History Part 10 : The Forgotten Front: Bacteriophage Therapy During World War II (1942–1945)

The Forgotten Front: Bacteriophage Therapy During World War II (1942–1945)

Introduction: Medicine in the Shadows of Total War

As World War II intensified between 1942 and 1945, the global medical landscape was reshaped by wartime necessity, geopolitical isolation, and scientific ingenuity. Amid the rise of industrial-scale antibiotic development in some parts of the world, a parallel, often overlooked story was unfolding: the persistent and at times groundbreaking use of bacteriophage therapy.

Phage therapy—based on the use of viruses that infect and kill bacteria—had already been discovered in the early 20th century by Félix d’Herelle and others. While enthusiasm in Western Europe had begun to wane by the late 1930s, the global conflict brought new urgency and complexity to the fight against bacterial infections. With logistics disrupted, pharmaceuticals rationed, and field hospitals overwhelmed, phage therapy found both revival and reinvention in unexpected corners of the war-torn world.

The Soviet Union: Strategic Medicine and Scientific Defiance

In the Soviet Union, bacteriophage therapy did not merely survive the war years—it expanded. Despite suffering immense human and material losses on the Eastern Front, the USSR maintained a robust infrastructure for the research, production, and distribution of therapeutic phages.

The Eliava Institute in Tbilisi, under the leadership of scientists like George Eliava (whose legacy persisted long after his execution in 1937), played a central role. During the war, its staff worked in coordination with military medical units and regional laboratories in Moscow, Odessa, and Leningrad to produce phages targeting pathogens such as Shigella, Staphylococcus aureus, and Pseudomonas aeruginosa. By 1944, these institutions had distributed more than three million doses of phage preparations to military and civilian populations.

Following the Siege of Leningrad, in one of the most desperate and unsanitary urban environments of the 20th century, phage therapy was deployed alongside basic sanitation campaigns to prevent typhoid and dysentery. Reports from the Soviet Ministry of Health in 1943 claimed success rates exceeding 75% for dysenteric infections treated with phage-based solutions, especially in children and soldiers with weakened immunity.

Despite resource scarcity, Soviet scientists advanced key aspects of phage science. Classified research focused on the stability of phage suspensions under extreme conditions, such as freezing and desiccation. Virologists like Dr. V. V. Menkin even tested inhalable phage aerosols in tuberculosis patients—an innovative technique decades ahead of its Western rediscovery.

This counting and filling machine for the packaging of bacteriophage drugs was designed at the plant in the city of Gorky (now Nizhny Novgorod)

As shown by these guidelines for practicing surgeons, which were published at the beginning of World War II, by that time bacteriophages had become a recognized antibacterial agent and were recommended for use in surgical practice to treat wounds and acute infectious and inflammatory processes. Photo: the title page and preface to the book Guidelines to Surgical Treatment Methods, Moscow: USSR People’s Commissariat of Public Health (Narkomzdrav), 1942

https://scfh.ru/en/papers/phages-attack/

Occupied Poland: Resistance Medicine in the Shadows

In occupied Poland, medical science continued under extraordinary duress. Fragmented by Nazi control and Soviet expansion, Polish physicians and microbiologists often had to work in secrecy or under duress. Nonetheless, phage therapy persisted, especially in institutions tied to pre-war research.

At the Institute of Epidemiology in Lwów, a small team led by former students of Rudolf Weigl—more famous for his typhus vaccine—managed to produce small batches of phage preparations, mainly targeting Shigella and Salmonella. Between 1942 and 1944, more than 10,000 doses were administered under strict secrecy in civilian hospitals.

In the Warsaw Ghetto, where malnutrition, overcrowding, and sanitation collapse led to explosive outbreaks of gastrointestinal disease, physicians like Marek Edelman later recalled the use of "bacterial viruses" to treat dysentery, obtained via underground medical networks. These efforts were often supported by sympathetic Soviet doctors or neutral diplomats, smuggling in small phage ampoules despite the risk of Gestapo reprisals.

Nazi Germany: Pragmatism in a Collapsing System

In Nazi Germany, bacteriophage therapy was officially marginalized by 1942, displaced by the rising use of sulfonamides and early batches of German-synthesized penicillin. Yet, the worsening conditions on the Eastern Front forced military physicians to reconsider phage treatment, especially when capturing Soviet supplies.

German medical units operating near Smolensk and Kharkov reportedly used confiscated phage solutions on prisoners of war and German soldiers suffering from severe dysentery and infected wounds. Anecdotal data from postwar debriefings suggest a 60–70% recovery rate among patients who had failed conventional treatments.

