A groundbreaking system for all

A New Zealand-designed parasite diagnostic tool shows global promise, not just for animal health but for human health too. Naomi Arnold explains.

ACCORDING TO THE World Health Organization, about 1.5 billion people – a quarter of the world’s population – are affected by intestinal parasites or worms. But that may be about to change, because a cloud-based, point-of-care diagnostic tool – originally designed for use with animals – is being trialled for use in human health in developing countries.

The tool is called FECPAK G2 and it’s the brainchild of Kiwi company Techion.

Techion founder and Managing Director Greg Mirams says the briefcasesized unit is at the point where it’s like “a really, really clever microscope” with a platform that can bridge both animal health and human health.

“Anything you can do microscopically you can put through this device,” he says.

The name FECPAK may be familiar to you, as it was first developed in the early 1990s. The product was designed for use with primary production animals as a tool for measuring parasite burdens and diagnosing issues such as facial eczema. Back then, farmers had to be trained to use microscopes to analyse and diagnose their samples.

In 2006 FECPAK was sold to PGG Wrightson, which had global aspirations for the technology. However, the subsequent financial crisis brought an end to that idea, and Greg decided to take it back and have another go. Its development was supported by Callaghan Innovation, and was backed

Techion’s founder and Managing Director, Greg Mirams, says data from tools such as FECPAK G2 has “the ability to empower experts and decision-makers”.

This page (top image): Research and Development Technician Chris Attwood works to improve the artificial intelligence’s ability to categorise different parasites. (bottom image): Severe Ascaris infection (eggs are marked in green) in a Tanzanian child. Facing page: Laboratory Manager Lisa Growden loads farm samples into a cassette that will be placed inside the FECPAK G2 tool. by several of New Zealand’s leading early-stage investors including Quayside Holdings (the investment arm of Bay of Plenty Regional Council), K1W1 (established by Sir Stephen Tindall), the Crown’s New Zealand Venture Investment Fund, and angel investors FKA and Enterprise Angels.

“Its evolution really kicked in from 2011, with the emergence of cloud computing,” says Greg.

This second-generation unit enables a farmer to look at parasite eggs in a faecal sample (via a patented viewing vessel), then capture a composite image and send it off to be analysed by skilled staff in a Techion Group diagnostic lab – usually within an hour of submission. Artificial intelligence is used to help analyse the image, and the image is stored in the cloud so it can be accessed anytime from anywhere. In addition, data trends from the testing can be used to help manage diseases and parasites. The team hopes to develop the artificial intelligence to a point where people won’t need to be involved in image

“WE CALL OURSELVES ‘THE MUDDY BOOTS DEVELOPER’. WE CAME FROM THE FIELD TO TRY TO DEVELOP A SOLUTION FOR THE FIELD.”

analysis, meaning users could get results in real time.

FECPAK G2 is just one of the diagnostic technologies being evaluated by STARWORMS (STop Anthelmintic Resistant WORMS) in a project bankrolled by the Bill and Melinda Gates Foundation.

STARWORMS is a global project run by a collaborative group of research partners led by veterinarian Bruno Levecke, from Belgium’s Ghent University. It aims to strengthen the monitoring and surveillance of drug efficacy and anthelmintic resistance through programmes designed to eliminate and control soil-transmitted helminth infections in humans.

The primary animal markets for FECPAK G2 are New Zealand, Australia, the UK and Europe, but aid programmes focusing on human health are using it in the likes of Ethiopia and Nigeria. Human and animal data is marshalled using the same platform, but sent to different places for diagnosis. Ninety-five percent of FECPAK G2 ’s clients are offshore.

FECPAK G2 ’s potential for use in human healthcare is also being explored by a team at the Swiss Tropical and Public Health Institute (Swiss TPH), based in Basel.

Swiss TPH parasitologist Jennifer Keiser says simple, fast and accurate diagnostic tools are critical in evaluating drug efficacy and the potential resistance of soil-transmitted helminth infections.

Her colleague Jakob ZinsstagKlopfenstein (a professor of epidemiology and trained veterinarian) recently came to New Zealand and spent three months promoting and supporting the One Health approach. While here he worked with Techion on the FECPAK G2

platform, contributing his design and technical expertise to ideas on how the platform could be used in a range of disease-testing applications.

