Breath Test Finds TBTracy Staedter chats with Jose Trevejo, physician researcher at Draper Laboratory in Cambridge, Mass.
Breath of Fresh Air An otherwise time-consuming test could be completed in real time, in just one breath.
Jose Trevejo Trevejo's work in 10 words or less: "I apply cutting-edge technologies to global health issues."
Tuberculosis still infects 8 million people worldwide. For those living in countries with no healthcare system, an infection can lead to death. A portable device that analyzes the breath for TB could be a solution to detecting the disease before it progresses. 1:29 PM imtracynotstacy: Hi Jose
trevejojose: Hi Tracy
imtracynotstacy: Thanks for taking the time to chat with me today.
trevejojose: No problem, I look forward to your questions
1:30 PM imtracynotstacy: Have you ever conducted an interview via IM?
trevejojose: No I haven't, but I have given interviews on the phone
1:32 PM imtracynotstacy: Ok. Well, this forum is meant to casual and informal, so on that note
let's start out by me asking you what you do.....can you describe your work in 10 words or less?
1:34 PM trevejojose: Generally: Application of cutting-edge technologies to global health issues.
imtracynotstacy: What are some of the global health issues you're trying to address?
trevejojose: Our current work focuses on diagnosing tuberculosis via a breath or volatile test.
1:37 PM imtracynotstacy: tuberculosis? I didn't realize that the disease was still around causing problems
1:38 PM trevejojose:
In the US it is not a major cause of illness, but abroad it continues
to infect around 8 million people a year and kill approximately 2
million.
In the US, however, we are worried about very resistant strains of tuberculosis.
imtracynotstacy: wow. 2 million people a year is pretty significant
why are people still being infected by this disease?
why is it such a problem abroad vs. in the US?
1:41 PM trevejojose:
Well first of all it is very difficult to detect if someone has it
until they are pretty sick. The symptoms could range from weight loss
to a cough to sweating at night.
Some
of the main reasons that it returned world wide have to do with lack of
public health infrastructure and the HIV epidemic which leads to
increased susceptibility to tuberculosis.
1:43 PM imtracynotstacy: I see
trevejojose:
For example after the former Soviet Union collapsed the public health
infrastructure collapsed and now they have a very serious problem with
TB in Russia.
1:45 PM imtracynotstacy: So what does a collapsed infrastructure mean for a person suffering from TB? What might be one scenario, for example?
1:46 PM trevejojose:
Well if there is no mechanism in place to look for tuberculosis
regularly and the proper measures are not taken when tuberculosis is
diagnosed it keeps spreading among families and close contacts. I
don't know if you have ever had them do that skin test in your arm, but
basically they are checking to see if you have been exposed to
tuberculosis.
1:48 PM imtracynotstacy: So it sounds like there's a fundamental problem with diagnosis. What do you mean by "proper measures" that need to be taken?
1:50 PM trevejojose:
Drugs have been around since the 1950's to treat tuberculosis so if you
are diagnosed with active disease you would be treated until you are no
longer contagious. Until then people are usually quarantined or have to
wear a respiratory mask when they are around people.
1:51 PM imtracynotstacy: I see. So what is the device you are developing? And how will it serve the need?
1:53 PM trevejojose:
As I said the symptoms for tuberculosis are pretty non-descript (fever,
cough etc) and the current methods to diagnose either take too long or
don't work very well.
Our device would be able to "smell" tuberculosis, either from the patient's breath or a sputum sample.
It
turns out that even thought the bacteria that causes tuberculosis grows
very slowly it gives off volatile compounds that we can detect or
"smell"
imtracynotstacy: You say that the current methods for diagnosis take to long. Why?
1:56 PM trevejojose:
Because they are based on growing the bacteria out of a sputum sample.
The bacteria that causes tuberculosis grows very slowly (about 2 days
to divide) and therefore it takes a while before it can be recognized.
imtracynotstacy: ah
1:57 PM trevejojose:
There are other more modern methods that are a bit faster, but they
don't transfer very well to the field or a clinic where they are needed.
imtracynotstacy: So your device would work faster than 2 days?
1:58 PM trevejojose:
Yes, so far it looks like we can detect within 24 hours and we are
working on even faster. The ideal would be less than 3 hours so that
the patient could be diagnosed almost immediately.
1:59 PM imtracynotstacy: And how potentially would the device work in the field? How would it be used?
