Mystery of the Misery: Expert Muses About Infections

Why is it that dogs can drink out of mud puddles with impunity but tots cannot? Or maybe we the people could also but just don’t know it? I’m not about to suggest that we perform that experiment, but it does intrigue me that within the past several years there has been a lot of talk about the “hygiene hypothesis.” Since it doesn’t promote the wisdom of “hygiene,” maybe it should be called “antihygiene” or “lowgiene”? Of course, parents or not, we have all observed with fascination and fear our little rugrats wrapping their gums around all kinds of nutritive and non-nutritive debris they have picked up off the non-hygienically approved floor. Do they survive in spite of — or because of — this activity?

When I was a wee tyke I got a tetanus shot and a smallpox vaccination. When I was in my ‘20s, typhoid and polio were added. Nowadays an infant hardly gets home from the hospital before it gets dozens of immunizations. But the hygiene hypothesis claims that we are getting all kinds of diseases, such as asthma and Type I diabetes, because we are not training our immune systems adequately in early childhood. Why? Because we avoid exposure to all the germs and stuff that we used to have before we began bathing in soap and alcohol 20 times a day. So, what to do?

I’m fascinated by all the widely accepted facts that we are now told ain’t so. For example, the Black Death was bubonic plague, right? Big rats and tiny fleas running around loaded with Yersinia pestis. Now we’re told by Scott and Duncan [Return of the Black Death] that the Black Death fits better with the picture of a viral hemorrhagic fever. Like Ebola. And, no, I don’t get my medical training from Hollywood, but the film Outbreak made a fascinating case about what might happen if Ebola mutated and suddenly started to spread by the airborne route. Not so far-fetched given how gene splicing could easily splice the appropriate Ebola genes onto some influenza or smallpox virus. Are there any mad scientists out there who would do such a thing and give us our 21st century Black Death? (Note that although no indictments have ever been made, there is good evidence that the post-9/11 anthrax came from an American lab.)

Wildfires, floods, tornados, hurricanes, earthquakes, tsunamis ... all seem to come with a higher cost in human misery and death nowadays than in former times. But is the higher cost only secondary to a higher count -- of us humans? The world population was 2 billion when I was born and is now 6.5 billion. So if humans are getting in the way of fires and floods, etc., does that mean that we are equally potentially getting in the way of nasty bugs? Would the 1918 flu pandemic have gotten off the ground in the absence of crowded military camps containing thousands of potential hosts waiting for the virus to arrive? Probably not.

Pandemics seem to be one of Mother Nature’s favorite strategies for population control (with war coming in a close second?). Granted that Earth could support several times its current people load if we eliminated inefficient nutritional programs (all meat animals, dairy, poultry, etc.) and went to a vegan diet, but is a world population from 10 billion to 20 billion or more humans compatible with a desirable lifestyle? Think global warming, inadequate recreational facilities, air pollution, road rage from congested highways, etc. We seem concerned about the extinction of nonhuman species like the spotted owl and all kinds of toads, but not about the impact of us humans leading to these extinctions. A coalition of foundations has pledged to eliminate a million deaths a year of children from malaria in Africa. Sounds wonderful but does Africa really need a million more mouths to feed every year?

What does it mean to be an enlightened humanitarian? Puzzling question. On our present course it seems certain that global warming will produce widespread effects that will not, in general, be desirable. But are we also setting ourselves up for a global pandemic that will prune the population to where it might have been in the first place if we had listened to those who have been warning us for some decades and are now entitled to say, “I told you so.”? Or will medical science give us enough vaccines and new antibiotics to prevent diseases from whatever bugs come along so that we can all live cosily in a global megalopolis.

Given our penchant for not doing anything until it is too late, I suspect that our experiment will continue but with Mother Nature at the controls — population controls, that is. Keep your fingers crossed and your seat belt fastened. It may be a bumpy ride.

Gordon Short, MD, a board-certified pathologist, is the founder of Brevis Corporation.