I am always amused by people who think that by living right, whatever right might be, that they can avoid infections. Nope. Living right is not going to do much to prevent infections.
It is good to be nutritionally replete, but more is not better for preventing infection. Can’t put more gas in the tank once it is full. And moderate exercise is good for you as well, with the emphasis on moderate.
You may credit diet or supplements for never getting the flu. More likely you were born with the right immune system that allows you to avoid getting an infection. No two immune systems are the same, and we are chockablock full of variations, polymorphisms (two or more variant forms of a specific DNA sequences) and mutations the at increase or decrease susceptibility to infection. Sometimes both. Lack the chemokine receptor, be resistant to HIV but have an increased risk for West Nile encephalitis. Evolution has an odd sense of humor. Pick and infection and Google it with polymorphism and like as not you will find interesting associations.
I was always fascinated by polymorphisms and often wished I had Dr. McCoy’s tricorder so I could scan patients and answer the question as to why they had a particular infection. Although I am not sure saying the reason for the severe influenza A infection is an IL6 rs1818879 (GA) heterozygous genotype is an improvement over crediting blind, stupid, simple, doodah, clueless LUCK!
The fault, dear Brutus, is not in our stars,
But in ourselves
And there ain’t much you can do about it.
You can avoid behaviors what put you at risk for infections. Most infections are acquired one of three ways: sex, eating, and breathing. You can avoid the first by getting married, but it is hard to stop the other two without adverse consequences. It is better to have unprotected sex in Provo than Detroit or avoid lettuce, the latter always a good idea. Salads are my dinner’s dinner.
I was always aware that the first word to describe my subspecialty was infectious (in the old days it was communicable). The raison d’ etre of most infections is to use us to reproduce. We are an irresistible dinner, flowers and water bed for viri. And nothing outside of preexisting immunity/vaccination is going to prevent them from using us as their love hotel. I wonder, am I oversharing? Nah.
Respiratory viri love crowds. Indoor crowds. Outdoor crowds. Filled with susceptible people. No better way to spread rapidly.
Schools are one example. There is an extensive literature trying to evaluate the effects of schools and the spread of influenza. The results are variable. Mostly they look at flu during school times and during breaks, and find there is a modest decrease in influenza in children during holidays but little to no impact on the spread in the community. Which seems about right, given the infectivity of flu.
It took COVID, with everyone stuck at home, to really decrease flu transmission, going so far as to drive one strain of B into extinction.
The military has long been plagued by outbreaks, especially in boot camps. In the 1918-1919 flu epidemic
The war fostered influenza in the crowded conditions of military camps in the United States and in the trenches of the Western Front in Europe. The virus traveled with military personnel from camp to camp and across the Atlantic, and at the height of the American military involvement in the war, September through November 1918, influenza and pneumonia sickened 20% to 40% of U.S. Army and Navy personnel. These high morbidity rates interfered with induction and training schedules in the United States and rendered hundreds of thousands of military personnel non-effective. During the American Expeditionary Forces’ campaign at Meuse-Argonne, the epidemic diverted urgently needed resources from combat support to transporting and caring for the sick and the dead. Influenza and pneumonia killed more American soldiers and sailors during the war than did enemy weapons.
Read that last sentence again. Wow.
Influenza was not the only problem at the time.
A US army-wide measles outbreak in 1917–18 resulted in more than 95 000 cases and more than 3000 deaths.
And there were other infections as well. Menigococcus and acute rheumatic fever were being spread.
The situation during World War I was similar. There were 24,770 admissions for acute articular rheumatism reported, but the significance of this disease was apparently overlooked even though it was occurring at the rate of 6.00 per 1,000 per annum.
And while spread was not due to crowding and crowds (I would hope), I would be remiss not to mention venereal diseases:
U.S. Army Medical Department statistics relating to venereal disease in the War are extensive and interesting. Thus, in 3,500,000 outpatient and hospital encounters 383,706 included a venereal disease, thus, 11%. The rate for officers as compared to enlisted soldiers was less than one-fourth. The rate of younger soldiers was higher than those older. Interestingly, the venereal disease incidence rate was about 50% higher for soldiers serving in the United States and even much higher yet for soldiers serving in the Philippines. French prostitutes, much maligned in 1918, appear to have been much less a danger than their American and Filipino sisters-in-sex. As might be imagined, the diagnosis of syphilis was much less common than that of gonorrhea.
I picked WW1, as it was the first war where influenza was a major cause of mortality and morbidity. But through time infections routinely killed or disabled more soldiers than combat and have had a major impact on readiness and fighting capabilities. Different wars had different infectious worries. For the civil war, it was dysentery.
Diarrhea and dysentery were the number one killers. (Dysentery is considered diarrhea with blood in the stool.) 57,000 deaths were directly recorded to these most disabling maladies. The total recorded Union cases was 1,528,098. Thousands of the afflicted went into battle fatigued with abdominal pain, malaise and dehydration. If wounded, they often died due to their poor constitutional state,
Although severe malaria resulted in 78 known deaths in the US Army (and 46 in the US Marines), the real military issue was lost days due to illness, averaging more than 1 month per malaria case and at least 200,000 lost man-days per year.
I do not doubt that future wars will have their own unique as well as traditional infection risks. Whether those infections will be prevented by testosterone replacement is uncertain. What little that is out there suggests testosterone replacement therapy (TRT) increases the risk of a variety of post-operative infections, so soldiers on TRT should avoid being wounded.
But at least we have vaccines. Right? Right.
Those who are too incompetent to understand history are going to repeat it.
No one is more crowded together than military trainees
Recruits live in tightly packed bays, shower communally and spend much of the day within arm’s reach of one another.
Hog heaven for flu and other infectious diseases.
Just two months after our wise Secretary of War scrapped the influenza vaccine mandates, (calling flu vaccine requirement an “absurd, overreaching” mandate that had served to “weaken our warfighting capabilities”) vaccination rates fell to 40% and guess what happened? Outbreak. Duh.
Lackland Air Force Base had 275 cases of flu with four hospitalizations and one death.
One death too many. When you volunteer to serve, there is the implicit recognition that you could die for your country. I respect those who make that choice. But I doubt they would sign up if that death was due to influenza because absurd, overreaching vaccine requirements were abandoned.
So they brought the vaccine requirement back.
And this policy change occurred knowing that
Military trainees have historically been vulnerable to acute respiratory disease due to relative immune compromise from physical, environmental, and psychological stress. Multiple studies have reported that recruits have a higher incidence of influenza-like illnesses compared to non-recruits.
You may not remember this, but the one death from the 1976 Fort Dix swine-flu outbreak was in a recruit who had just undergone a forced march. High intensity exercise, which defines boot camp, increases risk for influenza.
I keep wondering if those in the Trump administration have invested in casket production. Probably not. More likely just betting on the prediction market. It would explain a lot of their public health policies. That or rank stupidity.
Oh. BTW.
Scientists have found that men with relatively high amounts of circulating testosterone benefit less from vaccination against influenza than do men with lower testosterone levels.
Crowding. Influenza. A more dangerous mix than cheeseburgers and loneliness. Unless vaccinated.