2:00 PM trevejojose:
There are two potential versions. The first is more near term in
development and would involve taking a sputum sample from someone and
putting into a vial. The vial would then be sampled by the device and
the diagnosis would be given.
The longer term project would be that someone coudl breath into the device and know instantly if they have tuberculosis.
2:01 PM imtracynotstacy: So some kind of indicator on the device would confirm positive or negative? or something like that?
2:02 PM trevejojose: Yes we are working on a barcode-like readout that would be easy to interpret or just a yes/no indicator.
imtracynotstacy:
And the device is providing that information because it has a sensor
that can sense chemicals off-gassing from the bacteria. Is that right?
2:04 PM trevejojose: Yes we would be detecting chemical volatiles from the bacteria that would be concentrated and measured by the device.
2:05 PM imtracynotstacy: Interesting. How did you get into this kind of research....developing devices that could address global health issues?
2:06 PM trevejojose:
Well I have always been fascinated by both technology and infectious
diseases. As I child I grew up in Africa and both of my parents were
very ill from malaria. As for science, I was alway a dreamer.
2:07 PM imtracynotstacy: If you could dream really really big on this one.....what would you dream?
trevejojose:
Well there are some estimates that if we developed a point-of-care
diagnostic for tuberculosis we could save 200,000 lives a year or
more....
So
I would say getting this technology out there to the people who need
it. I think that is the exciting thing about this is that technology
shouldn't just make it easier to download music or order books it
should help save lives.
2:10 PM imtracynotstacy: How soon before such a technology would be out in the field?
trevejojose:
It is hard to say, if The Bill Gates Foundation showed up with a blank
check maybe 2-4 years. There are always unexpected surprises with
biology though and the bacteria that causes tuberculosis is very tricky
to work with.
imtracynotstacy: Do you have other diseases or world health issues in your sites?
2:13 PM trevejojose:
Well upper respiratory diseases in general are one of the largest
causes of infectious deaths worldwide so flu, pneumonia are other
potential diseases that would benefit from a rapid diagnosis.
2:14 PM imtracynotstacy:
Great. I've asked you about your dream and hope, what about the
day-to-day? What do you do on a day-to-day basis, as a researcher?
2:16 PM trevejojose:
Many things: plan experiments, troubleshoot recent experiments, try and
secure more funding for this and other projects, give talks.....I am
giving one in about two hours. One of my favorite things to do is also
to mentor students and get other people excited about science.
2:17 PM imtracynotstacy: What do you like least about research trevejojose:
It is incredibly frustrating and long term. I also am a practicing
physician and the feedback when you help someone is instant. In
research, you have to be ready for dissapointment and failures. In
fact, if you think about it, when something gets solved we move on
immediately to a problem that is not yet solved so we are deliberately
taking on difficult or impossible challenges.
2:21 PM imtracynotstacy: Addressing the impossible. Not everyone is cut out for that!
I know you have to go soon, so just one more questions
question
Do
thoughts of infectious disease enter your personal time? Like if you're
on the subway and someone coughs, do you wonder....TB? Or things like
that?
2:24 PM trevejojose:
Well I love to eat good food and too much knowledge is a dangerous
thing....for example soft cheeses or hollandaise sauce or even caeser
salad can be dangerous if they are not handled well.
imtracynotstacy: what about sushi?
2:26 PM trevejojose:
I love sushi....if the restaurant takes good care of the sushi to
prevent normal contamination the only risk in certain types of fish
like cod is a worm. We are not it's natural host though so it is not a
big risk.....
Doesn't stop me from ordering my favorites: spicy tuna roll and yellow tail...mmmmmm
imtracynotstacy:
Also, what are your thoughts on the 5-second rule? Drop something on
the floor and it's okay to eat as long as it hasn't been down for more
than 5 seconds? Or do you toss?
2:27 PM trevejojose: Officially I say don't risk it, but unofficially it depends on what you dropped ;-)
imtracynotstacy: Ha! Well, this has certainly been fun chatting with you.
I'll let you get back to your full list of duties
2:29 PM trevejojose: The pleasure was all mine.....hope I didn't keep you from going out to eat sushi.
imtracynotstacy: Actually, you made it seem less risky than I thought. I might even have some tonight!
2:30 PM trevejojose: Great take care
imtracynotstacy: All the best. Goodbye |
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