- Shigella bacteria kills thousands of people every year and currently there is no vaccine for it.
- 26-year-old, Ebert participated in an inpatient vaccine trial that required him to drink a Shigella smoothie.
- Despite the severe effects of the smoothie, Ebert said he would do it again. Both for the money and for humanitarian cause.
This article describes the case of a man who drank a dysentery smoothie as part of a human challenge trial to develop a potential vaccine for Shigella bacteria. The bacteria is known to cause around 80 to 165 million cases of Shigellosis each year. And of these cases, about 600,000 people lose their lives annually because of the infection. Most of the cases occur in temperate or tropical climates. The infection lingers in the intestine with watery, bloody or mucusy diarrhoea symptoms. It may also cause fever, nausea and stomach cramps.
How do the bacteria transmit?
A subtype of Shigella is S. dysenteriae, which is a cause of epidemic dysentery and infectious gastroenteritis. The infection presents with symptoms of bloody diarrhoea. The bacteria transmits through the faecal-oral route. Meaning, that the bacteria is ingested through contaminated foods or fingers.
In addition, the bacteria can also transfer through contact with surfaces containing bacteria or via sexual contact. Currently, teams in the US and France are working to create a vaccine for the disease. However, for creating the vaccine, they need volunteers who are willing to participate in the “human challenge” trials. In this trial, people are infected with the bacteria to test the efficiency of the vaccine. While finding volunteers for such “risky” trials is difficult, there are always a few people willing to take the bait. One such volunteer is Jake Eberts. He participated in a phase two trial at the University of Maryland School of Medicine.
In this trial, the participants were to be infected with the bacteria to test the efficacy of the vaccine. In any such trials, the participants are initially informed that some participants are given a placebo vaccine, whereas others are given the vaccine. Those given the vaccine may experience unpleasant diarrhoea and are kept under close supervision.
Here’s how everything went down with the Shigella smoothie
Jake took part in an 11-day inpatient trial at the University of Maryland, that pays $3,150 to $7,350 for both the money and good humanity. He further posted about his experience in excruciating detail on his Twitter feed. The first shots were given to him in February and March. However, it wasn’t revealed whether he was getting the vaccine or a placebo. The next part of the trial was to drink a shot of “Shigella smoothie”, a smoothie infused with diarrhoea causing bacteria, to introduce him to the infection.
While he felt fine for the first few days, on the fifth day he woke up with cramps late at night. He suspected that the cramps in all likelihood would soon progress into dysentery. And it did. “Fever/chills got super ugly around 4 am,” he wrote on Twitter. “No diarrhoea yet, but Chekhov’s diarrhoea revolver is now just hanging above me and every time I fart I’m pulling the trigger in the world’s worst game of Russian roulette.”
Although what followed were the “worst 8 hours” of Ebert’s life, he said he would do it again for the money and because it was for a good cause. “Probably around 3 pm yesterday is when things turned really ugly,” he wrote. “I went to go to the bathroom and every single part of that – getting up, walking, grabbing toilet paper – felt like a Herculean effort. I was so exhausted that I just laid down on the bathroom floor for several mins”.
“It felt like 15-20 minutes but I was at best mildly lucid so I truly have no idea. The nurses quickly realized there was an issue and waited for me outside the bathroom. Dr Chen quickly came in and they started treating me.”
Doctors treated him with antibiotics, and after a while, his GI symptoms began to get better
Doctors treated the infection with antibiotics and after a while, his gastrointestinal distress began to get better. Ebert’s bowel movements were captured during the trial and will be studied to see the amount of anti-shigella IgA antibodies they contain. This will enable the team to know the effectiveness of the vaccine. However, since Ebert did not have any reaction to the initial jabs, he believed that he most likely received the placebo, in addition to his severe reaction to the smoothie.
“The entire time, I was like, ‘Wow, this is an awful disease.’ And I just got really emotional, probably also because I was just delirious, about the thought of small children in the developing world dealing with this,” he told Insider of the experience.
“I don’t want to make myself out to be Mother Teresa here – would not have done this for free. It’s a big ask to ask someone to get dysentery.”
Dr Wilber Chen, the lead researcher of the trial hopes that the vaccine will show 70% protection and if it does not show at least 50% protection then the vaccine has unfortunately failed.