About germs

I've been avoiding discussing H1N1 (aka, swine flu) for some time and decided to finally approach the subject. Below are a few sentences about germs and H1N1 and immunity.

Good germs

My family and many of my friends know that I like dirt. So I was immediately intrigued by a book titled Why Dirt is Good: 5 Ways to Make Germs Your Friends. Author Mary Ruebush, PhD and microbiology/immunology instructor for Kaplan Medical, asserts that exposure to dirt – with dirt described in her words as, “soil, because humus, the organic part of soil, is crammed with bacteria, fungi, protozoa, and even viruses…also means all the other germ-laden things we normally encounter, such as raw foods, and all the germ-laden places we go” – is good for you. She explains, “More formally, “dirt is good for you” is called the hygiene hypothesis. This idea has been around since the 1980s, when doctors and researchers noticed a huge surge in the number of kids being diagnosed with asthma, food allergies, and even type I diabetes. At the same time, they noticed a general increase in irritable bowel disease and autoimmune diseases such as multiple sclerosis and rheumatoid arthritis. The hygiene hypothesis ties our modern obsession with cleanliness, along with our increasing tendency to stay indoors in a relatively germ-free and parasite-free environment, to the increase in health problems. When your immune system doesn’t get the sort of constant stimulation it has evolved to expect, it doesn’t function well. It may get hyperactive and confused. That’s when your immune system starts mistaking harmless pollen or food proteins for dangerous invaders, causing allergies, or mistaking your body’s own cells for invaders, causing autoimmune diseases…There is increasing evidence that normal, everyday infections in our youth may prevent the onset of autoimmune disease." (Follow this link for a brief cbsnews online article and book excerpt.)

Not-so-good germs

So I’m wondering, if exposure to microorganisms is good for us, why all this fuss around H1N1? Don’t we regularly have seasonal flu outbreaks? Is this one so different? Since I’ve had these questions I did some reading; here’s some gleanings from that. Please do correct or update me with whatever you know or if different.

The CDC (Centers for Disease Control and Prevention) says:

“The information analyzed by CDC supports the conclusion that 2009 H1N1 flu has caused greater disease burden in people younger than 25 years of age than older people.”

Hospitalizations and deaths have occurred, though from what I read, seemingly just slightly, in larger numbers. Numbers of visits for ILIs (Influenza-like Illness, note this includes more than H1N1) have risen more and sooner in the season. (A table that graphs incidence is at left, or at CDC online current to Sept 26, wk 38 – red line is for 2008-09)

Certainly the hype has toned down since some months ago: the suggestion for staying at home went from 7 days to 24 hours after the fever is gone, and no longer is this viral outbreak being always alluded to as pandemic (numbers “indicate that the amount of disease is about what we would expect for a severe influenza season and not at the levels of the pandemics from 1918 or 1957” – CDC web site).

Most of us have heard the recommendations numerous times (cover your nose and mouth when cough or sneeze, wash your hands for 15-20 seconds, get the vaccination, avoid contact with sick or exposing your sick self to others). We’ve heard about the symptoms. [But just in case you need the list again: “The symptoms of 2009 H1N1 flu virus in people include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may have vomiting and diarrhea.” - CDC]

Thankfully much of the medical community has caught on by now to recommend NOT using antibacterial products – antibacterial products promote development of supergerms and are rarely effective; “hospital studies have shown that antibacterial alcohol wipes don’t so much kill germs as just spread them around,” says Ruebush in "Why Dirt is Good."

What our body does with these germs

Back to some talk about immunity. Because we “may be able to infect others from 1 day before getting sick to 5 to 7 days after” (cdc.gov) it’s likely most of us will have some exposure to viruses this flu season. Some of us don’t get sick because our immune systems kick in quickly, or for whatever reason we are able to stop the virus before we feel sick. Let’s talk about immune system boosters (check out this webmd article for more on boosters as well as on immune system busters):

1. Get regular exercise: increasing your heart rate for even just 20 minutes three times a week is associated with increased immune function; regular exercise increases the level of leukocytes (white blood cells that destroy foreign microorganisms).

2. Eat more antioxidants: consuming a diet rich in antioxidant vitamins boosts immunity by neutralizing free radicals that damage cells (which can increase susceptibility to harmful germs). Top antioxidants include vitamins C and E, zinc, chicken soup ‘-). Possibly your mother has said it before: eat a variety of highly colored fruits and vegetables, beans, nuts, and whole grains. Maybe you’ll want to check this top 20 list of foods from a USDA study.

3. Get adequate sleep: getting 7 to 9 hours (an “adequate” amount for most folks) is linked to boosted immune function. Researchers aren’t sure just how, but it’s possibly that a lack of sleep can cause a rise in inflammation and an increase in the stress hormone cortisol. An experiment (Spiegel, K. Impact of sleep debt on metabolic and endocrine function. The Journal of the American Medical Association, Sept. 25, 2002; vol 288: no 12, pp 1471-1472) with U of Chicago students who were limited to only 4 hrs of sleep a night for 6 nights found that after given a flu vaccine, their immune systems produced only half the normal number of antibodies.

4. Practice relaxation: learning techniques to help you reduce stress can help you sleep better, and can lower levels of cortisol. One small study found the people who meditated over an 8-week period produced more antibodies to a flu vaccine than people who didn’t meditate; and still showed an increased immune system response four months later.

5. Laugh: laughing decreases levels of stress hormones while increasing a type of white blood cells. Even merely anticipating funny helps. A study – of a group of men who were told three days in advance they’d be watching a funny video – observed stress hormone levels drop and endorphin and growth hormone levels rise (both benefit the immune system).