Question about infection and contagion.
July 27, 2004 7:18 AM   Subscribe

A post on the blue got me thinking about something.. We are exposed to (and potentially infected by) bacteria/virii/parasites all of the time. There are treatments for most bacterial and parasitic infections. However, for many types of infections, a large percentage of people show no discernable symptoms. What should one do then? [MI]

I mean, one could still be a contagious carrier of said infection(s), and maybe even suffering damage from it without knowing. Would it be a good idea to periodically take antibiotics 'just to be sure'? I know that that's not a 'good thing', but is the alternative any better? Anybody ever think about this?
posted by eas98 to Health & Fitness (26 answers total)
 
What doesn't kill us makes us stronger. Getting sick occasionally is probably good for us in the long run.

You could live in a bubble, I suppose, or wipe everything you touch with anti-bacterial soap, but one day when the soap runs out you'll probably be more susceptible to infection.
posted by bondcliff at 7:39 AM on July 27, 2004


IANAD, But no.

You are right that our body is constantly covered with millions of parasites, bacterium, microbes, and fungi. However...

1) Ridding ourselves of them would require an unworkably long daily cleansing ritual.

2) Most of them are completely benign.

3) Some are actually beneficial and exist with us in symbiosis. By consuming dead skin, for instance, mites remove potential sites for more malignant parasites to take hold.

4) Antitiotics should only be used in the case of an actual bacterial infection. All that taking them "just to be sure" or constantly cleaning with anti-bacterial soap does is create an environment that encourages the evolution of bacteria resistant or immune to antibiotics. This phenomenon has only begun, and could become a major health crisis, since fewer and fewer antibiotics remain effective.

5) If you feel you are "suffering damage" from a parasite - common symptoms include fatigue, stiffness, skin rashes, and intestinal distress - then absolutely get checked out. If, however, you can't identify any symptoms that are bothering you, then you probably don't have a malignant parasite. Even if you do manage to eliminate them all on Tuesday, by Thursday they'd be back, so don't lose any sleep over it.

Besides, all the mites in your bed are getting hungry...
posted by ChasFile at 7:45 AM on July 27, 2004


What doesn't kill us makes us stronger.

I've always hated that line. Have you ever met a polio victim you couldn't take?

If, however, you can't identify any symptoms that are bothering you, then you probably don't have a malignant parasite.

But there are diseases that aren't always obviously apparent but which can do you damage. Eg, chlamydia, which can leave you sterile whilst having no little or no outward symptoms.

One major problem we have in the UK at the moment is a growing number of MRSA infections and deaths (5000p.a.). Quite a few people are carriers but how to deal with that? As noted by ChasFile, popping antibiotics can be a bad idea, and MRSA is one of the things that overuse of antibiotics has likely led to (IIRC it has a nasty little brother as well now, whose name escapes me).

And of course, there's prions too, pretty nasty. Does anyone know whether they ride around with you benignly or whether its just that they take awhile to get down to business, or what?
posted by biffa at 8:06 AM on July 27, 2004


Just to be clear, I am not suggesting taking antibiotics to clear ALL of the bacteria/parasites in our bodies, but just the harmful ones that may show no symptoms, of which there are many. Some infections only show symptoms in 10% of people. What are the 90% who are not symptomatic but yet infected to do?
posted by eas98 at 8:11 AM on July 27, 2004


What are the 90% who are not symptomatic but yet infected to do?

Well, how do they even know they're infected? If they don't know they shouldn't do anything -- if they do know, then whoever told them (that is, their doctor) will tell them what to do about it.

So if you're worried about silent infections, spend several thousand dollars on as many tests as you can afford. Please pay for it personally however, as I don't want my insurance rates affected by your hypochondria.
posted by aramaic at 8:24 AM on July 27, 2004


For many types of infections, a large percentage of people show no discernable symptoms. What should one do then?

One should relax and enjoy these machines we inhabit which take a surprising amount of abuse without breaking down or notifying us.

(This reminds me of one of the problems I had with the book "Fast Food Nation." There were large segments devoted to uncleanliness in the meat factories, but nothing at all was said about the human body's ability to handle that uncleanliness, even in a food source. It deserve at least a couple of pages.)
posted by Mo Nickels at 8:30 AM on July 27, 2004


if everyone took antibiotics to kill things they didn't know they had, then the antibiotic-resistant strains would be "selected for", which means that eventually you'd be in the same state as before, but with antibiotic resistant strains. at the same time, people that do show symptoms would become more difficult to cure because they'd also be infected by antibiotic resistant strains.

antibiotics have a restricted life span because of this selection effect. so it's only humane to use them only when they are necessary, so that there effects are not used up without need.