Together with the Techion team, Jakob identified more than 30 diseases that could be diagnosed through systems like FECPAK G2 . This would in turn accelerate their control and provide access to care for people who health systems often ignore. “In remote settings like those of mobile pastoralists in Chad, the combination of point-of-care diagnostic systems, digital technologies and mobile communication has great potential for animal and human health,” he says.

Greg agrees. “If we go into a village environment in Chad, we want a diagnostic system that can test water, children and animals in one system,” he says. “Third-world countries have some of the health challenges that we have in animals, but they don’t have the same health infrastructure. We can detect

(top image) Client Support Coordinator Alice Hill tests the FECPAK G2 system. (bottom image) Strongylid eggs. giardia in a sheep population using the same technique as we would for humans – we’re still seeing a giardia cyst.”

Techion is working on many such issues. Right now, it’s about to release a test for liver and rumen flukes. The parasitic worms cause problems worldwide and their treatment is the same for animals and people.

Greg says it’s a two-way thing; human health can sometimes benefit from treatment approaches used in production animal health. “When you peel it back, diseases are similar and drugs are similar, and there are more and higher-quality diagnostic technologies for animals than we often find in humans.” Greg explains that farmers in the primary production industry are driven to get on top of diseases quickly because they may otherwise lose money, so there’s a good system for diagnosing many animal diseases. That’s not always so for human diseases. “Leptospirosis, salmonellosis, giardia, cryptosporidiosis – veterinarians know much more about nasty protozoans than do most clinicians in human health.”

Greg cites a classic example of this gulf in the lag of COVID-19 testing and data

GREG SAYS IT’S A TWO-WAY THING;

HUMAN HEALTH CAN SOMETIMES BENEFIT FROM TREATMENT APPROACHES USED IN PRODUCTION ANIMAL HEALTH.

collation. In contrast, Greg says, “I can log on and show you, live, which farmers in southern England have a particular parasite in their livestock. We can understand how climate is triggering the disease and know the classes of animal affected, what they were treated with, their ages and their condition, and see this data coming through live.

“What we do is all about connecting point-of-care diagnostics to expertise,” he says. “We see this in everything from mycoplasma to salmonella outbreaks – if we have fast, live data coming from the field, we can make quick decisions based on it.”

Greg says the team is working more and more with New Zealand veterinarians to enable them to process samples in their clinics with their veterinary nurse teams or receive results from their farming clients using FECPAK G2 on farm. Veterinarians no longer have to post samples to a centralised lab; they can send them instantly, 24/7, any day of the year. What’s more, sending a sample in New Zealand at 8pm means the UK team can analyse it during their working day. And there’s always an audit trail, which is particularly important for drug efficacy work.

“We can go back and show someone the photos and say, ‘These eggs came out of your animals.’ They can bang samples through without having to be highly trained microscope technicians, and all the data is shareable. We’re a borderless business. We can be anywhere.”

At New York’s Cornell University, parasitologist Dwight Bowman has been working with Techion on validating the FECPAK G2 technology for environmental testing, particularly wastewater plants (although the work is now on hold owing to the COVID-19 pandemic).

“I’m a huge believer,” Dwight says. “I’m very interested in this technology replacing me when I’m gone.”

In human health, FECPAK G2 holds promise for applications such as recycling city wastewater solids into fertiliser, which has to be free of pathogens first. Dwight and Greg visited a Chicago municipal waste plant

The FECPAK G2 platform fits snuggly inside a suitcase, meaning it can go where veterinarians or human healthcare workers go. This is a huge boon in developing countries, where access to laboratories may not be easy.

to demonstrate the technology, and a trial with large processing sites is now on the horizon.

Dwight comments that the tool is offering major benefits during the COVID-19 pandemic, as samples don’t have to leave farms or infected areas; biosecurity is in place immediately. “It’s a great tool,” he says. “It’s simple to use, and the methods are practical and easy to implement on farm.”

Greg, who is the son of a farmer and trained at Lincoln University, says growing up on a farm had a big influence on the tool’s development.

“I’m a farm systems guy,” he says. “When I think about parasites on farm, I come from a view of ‘What can I do to prevent those animals shedding lots of parasite eggs?’

“We call ourselves ‘the muddy boots developer’. We came from the field to try to develop a solution for the field.”