By: Kellie Vinal, Ph.D.

What if we could stop an outbreak of Legionnaires’ disease before it began? Up until now, that’s been an incredibly difficult prospect — one might say it’s virtually impossible.

Enter Dr. Paul Lem, an infectious disease medical doctor and CEO of Spartan Bioscience Inc. With a new device he’s spent the last 12 years developing – the world’s smallest on-site DNA analyzer — he’s hoping to revolutionize the standard protocol of testing for Legionnaires’ disease.

The threat of Legionnaires’ disease

Legionnaires’ disease, which causes a severe form of pneumonia, is contracted by inhaling small, airborne droplets of water containing a type of bacterium called Legionella. In 2015, there were about 6,000 reported cases of Legionnaires’ disease in the United States. However, some infected individuals recover without an issue or doctor’s visit, and others don’t realize the pneumonia they’ve contracted is actually Legionnaires’ disease.

“I think the math breaks down to about 5 million cases of pneumonia [in the United States], and then 2-9% of them are Legionnaires’,” says Dr. Lem.

As such, the CDC predicts that many cases of Legionnaires’ are underdiagnosed and/or unreported. Alarmingly, approximately 10% of all people who get infected with Legionnaires’ disease will die.

Adding to the problem, Dr. Lem says, “On the medical side, we don’t actually routinely check for Legionnaires’. We just treat it. And no one really thinks about how we eliminate it at the source.”

Legionella, the bacteria responsible for the disease, is found naturally in fresh bodies of water, but causes a threat when it infects man-made cooling towers, ventilation systems, and air conditioners that are common in hospitals, shopping malls, hotels, and large office buildings.

Though there are ways to test water samples for the causative agent of Legionnaires disease, the testing process itself is tricky and time-consuming, involving growing notoriously difficult-to-grow bacteria on petri dishes. In many cases, the resources just aren’t available to check every potential reservoir of the bacteria — imagine sampling and testing each office building or mall’s cooling tower regularly using the petri dish method (also called “culture testing”).

“In forward-thinking jurisdictions, like New York City for example, you test every cooling tower once a month with culture testing. But everyone knows culture testing can take about two weeks to get a result, and it’s not [necessarily] accurate,” says Dr. Lem.

Revolutionizing detection of Legionella

Now, thanks to Dr. Lem and his team at Spartan Bioscience Inc., the future of Legonnaires’ disease prevention is significantly improving. Using a new portable DNA testing device approximately the size of a clock radio called the Spartan Cube, building managers can now test a sample on-site and get results within 45 minutes.

“Finally, for the first time, in the 40 years since Legionnaires’ was discovered, there’s actually going to be a solution that we have on-site [that will] prevent Legionella from ever getting out of control and infecting people.”

So, how does it work?

“Imagine you’re a building manager,” Dr. Lem says, “you would go up onto the roof, go to your cooling tower, collect a sample [of about] 100 mL of water. You’d bring it down to the device, which is about the size of a coffee cup. The device has a consumable cartridge – you use a syringe and put that water into [it], and then what it does is filters and concentrates the water and puts it into a tiny DNA testing cartridge. You put that cartridge into our box, hit ‘go’ on the touch screen, then 45 minutes later, it’ll tell you how much Legionella – the concentration – that’s in your water sample.”

The future of disease prevention

Dr. Lem’s team predicts this technology will expand to prevent the spread of other diseases, as well.

“We always had this vision that [the Spartan Cube platform] was going to be like the Microsoft Xbox. Once you have the platform, you can make dozens of games on it and [we hoped] that people would be coming to us and telling us what game they wanted to make,” he says.

As they evolve and expand, Dr. Lem cites several areas of focus to improve their technology. In addition to making their already-speedy test even quicker, he hopes to increase accessibility for this kind of DNA testing.

“We’re hoping to lower the cost of these DNA tests so they’re affordable and accessible to everyone,” he says.

“We are working toward this grand vision, which is DNA [testing] devices everywhere – in your home, in every building, every school, every office, every hospital, every doctors office, every pharmacy,” he says. “I think the next step is, we need to broaden out our test menu, so kind of like the iPhone and the app store, we have our first app. We want to now create dozens, hundreds, thousands of apps – [to] have a whole test menu to choose from.”

Looking ahead, he feels confident that this type of technology is the future.

“The way that we think of it at Spartan — in our ideal world – any time that you thought that you might be sick with something, you would want, at your fingertips, an instant diagnosis machine,” says Dr. Lem. If you thought you had strep throat, “you would just take a swab of your throat, walk to your bathroom, stick it in this box, and it’ll tell you. ‘Nope, you don’t have strep throat’ or ‘yes you do, and here’s an antibiotic.”

Dr. Lem also believes that personalized medicine is crucial for impactful healthcare, and as we gain more knowledge about our genetic makeup, our healthcare system will start to become more individually tailored.

“Most people around the world would say [at Spartan] we’re the leader in really fast pharmacogenetic testing,” he says. “That’s a long word – pharmacogenetics – but it basically means, [this]: when you walk into Walgreens and get your prescription, right now, everyone gets the same prescription. But we know from the Human Genome Project that your DNA is different from my DNA. [So what we should actually do] is a DNA test and find out – oh, you should have to get a different dose, or a different drug that’s personalized to you. Personalized medicine.”

For the immediate future, Dr. Lem and his team are participating in a government-led study that compares the Legionella test results of the Spartan Cube with results of the previous standard, culture testing.

“[The government] is going to be announcing the results of this study soon, and we think, if it’s positive, this could potentially be the practical solution everyone’s been waiting for to prevent Legionnaires’ disease. So stay tuned on that,” he says.

To find out more about this technology and Dr. Lem’s work, check out the Spartan Bioscience website.