Originally, the Warwick IGEM team were aiming to tackle the issue of Lyme disease diagnosis using our modular CRISPR based RNA detection system. However, over the course of the project, we were faced with difficult problems in the application and feasibility of our system, with regards to detecting Borrelia. It was originally considered that, as Borrelia burgdorferi is present in the blood immediately after infection, our blood test kit would be an effective front-line method for disease detection after a tick bite. Having surveyed the areas most at risk of contracting the disease in Britain, and realising the extent of public lack of awareness, attempting to manufacture a product requiring self-testing would be difficult, as few people would have adequate knowledge as to how to test themselves. Under these circumstances, it appears most appropriate to develop our test for doctors, however as current NICE guidelines for Lyme disease are still being confirmed, generating a standardised test in a first world country would be a long term endeavour.

Furthermore, after attending the Lyme Disease Action conference in Cambridge and speaking to Tim Brooks, head of the Rare and Import Pathogens Laboratory (RIPL), we established that although the average amount of Borrelia in the blood stream was capable of detection by PCR screening techniques, it would be difficult to detect using our RNA detection system without using additional amplification techniques which may alter the accuracy of the test.

This initial setback invigorated the team in pursuing other avenues of application for our system, that would both be viable in the real world and have a significant impact on the quality of human life. We opted to change our sensing target to leptospirosis, which similarly to Lyme disease is a spirochetal infection. Leptospirosis is a disease for which a cheap, stable detection system would be very useful, given it’s prevalence in southeast Asia, and the high frequency with which it is transported back to Britain by travelling tourists – it is the second most common foreign disease in the UK.

The Leptospira bacteria responsible for leptospirosis are present in the blood in sufficient quantity post-infection to be detected by our system. Current methods for testing for leptospirosis require expensive maintenance of stocks of the bacteria in hospitals, whereas most infections occur in poor areas with limited access to hospitals, or anything larger than poorly supplied clinics. This makes our device, the paper mounted sensor, perfect for use in this context. The low cost nature of our device improves accessibility to poorer communities, with the simple storage conditions required making our construct easy to store and transport. This allows our detection technology to benefit communities in hard to reach places. The only knowledge required to our self-test device is the safe collection of blood samples, with diagnosis being a very quick process with a clear distinction between positive and negative results. After having been diagnosed through the use of the device, access to treatment is more difficult in more inaccessible areas.