The most fortunate people during the recent outbreak of H1N1 (Swine) flu are those that got either a mild case of the infection or a subclinical infection. They received a rich dose of natural immunity.  It is likely that they will be relatively protected if a much worse variant of this virus comes along, possibly this winter. 

But did you ever hear this medical information during the media coverage of the well-documented pandemic?  All we heard was how we must all stay away from any possible exposure.  Vice President Joe Biden even suggested we refrain from flying to avoid exposure.

The public should know that we primary care physicians rarely get sick with respiratory viral infections BECAUSE of so much exposure to them.  Medical students rotating on pediatrics often get a series of colds and then develop their resistance to infection.  Young children may suffer with frequent infections at day care centers but they sure are hardy when they reach first grade.  It is the "protected" young children that suffer the most when they start school.

Getting sick is good for you! This side of the infectious disease story should be told more often.  Sure we face the reality that with any flu virus, some will get seriously ill and even die.  But I am sure many more people will die if we overly "hygiene" our population.  We will never have immunizations against all the many cold and flu type viruses we will get exposed to during our lifetimes. Too much social isolation and protection, especially with mild forms of the viruses makes us weak and vulnerable.

There is a science behind my argument.  It is referred to as the "hygiene hypothesis." In his wonderful editorial in the New England Journal of Medicine, Weiss presents the literature on how early exposure to "germs" may protect us from allergic disease.¹  A similar scientific essay should be written for infectious diseases.

My patients sometimes look at me strangely when I say "good for you" after they have had a recent cold or flu.  They think they had an unlucky or bad experience.  We need to educate our patients in just how fortunate they are to have received a good boost to their immune system.  It may just save their life someday.

Reference
1. Weiss ST. Eat dirt—the hygiene hypothesis and allergic diseases [editorial]. N Engl J Med. 2002;347:930-931.