(i've noticed that here in chile antibiotics are prescribed much more than in the uk. maybe it's partly the nhs trying to save money, but maybe it's also a different attitude to social risk).
posted by andrew cooke at 8:36 AM on July 27, 2004


aramaic

You are obviously missing the point of the post. Whether or not someone is a hypochondriac does not change the fact that some diseases are silent, and some people are affected by them without knowing. Try to limit the discussion to that.
posted by eas98 at 8:39 AM on July 27, 2004


What doesn't kill us makes us stronger.

I've always hated that line. Have you ever met a polio victim you couldn't take?


Awesome. I hope you don't mind if I use that.
posted by bondcliff at 8:43 AM on July 27, 2004


some people are affected by them without knowing

Yes, and? If you're worried about it, spend thousands on tests. That's the only option. Any sane treatment REQUIRES diagnosis. Discussing possible treatments is pointless without a diagnosis, because you're simply shooting in the dark.
posted by aramaic at 8:47 AM on July 27, 2004


eas98: aramaic had a good point. If an "infection" isn't causing you any harm then you probably would never know you had it and getting rid of it wouldn't change anything. Therefore, there's no reason to worry about it.

And yes, if you're going to go all paranoid then you should do it on your own dime.
posted by bshort at 8:51 AM on July 27, 2004


bshort: but as already noted, it is possible to have diseases which aren't immediately apparent but which can cause permanent damage.

bondcliff: be my guest.
posted by biffa at 8:58 AM on July 27, 2004


Chill. Evolution has done a great job of refining the human immune system such that it works very well. Some people can go years between colds.

e.g. You catch Chicken Pox as a child and after the acute infection is fought back by your ImSys, its held in check for ther est of your life. Even if it breaks through again (Shingles) it again beats it back yet again. There are many herpes infections caught in childhoos this way that the body lets co exist in this manner and infection is not only largely unavoidable, but prefered. (To acquire Chicken Pox in adulthood is a serious and life-threatening illness with risks of Blindness or worse whereas childhood infection is a mere inconvenience)

Further, Med School has done a great job of training your doctor to screen and/or test for the symptomless infections your inquiry concerns . e.g. Chlamydia, Hep C, Papilloma.

The bottom line: Immune Systems work best uncontemplated. You don't wanna know how many infections, parasytes, and even CANCERS your immune system topples each and every day, and worrying/stress/anxiety/anger has been shown to decrease immune function.
posted by Fupped Duck at 9:03 AM on July 27, 2004


i've noticed that here in chile antibiotics are prescribed much more than in the uk.
Interesting. In the US, I know prescribing antibiotics for kids with ear infections is becoming very discouraged due to the reistsant-strains becoming prevalant. This would have made my youth a living hell, but there is defintely some merit to the policy.

The other problem with this premise is that not all diseases and illnesses are caused by bacteria. There are other nasty little organisms out there. Also, as already mentioned, a healthy chunk of the bacteria in us lives in symbiosis- bacteria that helps to eat other harmful bacteria that might hurt us.
posted by jmd82 at 9:22 AM on July 27, 2004


What doesn't kill us makes us stronger.
I've always hated that line. Have you ever met a polio victim you couldn't take?


I always assumed that refered to ones character moreso than ones constitution.
posted by piskycritter at 9:26 AM on July 27, 2004


What doesn't kill us makes us stronger.

I've always hated that line. Have you ever met a polio victim you couldn't take?


Heh, you never met my mom. Leg braces are deadly weapons in the right hands.
posted by headspace at 9:49 AM on July 27, 2004


How would one selectively kill the bad bacteria without also killing the good ones?

Given that we have more bacteria in our bodies than actual human cells, I think the idea of "cleaning them out" is an unhealthy fantasy.
posted by five fresh fish at 10:11 AM on July 27, 2004


Given that we have more bacteria in our bodies than actual human cells, I think the idea of "cleaning them out" is an unhealthy fantasy.

An unhealthy fantasy? Hey, sounds like you've just found the next multibillion dollar weight loss fad.
posted by Mars Saxman at 10:36 AM on July 27, 2004


(actually, my comment abut antibiotic use was terribly biassed. it seems to be prescribed for evey little thing if you're well off (have good healthcare). for the majority of the population if have no idea what happens.)

