21 April 2010

Short Term Personal Healing vs. Long Term Public Health

The Rise of the Superbugs has been in the news lately. 

Dave at Spark of Reason tweeted an article about disinfectants promoting the growth of superbugs.

The New York Times had an op-ed piece on antibiotics in the the food supply (Cows on Drugs).

Nicholas Kristof at the NY Times did a good article about this. The Rise of the Superbugs the view expressed in that column is that the large scale use of antibiotics that we feed to cattle is the leading cause of the evolution of the antibiotic resistant bacteria.

The articles are about microevolution in action, and more broadly about the tragedy of the commons.

In simple terms, it works like this. If you clean something with a disinfectant, there is a chance that some of the bacteria and germs will survive. The ones that survive are, in principle, those best adapted to repel the disinfectant. Their offspring will then be more fit, meaning that we would need stronger or different disinfectants to kill them, etc. The Kristof article goes further, and in fact, the microbes become more immune to antibiotics as well.

This is one of the reasons that when you get antibiotics from your doctor they tell you to finish the prescription. If you take a few pills and it kills only some of the microbes--enough to make you feel better--the remaining microbes will be those most immune to the drug.

It's escalation at a microscopic level. The more people that use disinfectants and clean the beejeezus out of themselves, the more likely that strong bugs will proliferate. So for all of us, keeping ourselves clean with soap and other anti-bacterial agents is, at some level a disservice to society. Just sayin'.

Many workplaces have taken to putting out alcohol based hand cleansers to help prevent the spread of colds and flu. Is there an unintended consequence waiting to happen. I would recommend vitamin D, over using sanitizers.

There is also an idea that our children are more prone to disease and autoimmune issues because of the relatively sterile environments in which we live today (hygiene hypothesis).  There is even a type of therapy called helminthic therapy in which you are infected with hookworms, which has the effect of reducing allery symptoms.

My father was a doctor. Some years ago, I asked him about antibiotics and strengthening the enemy. His response was that if a patient came to him with a disease that could be treated by antibiotics, he would not hesitate to prescribe them. His focus was on treating the person, and for him a worse case scenario was something like, person comes in, he doesn't prescribe, and that person dies.

In my own mind, I have arrived to the conclusion, after reading the articles above that fundamentally, my father's view is a good perspective.

Judicious treatment of large numbers of symptomatic people with antibiotics, may result in some cases of creating stronger bugs, but the benefit to individual humans can't be ignored. However, blanket antibiotic treatment, as happens in the meat and dairy industry, is not good for anyone.

E4E Recommendations:
1. Keep adequate vitamin D levels in your body. It strengthens your body's ability to repel the invaders.
2. Consider organic and grass fed meat raised without the use of antibiotics. Corn is not a normal diet for cattle, and they tend to get sicker on that diet, thus the antibiotics. If you're worried about some of the recent press around beef and global warming, Spark of Reason has something to say about it.
3. I won't recommend hookworm (helminthic) therapy, don't worry. It is intriguing though.
4. If you are sick, and your doctor recommends antibiotics, take them, get yourself well. Consume the entire bottle, don't stop partway through the course.
5. You should still wash your hands with soap after using the toilet and before cooking. There are nasty bugs that can live in the digestive tract and nether regions.
6. Consider going soapless. I don't do it myself, but personally know one person who has done it, and Richard over at Free The Animal has also done it. Wash yourself, but use cloths, brushes, and water to get clean, not soap.

Thanks for reading. I hope you follow my tweets on twitter as well. My tweet handle is ee4ee.


  1. I prefer the Nietzschean philosophy; that which does not kill me makes me stronger. I prefer to let my immune system get programmed to fight off the microscopic invaders before I go the antibiotic route. I have to be really sick before I'll take antibiotics. If I do, I'll finish the antibiotic regimen with a regimen of probiotics to replenish the healthy gut bacteria that the antibiotics kill off.

  2. Nice post, and thanks for all of the links.

    Nobody in our family has needed any antibiotics since going low carb and supplementing with Vitamin D. And I would certainly give them to my children if needed (the used to get ear infections about once/month during winter), but nobody gets very sick at all anymore.

    I get the impression that most people think that rampant illness is just "part of life". But think about it: if you lived in a wild environment, where you had to chase your own food and get chased to avoid becoming food for others, any significant illness would carry a high chance of death. As a society, we worry about "pandemics", but I believe these are largely only possible due to the relatively poor health of people, mostly caused by industrial food and living conditions.

    Eat a steak and sit in the sun!

  3. Thanks Eric and Dave,

    I philosophically agree with Eric, and would add the caveat that if you wait too long to get yourself fixed, you could end up dead. That which kills you, kills you. Modern medicine is lousy on prevention, but once you're sick, it is sometimes the best option for staying alive. I like the idea of taking probiotics after the antibiotics. Diarrhea after penicillin is no fun...

    Great perspective Dave, I have wondered how the cavemen survived during the "cold and flu season"...