More Neglect of the Immune System: Bioterrorism Fear

At UC Berkeley several years ago, I learned about an introductory epidemiology class. I knew the professor. I phoned him. “Are you going to discuss factors that make the immune system work better or worse?” I asked. “No,” he said. I wasn’t surprised. In my experience, epidemiologists completely ignore this question. As if the immune system had never been discovered. It sounds absurd, but there it is.

Epidemiologists aren’t the only ones. All well-publicized attempts to “battle” or “combat” or “defeat” or “beat” viruses, such as cold or flu viruses, neglect this possibility, in my experience. Whole books on the subject do not mention the immune system. The latest example of the blindness is an article by Michael Specter at the New Yorker website about fear caused by discovery of how to make a bird flu virus spread more easily. Maybe the knowledge could be used by terrorists. Specter writes as if the immune system doesn’t exist. He doesn’t mention it and ignores the possibility of defending against new viruses by improving immune function. For example, he writes:

Instead of focussing so heavily on human terrorists, we ought to take this opportunity to defeat a natural pathogen—one we can now recognize and manipulate with all the sophistication of molecular biology.

You don’t need molecular biology to study immune function. He also writes:

There are three conditions necessary for a flu outbreak to become a deadly pandemic, like the one in in 1918 that killed between fifty and a hundred million people. Those conditions rarely converge. First, a new virus—one that has never before infected humans and to which nobody would have protective antibodies—must emerge from the animal reservoirs where they originate. That virus has to make people sick. (The vast majority do not.) Finally, it must be able to spread rapidly and efficiently—through a cough, a handshake, or a kiss.

He writes as if whether a virus makes people sick and spreads rapidly depends solely on the virus. This is false: How well your immune system is working makes a big difference. If a virus is fought off quickly, you won’t notice — you won’t “get sick”. Because you are infected more briefly, you will spread it less. (Possibly much much less. If a virus doubles in number in 4 hours, then two fewer days of infection equals a huge reduction in the number of virus particles inside you while you are contagious.)

In this blindness, I’m sure Specter reflects the blindness of the scientists he talks to. They simply talk and think about what they do, which is molecular biology.

I became aware of the power of improving the immune system when I improved my sleep and stopped getting colds. More recently, I have become sure that eating fermented foods improves immune function. I suspect that a lot of traditional medicine, such as Traditional Chinese Medicine, is effective because it improves immune function. (For example, the use of bee venom to treat arthritis.) Everyone knows at an answer-test-question level that the immune system exists. A lot has been learned about how it works. But the vast majority of doctors and other health experts (and journalists) ignore this knowledge in practice.


14 Replies to “More Neglect of the Immune System: Bioterrorism Fear”

  1. You coflating two things.

    You get bird flu, you die. No immune boosting there. More lucky genes.

    Is herd immunity better for populations or better health overall. A but of both.

    The difference between individuals and groups.

  2. Any thoughts on how a layperson can track/measure “immune function”?

    Seth has mentioned several times that he “stopped getting colds”, but this is a pretty long-term measure.

    Any thoughts on some type daily measure of “immune function”?

    1. Any thoughts on how a layperson can track/measure “immune function”?

      I’ve looked into this. I have been unable to find a practical measure other than measuring how often I get sick and when I get sick how fast I get better.

  3. Robert Trivers has a book out on self deception that focuses a lot on the immune system:
    “The Folly of Fools: The Logic of Deceit and Self-Deception in Human Life”

    He spoke at Microsoft recently.

    About 28 minutes in, he starts talking about self deception and the immune system. It is empirically clear to him that engaging in self deception (which we do primarily to successfully maintain deception of others, which has advantages) or holding in deep dark secrets for that matter, harm the immune system — but he does not yet know why or how it is biochemically mediated. He is looking for chemicals that are active in the brain and immune system to find an answer. He also looks at Pennebaker’s work showing that writing about painful experiences initially lowers your mood because it is painful; but simultaneously improves your immune system. And over time your mood catches up with your improving mood system. Improving the immune system improves mood. No surprise — poor sleep and poor nutrition both harm mood and the immune system.

    The concept of immune function is one that needs clarification. Dean Edell, the doctor who had a call-in show and who reviewed medical findings, is scientifically very conservative in making claims and generally wants strong, controlled, double blind, research before he will endorse things. He is to me, competent at that conventional, rather uncreative level of analysis. When someone would claim that a substance would “enhanced immune function” or “strengthen your immune system” he saw this as either nonsense, or as negative, meaning that it would cause auto-immune dysfunction and disease. He could not give “strengthening the immune system” a positive, substantive meaning or interpretation.

