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I'm not providing a reference with this comment but I've heard numerous times that at the time of the polio epidemic it was a common observation that kids raise

I'm not providing a reference with this comment but I've heard numerous times that at the time of the polio epidemic it was a common observation that kids raised in "rough" conditions, i.e. on the streets and exposed to all the insalubrity that goes with it, were handling polio infections much better than kids raised with modern hygiene. The so-called "hygiene hypothesis"...

323 4y ago
I think the "hygiene hypothesis" is mostly related to allergies, not infections per se. Kids in countries with "rough" conditions have a much higher mortality than kids in the developed world. I think it's pretty well accepted that the hygiene revolution decreased child (and adult) mortality a lot. That's not to say it didn't create other problems, but surely on net a "cleaner" world is better. Nobody is advocating not washing your hands before you eat. So while "tougher raised" kids probably have a better immune system, the risk associated with pathogen exposure grow even more dramatically, such that they surpass the benefit.
- mush_room 4y ago
  I think both can be true, question of balance. Concerning kids exposed to those pathogens in the developing world, we have to consider that malnutrition is a major contributor.
- generalizations 4y ago
  Or, said another way - it was harder to survive being raised in those 'rough' conditions, but if you did, you were tougher. Survival of the fittest.
  - Klinky 4y ago
    One of the failings of the simple concept of "survival of the fittest" is that survival just means you pass on genes, your quality of life might be poor up til then or you die shortly after, and fitness is towards the environment you grew up in, you may fail completely at adapting to an environmental shift later on. The concept only goes so far, and people need to be wary of it being used to potentially justify that harsh living conditions are okay or "better". It can come off as an appeal to nature.
    - Hextinium 4y ago
      I think the previous comment was referring to that the people with weak immune systems/severe allergies don't make it to adulthood. And so of course in clean environments where they survive there is a higher population of people with allergies.
      - Klinky 4y ago
        Only in very severe disease would that be the case. Many can become maimed & debilitated instead of just dying(e.g. Polio), and even those who come through "unscathed", the damage may just be hidden. You can see this with a lot of diseases like HPV, herpes(chickenpox/shingles) or hepatitis, where severe disease manifests well into adulthood. Many diseases have adapted to not kill the host and evade the immune system. You also may just have chronic re-exposure or a failure to clear pathogens, which can be detrimental to an entire population. An example would be worms that don't get cleared by the immune system and for which the person is constantly being re-exposed to. You end up with cognitive and physical issues that don't kill, but reduce a person's quality of life. Some of the hygiene hypothesis is around the immune system amping up its response due to parasites, and without the parasites present to attack it turns against the body itself. This is kind of what I am talking about. The people with amped up immune systems possibly handled parasite infections better when they were a common problem, but in a society where most people no longer live with chronic parasite infections, it manifests as allergies/immune disease. Living with chronic parasite infection is certainly not on the top of anyone's list to do, though helminthic therapy is something some people have tried to fix their allergy issues. It is also incredibly hard to determine who has truly lived a "pure" lifestyle free from interference of modern conveniences, so that evolution can truly be the driving factor in their life. Civilization has disrupted evolution for millennia by now, we can't just look back a few generations and claim they were a "tougher breed" who were better because of their purer natural lifestyle.
        secondcoming 4y ago
        Doesn't matter, had sex.
- vbezhenar 4y ago
