A man has documented, in glorious detail, how he drank a dysentery smoothie as part of a human challenge trial for a potential vaccine.
Shigella bacteria causes around 80–165 million cases of Shigellosis per year, and of these, it goes on to kill around 600,000 people annually, largely in areas with temperate or tropical climates. The infection lurks in the intestine, causing symptoms including watery, bloody, or mucusy diarrhea, as well as fever, nausea, and stomach cramps. A subtype of shigella – S. dysenteriae – causes epidemic dysentery, or infectious gastroenteritis that brings about bloody diarrhea. It is largely contracted through the "fecal-oral" route, through consuming contaminated water and food, contact with surfaces containing the bacteria, or sexual contact.
Several teams – one in the US and one in France – are currently attempting to create a vaccine for the disease, but for this they need volunteers who are willing to participate in "human challenge" trials, where people will be infected with bacteria in order to test the vaccine's efficacy. Fortunately, there are such heroes willing to undertake the ordeal, knowing that they could be one of the unlucky participants who are given a placebo vaccine and will spend a number of days experiencing quite unpleasant diarrhea under close supervision.
One such hero is Jake Eberts, who took part in a phase two trial taking place at the University of Maryland School of Medicine. Jake took part in the trial, which pays $3,150 to $7,350, partly for the money and partly for the good of humanity. It also helped his Twitter feed, as he detailed the experience in excruciating detail. First Eberts was given shots back in February and March before his inpatient stay, not knowing whether he was receiving the vaccine or a placebo.
Then came the icky part – drinking a shot of "Shigella smoothie" (as he puts it) in order to induce infection.
For the first few days he felt fine, but on day five he woke up late at night with cramps, which he suspected would soon progress into dysentery.
"Fever/chills got super ugly around 4am," he wrote on Twitter. "No diarrhea yet, but Chekhov’s diarrhea 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."
Chekhov soon did his thing, and he soon experienced diarrhea, along with blood in his stools.
"Probably around 3pm 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."
He was treated with antibiotics for the infection, and, after much gastrointestinal distress, began to get better again.
The bowel movements he captured during the trial will be studied to see the amount of anti-shigella IgA antibodies they contain, enabling the research team to know how effective the vaccine is. However, Eberts believes that he likely received a placebo, given that he had no reaction to the initial jabs, and one hell of a reaction to his smoothie.
The experience gave him first-hand insight into how children must feel with the disease, prompting him to start a fundraiser for sanitation infrastructure.
"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 Wilbur Chen, who is leading the trial, is hoping for 70 percent protection from the vaccine, adding to Insider that if it doesn't show 50 percent protection against severe disease, then the vaccine has unfortunately failed.
The researchers still need people for further trials, should you be interested.
Meanwhile, another team at Institut Pasteur in France is also working on a vaccine.
"The monetary compensation and philanthropic feelings have faded as motivating factors for me," as Jake wrote during his ordeal. "My primary concern is now beating the French."