it's not really clear where the body stops and bugs begin is it? i'm sure you can find stuff in the gut that we would die without, and which would die without us. i've never really understood how you draw the line, since we're just cells too.
posted by andrew cooke at 10:42 AM on July 27, 2004


andrew: The cells of bacteria and humans, it's as simple as that. If you were to randonly sample 1000 cells from the human intestines and half were human and half bacterium, a cell biologist should readily be able to differentiate between the two types of cells from simply using a microscope.
Similarily, ouy body's Immune System can tell the difference between different types of cells through some known (antigens are the main method, but there are other ways) and some unknown pathways (a big area in cancer research). Beyond the primary reason of mutations, this is one of the 5 or 6 ways cancers become malignant- trhe cells loose their normal ability to be recognized and hence killed off by white blood cells.
IIRC, most antibiotics work by attacking the reproductive cycle and the cell membrane of bacteria. Humans cells are much different and are thusly not directly affected by antibiotics (except in the case if an alergic reaction).
And as far as being cells, another huge difference is our cells differentiate into different kind of cells. We have muscle cells, nerve cells, etc, and once differentiated, typically cannot revert back to their somatic state. Bacteria cells usually don't follow this bathway but come as-is (there are technical exceptions and there are different type of bacteria cells within a genus, but the differences aren't as stark as higher organism differentiation).
All that, and bacteria are of a completey differen domain/kingdom than humans (some evolutionary biologists believe we all came from one common anscestor, while some postulate that with the diversity among the domains- primary eukaryote and prokaryote, that is not possible and this there were at least two cells that developed indepent of eachother).
posted by jmd82 at 11:18 AM on July 27, 2004


i think i was mixing up two points. first, it's not clear to me what you look for in a microscope, given a *single* cell. are they different shapes or colours or something? whatever, i guess the ultimate resolution is via dna.

but second, if we need certain bacteria to survive, it seems odd to exclude them from (what we call) "us". while dna gives a clean, well-defined answer, it's not the kind of thing that is used intuitively - presumably there was a time when the contents of the intestines were considered to be either food or part of our bodies, rather than (i now believe) a bunch of bacteria working for our (us and the bacteria's) mutual benefit.

on the other hand, we need oxygen too, and it would seem odd to claim that oxygen molecules are part of our intuitive physical identity...

in other words, i accept that there's a clear "scientific" answer, but it's not necesarily the answer to the question i'm asking. i'm not asking "does this cell contain my dna?" but "is this cell part of me?", which is a rather fuzzier question that doesn't necesarily boil down to dna (as far as i can see). do you see what i mean?
posted by andrew cooke at 11:38 AM on July 27, 2004


As far as the microscope question goes, the cell's components are vastly different. The biggest difference is our cells have membrane bound organelles, each of which perform a precise function. Bacteria doesn't. Prokaryote cells are usally significantly lager that bacteria. One of the main defining features is our eukaryotic cells have a defined nucleus and nuclear envolope where all the DNA is kept which shows up as a big ball under the microscope. Prokaryotes don't have the defined nucelus and thus the large darkened area will not show up under the microscope. Here's a link with different shapes of bacteria

I think I see your final point, but at that point, we could partake in pure sophistry and ask if my skin is truely a part of me as it will rub off when it dies. However, maybe on the most simplistic level without even involving hard science, for me, the easiest way to differentiate between what's a part of me and what isn't is did I synthesize the living cells inside or outside of my body or are they a part of me through some other method? That does seem intuitive to me.
posted by jmd82 at 11:55 AM on July 27, 2004


thanks for the interesting links! (+ good intuitive defn).
posted by andrew cooke at 12:15 PM on July 27, 2004


It's not that easy, jmd. What about your mitochondria? They don't have human DNA, but you own human cells can't live in the least without them. What about red blood cells? AFAIR, they have no DNA at all, but they certainly are a part of you.

IMO there is no sharp dividing line. There are gut bacteria that certainly are not human cells, but without which you simply can not live.

We are a symbiotic creature.
posted by five fresh fish at 6:37 PM on July 27, 2004


Eh, but mitochondria DO have human DNA. Yes, it is a descendant of bacteria via symbiosis along the bacteria DNA (if there was no human DNA, I would venture to guess that the mitochondria would still operate independent of our cells commands, much like I'de guess the early symbiotic bacteria did- there's actually an algaue, blue or green I think, which undergoes symbiosis with an archeabacteria for a few days. Very interesting for the study of evolution...), but during reproduction, it is our body that create the mitochondria and our body which creates the red blood cells, usually via lovely enzymes (though, I've always wondered: what came first? the enzyme or the DNA?).

On your last point, I 100% agree that we are symbiotic creatures. However, it sounds like from my posts, you got the idea I think we act and live independently of the bacteria. I was moreso referring to where we simply draw the line between us and them, without using DNA for my reasoning.
posted by jmd82 at 7:53 PM on July 27, 2004


I always assumed that refered to ones character moreso than ones constitution.

I'm not convinced that it's true even given that. We have the phrase 'mentally scarred' for a reason I think.
posted by biffa at 2:23 AM on July 28, 2004


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