  We could give birth to more children and let them die. Those who survive will be stronger. People removed natural selection from the equation with children healthcare. It could be a wrong direction for humanity.
- pessimizer 4y ago
  > So while "tougher raised" kids probably have a better immune system, the risk associated with pathogen exposure grow even more dramatically, such that they surpass the benefit. Maybe, but 1) the younger you are, the better you can deal with a lot of these infections, it's when you're older and you haven't seen them that they become a problem, and 2) the kind of exposure you get from being filthy is not going to be as concentrated as most of the exposures that make you sick e.g. from other people. A tiny exposure from a bit of dirt is going to take forever to grow into something that will hurt you, so your immune system has plenty of time to figure it out before it gets there. Then when somebody sneezes in your face, you've had the immunity without ever being aware of the sickness.
- tootie 4y ago
  Yeah this is the failing of hygiene hypothesis. Do kids raised in dirt or near animals have stronger immune responses than kids raised in a sanitized modern life? Probably. Do they have better long term outcomes in terms of overall health and longevity? Very unlikely and certainly never proven.
- Fricken 4y ago
  Is it the exposure to dirt, or the lack of health care that contributes more to the excess mortality?
o_____________o 4y ago
> insalubrity great word
- metadat 4y ago
  > Noun. insalubrity (usually uncountable, plural insalubrities) The condition of being insalubrious; unhealthiness, unwholesomeness.
MichaelCollins 4y ago
> I'm not providing a reference with this comment Here is the CDC saying it: > Before the 18th century, polioviruses probably circulated widely. Initial infections with at least one type probably occurred in early infancy, when transplacentally acquired maternal antibodies were high and protected infants from infection-causing paralysis. > In the immediate prevaccine era, during the first half of the 20th century, improved sanitation resulted in less frequent exposure and increased the age of primary infection, resulting in large epidemics with high numbers of deaths. The incidence dramatically decreased after the introduction of inactivated polio vaccine (IPV) in 1955 and continued to decline following oral polio vaccine (OPV) introduction in 1961. From the more than 21,000 paralytic cases reported in 1952, only 2,525 cases were reported in 1960 and 61 cases in 1965. > Poliovirus Secular Trends in the United Status: > * Before the 18th century, polioviruses probably circulated widely > * In immediate prevaccine era, improved sanitation resulted in less frequent exposure and increased age of primary infection, resulting in large epidemics with high death count > * Incidence dramatically decreased following inactivated polio vaccine (IPV) introduction in 1955 https://www.cdc.gov/vaccines/pubs/pinkbook/polio.html https://www.cdc.gov/vaccines/pubs/pinkbook/polio.html
- mush_room 4y ago
  This wasn't in infants, children of age to play in the streets.
  - MichaelCollins 4y ago
    No, it's only in infants. If a child old enough to walk around is exposed to polio for the first time (no vaccination or exposure as an infant), they'll have no protection and have a serious risk of being crippled. The sanitary conditions in which infants were kept in the decades preceding polio vaccination prevented them from being exposed to polio during their short window of protection, and as soon as they left the crib they were at serious risk. It's specifically the sanitation of the living condition of infants that had the effect, not the general sanitation level of society. Polio was still circulating through the population outside during this time period, but infants were shielded from it during their short window of protection.
deleted 4y ago
[deleted]
raydev 4y ago
I don't see how one can conclusively say rough conditions improved immune systems. What rules out the theory that those who survived were born with superior immune systems, or that they were missing traits that would make them susceptible to severe illness?
pengaru 4y ago
You've reminded me of this George Carlin rant: https://www.youtube.com/watch?v=X29lF43mUlo https://www.youtube.com/watch?v=X29lF43mUlo Edit: Usually I regret scrolling down to youtube comments, not this time: > This is not a comedy, this is a TED talk.

