DeRisi argues that IDseq is different in that it was crafted not by academics, but by a large team of software engineers, security experts, and more. “It is industrial-strength commercial software,” he says, and should be easier to both scale up and keep running. The team has also worked to fit IDseq with an intuitive and user-friendly dashboard so it can be used by people without advanced technical expertise. “I wasn’t able to find anything else that’s free and has a good interface,” Saha says.
So far, DeRisi’s team has also used IDseq to analyze bodily fluids from feverish Ugandan children. Amid the several predictable cases of malaria, they found a rogue’s gallery of respiratory viruses, including one that was new to science. They have started working with health officials in California’s Alameda County to identify viruses in local mosquitoes. And they’re now ready to roll out the platform more widely.
On Tuesday, at a meeting in Berlin, the Bill and Melinda Gates Foundation announced a new training scheme for clinicians around the world. The foundation will bring successful applicants to the Chan Zuckerberg BioHub labs in San Francisco, where DeRisi is co-president, so they can learn how to use IDseq from his team. Each clinician will get a backpack-size sequencer, a year’s worth of chemical reagents, and technical support so they can start doing sequencing in their home countries.
DeRisi’s grand plan is to turn IDseq into a common dashboard, shared by disease detectives around the globe. If enough people use it, they could theoretically start spotting the movements of diseases across borders, the emergence of new illnesses, or the spread of drug-resistant strains. “That will be incredibly valuable,” says Jennifer Gardy, an epidemiologist at the University of British Columbia who is not connected to the project. “Information sharing is one of the most powerful public-health interventions in an outbreak.”
But Gardy adds that there’s still a lot of work to be done. “It’s easy for us to sit in our labs dreaming up tools and platforms, but we need to make sure we’re designing them in a way that makes sense to the doctors, nurses, lab techs, and epidemiologists out there in an outbreak,” she says.
Paula Fernandes of GSS Health, who is currently assessing different diagnostic technologies, is skeptical about how ready IDseq is for use in the field. Even if it’s easier to analyze the results of metagenomic sequencing, the technique itself still demands bulky equipment and a lot of expertise. “It’s not at all remote-friendly,” she says. And there’s a history of scientists’ getting overly excited about “promising technologies, which then simply sit on shelves in poorly resourced labs gathering dust long after glossy global-health reports have been filed.”
There are other limitations, too. Saha says it can be hard to acquire the chemical reagents used in sequencing experiments, because of issues with customs and unreliable supply chains. Once those experiments are complete, health workers would also have to upload their data to IDseq—a challenging feat in rural areas with slow connection speeds. “If the transfer is too slow or the data too large, we just FedEx hard drives,” she says.