Meanwhile, in Berlin, the Charité Hospital briefly resumed phage experimentation. A 1944 study by bacteriologist Klaus Birkhahn on 200 osteomyelitis patients using staphylococcal phages showed modest success, although the collapse of Nazi infrastructure soon brought these efforts to a halt. Much of this research was destroyed or disappeared in the bombing of Berlin.

Switzerland: A Neutral Node of Phage Exchange

In neutral Switzerland, researchers took advantage of their country’s unique position as a conduit between warring blocs. At the Swiss Tropical and Public Health Institute in Basel, scientists conducted quiet but rigorous trials of phage therapy on skin and wound infections.

Swiss hospitals reported that patients treated with staphylococcal phages recovered 30% faster than those given sulfonamides, with fewer side effects. Pharmaceutical firm Zyma (a precursor to Novartis) prepared several prototype phage cocktails in 1944, although the company would later suspend development in favor of antibiotic licensing deals after the war.

Switzerland also served as a bridge for information exchange. French doctors under Vichy control and Polish scientists in exile corresponded—often secretly—with Swiss colleagues, helping to preserve phage knowledge at a time when it was disappearing elsewhere in Western Europe.

Japan: Independent Discoveries Under Military Secrecy

Though isolated from Allied scientific developments, Japan pursued its own phage research during the war. At Keio University and the Imperial Army Medical College, scientists investigated the use of bacteriophages for enteric infections in occupied territories such as Manchuria and Indonesia.

By 1945, Japanese military doctors had conducted field trials with phages on soldiers suffering from dysentery and cholera. Internal reports indicate that phage-treated soldiers recovered faster in 40–60% of severe cases, often when sulfonamide supplies were exhausted or ineffective.

This research remained largely classified during and after the war. Some of it resurfaced only during American occupational investigations in the late 1940s.

Middle East and British Colonies: Scattered Deployment

In the Middle East and North Africa, British field hospitals and Red Cross units occasionally used bacteriophages during outbreaks of gastrointestinal disease among troops and civilians. In Egypt and Palestine, phage preparations were imported via Turkey or directly from the USSR.

In Haifa, over 2,000 patients received phage treatment for dysentery and cholera during 1943–44, many of them refugees or wounded Allied soldiers. These efforts were rarely recorded in official medical dispatches, but survive in hospital logs and personal memoirs of military doctors.

Peripheral Frontiers: Latin America and British India

Even outside the main theaters of war, phage therapy continued to find use. In Argentina, microbiologist Ángel Gallardo and his team experimented with phages to control urban outbreaks of dysentery in Buenos Aires. State hospitals reported treating over 3,000 patients with Soviet-inspired phage solutions between 1943 and 1945.

In British-controlled India, a more desperate context prompted phage deployment during the 1943 Bengal famine. At the Calcutta School of Tropical Medicine, trials involving 500 cholera patients suggested modest success, especially where oral rehydration and antibiotics were unavailable.

Conclusion: Resilience Without Recognition

While the Allies invested heavily in antibiotics, and the Axis powers fractured under the weight of war, bacteriophage therapy quietly endured. It served as a lifeline in places where antibiotics were inaccessible, and a field of innovation in countries with limited industrial capacity.

Between 1942 and 1945, millions of phage doses were administered across the globe, in secret hospitals, mobile army clinics, besieged cities, and colonial outposts. The war forced phage therapy to adapt: new purification methods, delivery systems, and combined phage cocktails were developed—often with little recognition.

This remarkable period of medical improvisation and scientific resilience laid the foundation for today’s phage revival. In a world once again challenged by antibiotic resistance, these forgotten wartime efforts serve as both inspiration and cautionary tale.

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References :

• Adamia, R. (2010). Phage Therapy During WWII in the Soviet Union. Georgian Medical Journal.

• Chanishvili, N. (2009). Eliava Institute’s Wartime Contributions. Eliava Institute Archives.

• Edelman, M. (1976). Memoirs of a Ghetto Doctor. Polish Medical History Journal.

• Weigl, R. (1944). Confidential Research Notes, Krakow Institute.

• Birkhahn, K. (1945). Osteomyelitis and Viral Therapy. Charité War Records.

• Swiss Institute of Public Health (1944). Internal Reports on Phage Efficacy. Basel Archives.

• Imperial Army Medical College, Japan (1945). Field Reports on Bacteriophage Trials.

• Calcutta School of Tropical Medicine (1944). Bacteriophage Field Studies in Bengal.

• Gallardo, A. (1945). Dysentery Management in Urban Argentina. Buenos Aires Medical Bulletin.