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No need for immunity envy

By Dr. Gulshan Harjee Email By Dr. Gulshan Harjee
June 2011
No need for immunity envy

Why is it that the unhygienic conditions of food, water, and air in India make many foreign visitors sick but don’t affect most locals? It doesn’t make sense that they live in classically unhealthy environments and yet have stronger immune systems, while we in the West live in far better sanitary conditions but have weaker immunity.

Answer: This is an interesting question as it addresses a classic irony related to immunity and hygiene. Many people who travel not just to India but to other foreign lands often get travelers’ diarrhea. Immunity is one aspect of health where familiarity does not breed contempt but rather protection. The body generally fares better with known germs than unknown ones.
Recently I traveled to my birthplace, Tanzania, after 40 years and was spared the fate of travelers’ diarrhea—perhaps because there may have been some recall mechanisms in place that protected me from getting ill. This is an example of an active immunity acquired by getting exposed to the illness and acquiring protection as a result. With recurrent exposures these recalls get stronger. Locals and natives get repeated doses of exposure that have helped them develop antibodies to these infectious organisms. To that extent, the following saying may be true: “What doesn’t kill you can only make you stronger.”
So does this mean we too should wish for unsanitary conditions for ourselves? Not so soon! The flip side of the equation is that infections and germs do kill far more people in unsanitary regions than in hygienic environments. The process of acquiring active immunity is like Russian roulette—if your body is able to sustain and overcome an infection, it builds immunity; but it could get cooked in the process! Infectious diseases are a major cause of infant and child mortality in India—far higher than in Western countries. 
So while in India, don’t become envious of the fact that you might fall sick eating the roadside pani puris while your hosts merrily gobble them up. Instead, take the following precautions:

As regards to our lives here in the U.S., while wishing unsanitary conditions to build a stronger immune system is not advisable, there are certainly some lessons to be learnt for those of us obsessed with cleanliness. A clean living environment is good and needed; but excessively sterile conditions may only be weakening our immune systems. Excessive use of antibacterial wipes and sprays, and an over-reliance on antibiotics for minor symptoms are just some of the habits that may hurt more than help. Let minor sniffles and coughs run their course in children who are otherwise healthy—while treating them with home remedies that don’t weaken the immune system.
And thank your lucky stars that you don’t live in a region where there is a constant threat of malaria, pneumonia, typhoid and many other infectious diseases that are still major killers in many parts of the world. 

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