate in a certain area of the test, which means a protein for a specific virus is present in the sample.”
Not only does this visible color indicate whether a patient is infected with a virus, but it also reveals the virus’s specific strain.
REAL-TIME RESULTS
According to Gómez-Márquez, aggregating the results of the rapid diagnostic through an accompanying phone app allows researchers to track the spread of viruses in real-time, which he hopes will prevent their spread in the future.
He called the device a crowdsource diagnostic because it relies on many users to send images of their results via the phone app. The diagnostic itself gives a result, but the phone app quantifies it and measures the location of the infectious diseases so that the spread of viruses can be tracked rapidly, Gómez-Márquez said.
“If we can do that for hundreds of patients, then we can get a real-time map of the spread of the disease,” he added.
He said that up to now, maps of the spread of viruses include information of what occurred in the past, based on death records and hospital records that are weeks old. The new technology gives health providers a better understanding of the path viruses could take in the future.
“In public health, we don’t have real-time maps for epidemiology, but that’s important for saving the next lives.The prevailing attitude is looking at the past, which doesn’t allow us to help the future,” he said.
According to Gómez-Márquez, several people are working on the phone app for different platforms, including the Android phone.
According to JN Fang ’16, who is working on an Android version of the app, health workers administering the diagnostic will be able to use the app to read and aggregate the results of the test. The app can determine “if...the change in test strips is enough of a change to indicate that the patient has tested positive for either of the four strains of dengue fever or Ebola,” she said.
After testing the diagnostic in the laboratory, Gehrke said his lab is currently field-testing the device. According to Gehrke, the commercial launch of the device will depend on the regulatory process for approval by the FDA.
This rapid diagnostic will be another tool among “a number of different methods [that] are going to be necessary for detecting and hopefully stopping this virus and other infectious viruses,” Gehrke said.
Source: The Havard Crimson