323 4y ago

I think the "hygiene hypothesis" is mostly related to allergies, not infections per se. Kids in countries with "rough" conditions have a much higher mortality than kids in the developed world. I think it's pretty well accepted that the hygiene revolution decreased child (and adult) mortality a lot. That's not to say it didn't create other problems, but surely on net a "cleaner" world is better. Nobody is advocating not washing your hands before you eat. So while "tougher raised" kids probably have a better immune system, the risk associated with pathogen exposure grow even more dramatically, such that they surpass the benefit.

mush_room 4y ago
I think both can be true, question of balance. Concerning kids exposed to those pathogens in the developing world, we have to consider that malnutrition is a major contributor.
generalizations 4y ago
Or, said another way - it was harder to survive being raised in those 'rough' conditions, but if you did, you were tougher. Survival of the fittest.
- Klinky 4y ago
  One of the failings of the simple concept of "survival of the fittest" is that survival just means you pass on genes, your quality of life might be poor up til then or you die shortly after, and fitness is towards the environment you grew up in, you may fail completely at adapting to an environmental shift later on. The concept only goes so far, and people need to be wary of it being used to potentially justify that harsh living conditions are okay or "better". It can come off as an appeal to nature.
  - Hextinium 4y ago
    I think the previous comment was referring to that the people with weak immune systems/severe allergies don't make it to adulthood. And so of course in clean environments where they survive there is a higher population of people with allergies.
    - Klinky 4y ago
      Only in very severe disease would that be the case. Many can become maimed & debilitated instead of just dying(e.g. Polio), and even those who come through "unscathed", the damage may just be hidden. You can see this with a lot of diseases like HPV, herpes(chickenpox/shingles) or hepatitis, where severe disease manifests well into adulthood. Many diseases have adapted to not kill the host and evade the immune system. You also may just have chronic re-exposure or a failure to clear pathogens, which can be detrimental to an entire population. An example would be worms that don't get cleared by the immune system and for which the person is constantly being re-exposed to. You end up with cognitive and physical issues that don't kill, but reduce a person's quality of life. Some of the hygiene hypothesis is around the immune system amping up its response due to parasites, and without the parasites present to attack it turns against the body itself. This is kind of what I am talking about. The people with amped up immune systems possibly handled parasite infections better when they were a common problem, but in a society where most people no longer live with chronic parasite infections, it manifests as allergies/immune disease. Living with chronic parasite infection is certainly not on the top of anyone's list to do, though helminthic therapy is something some people have tried to fix their allergy issues. It is also incredibly hard to determine who has truly lived a "pure" lifestyle free from interference of modern conveniences, so that evolution can truly be the driving factor in their life. Civilization has disrupted evolution for millennia by now, we can't just look back a few generations and claim they were a "tougher breed" who were better because of their purer natural lifestyle.
      - secondcoming 4y ago
        Doesn't matter, had sex.
vbezhenar 4y ago
We could give birth to more children and let them die. Those who survive will be stronger. People removed natural selection from the equation with children healthcare. It could be a wrong direction for humanity.
pessimizer 4y ago
> So while "tougher raised" kids probably have a better immune system, the risk associated with pathogen exposure grow even more dramatically, such that they surpass the benefit. Maybe, but 1) the younger you are, the better you can deal with a lot of these infections, it's when you're older and you haven't seen them that they become a problem, and 2) the kind of exposure you get from being filthy is not going to be as concentrated as most of the exposures that make you sick e.g. from other people. A tiny exposure from a bit of dirt is going to take forever to grow into something that will hurt you, so your immune system has plenty of time to figure it out before it gets there. Then when somebody sneezes in your face, you've had the immunity without ever being aware of the sickness.
tootie 4y ago
Yeah this is the failing of hygiene hypothesis. Do kids raised in dirt or near animals have stronger immune responses than kids raised in a sanitized modern life? Probably. Do they have better long term outcomes in terms of overall health and longevity? Very unlikely and certainly never proven.
Fricken 4y ago
Is it the exposure to dirt, or the lack of health care that contributes more to the excess mortality?

o_____________o 4y ago

> insalubrity great word

metadat 4y ago
> Noun. insalubrity (usually uncountable, plural insalubrities) The condition of being insalubrious; unhealthiness, unwholesomeness.

MichaelCollins 4y ago

> I'm not providing a reference with this comment Here is the CDC saying it: > Before the 18th century, polioviruses probably circulated widely. Initial infections with at least one type probably occurred in early infancy, when transplacentally acquired maternal antibodies were high and protected infants from infection-causing paralysis. > In the immediate prevaccine era, during the first half of the 20th century, improved sanitation resulted in less frequent exposure and increased the age of primary infection, resulting in large epidemics with high numbers of deaths. The incidence dramatically decreased after the introduction of inactivated polio vaccine (IPV) in 1955 and continued to decline following oral polio vaccine (OPV) introduction in 1961. From the more than 21,000 paralytic cases reported in 1952, only 2,525 cases were reported in 1960 and 61 cases in 1965. > Poliovirus Secular Trends in the United Status: > * Before the 18th century, polioviruses probably circulated widely > * In immediate prevaccine era, improved sanitation resulted in less frequent exposure and increased age of primary infection, resulting in large epidemics with high death count > * Incidence dramatically decreased following inactivated polio vaccine (IPV) introduction in 1955 https://www.cdc.gov/vaccines/pubs/pinkbook/polio.html https://www.cdc.gov/vaccines/pubs/pinkbook/polio.html

mush_room 4y ago
This wasn't in infants, children of age to play in the streets.
- MichaelCollins 4y ago
  No, it's only in infants. If a child old enough to walk around is exposed to polio for the first time (no vaccination or exposure as an infant), they'll have no protection and have a serious risk of being crippled. The sanitary conditions in which infants were kept in the decades preceding polio vaccination prevented them from being exposed to polio during their short window of protection, and as soon as they left the crib they were at serious risk. It's specifically the sanitation of the living condition of infants that had the effect, not the general sanitation level of society. Polio was still circulating through the population outside during this time period, but infants were shielded from it during their short window of protection.

deleted 4y ago

[deleted]

raydev 4y ago

I don't see how one can conclusively say rough conditions improved immune systems. What rules out the theory that those who survived were born with superior immune systems, or that they were missing traits that would make them susceptible to severe illness?

pengaru 4y ago

You've reminded me of this George Carlin rant: https://www.youtube.com/watch?v=X29lF43mUlo https://www.youtube.com/watch?v=X29lF43mUlo Edit: Usually I regret scrolling down to youtube comments, not this time: > This is not a comedy, this is a TED talk.