    Yet the evidence is now clear that certain things protect us from disease. Perhaps most strikingly, being happy, according to Ed Diener and others, correlates with a longer life by a number of years.

    The “immune system” must be many different systems operating together.

  4. I read an article some years ago (partly) about the Australian swimming team, in New Scientist. I believe it said they regularly measured the athletes’ IgE levels as an indicator of their immune system function. Low levels suggested vulnerability to infectious disease and they were prescribed light training until levels recovered. Prior to this, swimmers suffered colds as often as once a month because they didn’t know when they were overstretching themselves.
    Unfortunately I can’t access the article online, so my memory may be betraying me somewhat. I have the notion that it was a salivary test, but I haven’t been able to find any kind of testing kit that would be available to the layperson, or even the medical professional. (Presumably the swimmers were tested daily, with fast turnaround of results.)

  5. The great influenza epidemic of 1918 killed the young and healthy in disproportionate numbers precisely because they were young and health and had good immune systems. The disease provoked an overwhelming immune system overreaction that killed quickly. (See The Great Influenza by John Barry for details.) So maybe boosting your immunity, assuming that can actually be done in any meaningful way, could be detrimental in some cases.

  6. The 1918 general public were born vaginally, breastfed, never exposed to antibiotics. These people ate home cooked meals, many ate raw dairy and homemade fermented foods. The livestock they got their meat from wasn’t raised in a huge factory, fed the wrong foods. They were doing all the right things (because that was the only option) except that they probably ate too much white sugar and flour and had some bad oils.

    All in all, they were already doing much of what I’m doing to promote good gut health and a good immune system, yet the death rate from the influenza epidemic was enormous.

    I completely agree that you can’t talk about epidemiology without considering the immune system, but a good immune system can’t ward off everything.

  7. From the mid-19th century to the early 20th, Japan experienced cholera epidemics on the scale of the 1918 flu pandemic. This was probably the result of populations exploding in the cities. I’ve heard Japanese unironically compare the British engineer W. K. Burton, who designed Tokyo’s first modern sewer system, to Jesus.

    Another critical factor is that early in the 20th century, rickets had reached epidemic proportions across the “developed world” due to changes in diet–especially an emphasis on processed grains–and lack of exposure to sunlight in the cities. In Japan, beri-beri, also related to dietary “improvements” (polished rice), became endemic.

  8. I am finding it hard to believe that any epidemiologist could forget the role of immune function. Hygiene and vaccination are the epidemiologist’s belt and suspenders: half of their prescription is to improve immune response.

    Maybe you mean they should also pay attention to countering practices that suppress immune function? We know that long-term stress suppresses immune function, and a long but poorly-known list of bad habits produce long-term stress. What should epidemiologists be doing to counter these habits? Do they have any chance of restoring population-wide immune function, through reduced stress, to a degree that would be detectable vs. the results they get concentrating on vaccination and hygiene?

    It is hard for me to imagine epidemiologists succeeding at reducing a population’s long-term stress levels. That seems to be a political and educational challenge much harder than enforcing hygiene. In principle, though, it seems possible to break the connection between long-term stress and suppressed immune function by directly modulating everybody’s stress response. Perhaps, as is seen in some people, long-term stressors need not actually trigger the response that suppresses immune system function and damages health in numerous other ways. Is that what you meant?

    1. Nathan, epidemiologists could pay more attention to sleep, for example. Do differences in sleep explain why some people get sick more than others? Do differences in sleep explain why some epidemics spread faster than others? There is no doubt that better sleep improves immune function.

  9. I suppose I am assuming that sleep disruption causes the stress that has been suppressing the immune system. Better sleeping reduces stress, and thereby enables increased immune-system activity.

    It’s not too surprising to me that epidemiologists don’t pay much attention to reducing stress. Efforts to reduce collective stress necessarily operate on a time scale much longer than epidemiologists have to work in. Epidemiologists could point out every time a plague spreads that sleeping and eating better, and establishing a more secure social standing, improve your chances of survival, but at the point they get involved, they need measures that have large and immediate effects (e.g. vaccination, quarantine) to help contain a crisis. Stress reduction is more a topic for (i.e. neglected by) the family doctor.

    If by some cheap and easy intervention, long-term stress could be prevented from suppressing the immune system (and, perhaps, other systems), that could result in a large and immediate public health boon. People are attempting a superficially similar sort of intervention chasing a long-term goal by taking statins.

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