Shaker's Medical Innovators
Dr. Brian Grimberg
By Jennifer Kuhel
Brian Grimberg's path to becoming a world-renowned malaria expert is the stuff of a Hollywood dream-come-true biopic: The film opens with a close-up of a curious little boy hunched over a science book – just one from a wobbly, towering stack perched behind him. Dissolve scene to a teacher with a benevolent smile, sharing her collection of science filmstrips and books with the boy, who places each one into his backpack.
Cut to a modern-day sequence with this boy turned 40-something-man, now hunched over a small machine in a remote Kenyan village. The machine's parts move like miniature pistons on a locomotive, pushing toward and pulling away from a blood sample. Mosquitoes circle the scientist, but he's unfazed. His focus is on the little machine and the information it yields: a blood sample that tests positive for malaria.
"I've wanted to do this job since I was eight years old," says the affable Grimbeg, assistant professor of International Health, from his office in the Biomedical Research Building at Case Western Reserve University School of Medicine. He became an assistant professor there in 2009 and moved with his family to Shaker's Onaway neighborhood, drawn by its proximity to work and great schools.
The MOD Device
Today, "this job" is the study of infectious organisms, specifically malaria.
While there are only 1,500 cases of malaria in the U.S. each year, this parasitic disease remains a global health problem. According to the Centers for Disease Control, in 2015 an estimated 214 million cases of malaria occurred worldwide, killing 438,000, most of them children in Africa. As scientists around the world, including Grimberg, work on a vaccine, a combination of mosquito evolution, drug resistance, and a lack of funding means malaria persists, especially in developing countries. This makes Grimberg's Magneto Optical Detection (MOD) device – a lowcost, portable, hand-held malaria detection instrument that quickly determines the presence of the disease from a drop of blood – all the more valuable as a diagnostic breakthrough.
Speed of diagnosis is important in malaria detection, especially for finding those reservoirs of the disease that are infected but aren't exhibiting symptoms. Early detection and treatment reduce the opportunities for carrier mosquitoes to pass the disease on to those who aren't infected. The trouble is that most malaria diagnoses today are made with a microscope in the field under less than ideal conditions, and can take up to an hour to perform. By comparison, Grimberg's MOD device can make a diagnosis in as few as 30 seconds. Higher throughput means more people can be screened at a time and, maybe one day, eradication of malaria.
The technology behind the MOD device is straightforward: It relies on magnets to detect an iron byproduct (Grimberg smiles and calls it "malaria poop") produced after the malaria parasite eats hemoglobin. A blood sample under a laser light is tested as small magnets move closer to and away from the sample. As the magnets get closer, the iron particles line up and block the light. No light means the sample is positive for malaria.
One Village at a Time
So far, Grimberg and his team have tested about 1,000 samples from Papua New Guinea, Peru, Kenya, and the U.S., all with promising results.
Last September, the device also received the U.S. Patent and Trademark Office Patents for Humanity Award, a prestigious award that carries with it a fast-track patent application. Grimberg hopes the MOD device may be manufactured for wider distribution and use in the near future.
Recently, Grimberg expanded his research to study Zika virus, as the same mosquitoes carry both Zika and malaria. He has permits to bring Zika samples into the U.S. (he stores them in a locked fridge in his lab) and he cultures the virus, studying its genetics. He's also working on a vaccine.
"We're just at the beginning of the research so it's difficult to say if the current strains we're seeing in this outbreak have mutated to become more virulent or if the virus has just found a more receptive environment," he explains. "The reason it has spread so rapidly is that we live in an ever more interconnected world and the mosquitoes that transmit this and other disease are everywhere."
Ultimately, Grimberg would love a world without malaria, but that's an ending to his story that's a bit too pat. For now, most reductions in cases will result from one-village-at-a-time efforts. "The most realistic goal is to create pockets of localized elimination," he says. "If you can get rid of malaria in certain areas, then you can keep it out." SL
Click here to read more features from Shaker Life's Winter 2017 issue.