Do germ-phobia and hyper-sanitation protect the public, or should we be exposed to infections and get more resilient?

Are we going overboard on protecting the public from “germs”?

That’s an especially good question given the flu season.

I downsized into a high-rise condo building, so I am exposed to a lot more people (especially kids) every day. Furthermore, a garage I use in Arlington forces me into contact with people because of construction problems that lead to delays.

I did get the flu shot from the doctor in September.  On New Years Day, I had the scary dry cough and a very slight fever, but it went away in 36 hours, leaving a bit of a rattle.  I would like to think this was a case of a vaccination providing partial protection and making the symptoms of H3N2 mild (NY Times blog post).

There is also variation among people in how they react to flu.  About half of adults can have an exposure with relatively few symptoms.  That may be related to exposure size (very small exposures may be like vaccinations), or to the anti-oxidants in the persons immune system.  But, we also see a replay of the 1918 H1N1 flu: some younger adults with robust immune systems die of their own overreactive immune response and cytokine storm and “drown”.

When kids are exposed to more germs through less sanitation, they are sick more often as kids, but may grow up to be more resilient as adults.  NBC News as a good article on that from Dr. Ty here.   That was pretty much the case with me.  I had very few missed sick days during my entire career working as an adult. But I was “sickly” as a child.

In my early 40s, I had  couple of strep throats, but that hasn’t happened since, suggesting natural immunity.  In 2004, I had a serious periodontal infection leading to a cat scan.  It went away with stronger anitbiotics and did not return probably because of immune response.

A natural infection does provide more exact protection than a flu shot, but it seems reasonable that a fly shot that blunts a subsequent natural infection is the best chance.

But there is a larger question of how far society should go in preventing infections altogether.   I hear the debate on “presenteeism”, but I wonder if people just need to get tougher and more resilient.

We believe some infections are very dangerous, and have quarantined people who are exposed, as we saw with Ebola when a few people who had worked in Africa were isolated in 2014 (one in particular in NYC).  We’ve also treated SARS that way, like back in 2003, with aggressive contact tracing.  SARS (and MERS) are caused by coronaviruses, most of which produce only mild laryngitis or cold-like diseases;  but a few of them are novel and dangerous.

We got through the H1N1 crisis in 2011.  And we hear talk of bird flu (which became an ABC TV movie in 2005), like H5N1 or H7N9, with the idea that it could jump from species to humans (through other animals) and sustain transmission. In southeast Asia, the practice of having agriculture very close to homes increases the risk.

We have to deal with whether an enemy could introduce something like anthrax, as we saw in September 2001 right after 9/11, and that was dramatized on ABC Nightline in 1999.  There are good reasons to think this is harder for an enemy to do than most novelists admit.

Finally, there are sexually transmitted diseases, with the outdated “chainletter” debates from the rightwing in the 1980s where HIV could become more transmissible with time (a sci-fi horror scenario) or lead to the spread of more secondary infections (like TB).  But we never know when some bizarre new disease will arise and behave in an unprecedented way (as in my novel manuscript “Angel’s Brother”).   Likewise, with Zika, you have the idea that a virus could be spread both by insects and sexual transmission and affect only some people (unborn kids) a lot more than normal healthy adults.

The film “Unrest” presented the idea that clusters of chronic fatigue syndrome have been noted since the 1980s. In fact, clusters of Hodgkin’s Disease had been reported in a few communities in the late 1970s, a few years before AIDS became known.

(Posted: Friday, January 26, 2018 at 4 PM EST)