Good Germs, Bad Germs: Health and Survival in a Bacterial World

Starting at birth, the new, innocent body becomes home to a host of microscopic invaders. These days, at that same instant, forces are brought to bear to stop or repel that horde. As Jessica Sachs explains in this comprehensive account, we are only learning the first lessons in what microbes mean in our lives. Perhaps the first thing readers should take from this book is that "antibiotics" don't contend with viruses. Those costly drugs only fight bacteria, a more complex and elusive critter. Another difference between bacteria and viruses is that we generally need the former, but not the latter. Which means we'd best be cautious about trying to ravage them with chemicals. The number and variations of bacteria in our bodies seems countless as you follow Sachs' account of who they are and what they do. Or fail to do. Most of us grew up with the "bad germs" litany drummed into us. "Wash your hands before dinner!" and "Don't play in the mud!" still echo in our minds after many years. The point was to "prevent" germs from entering our bodies. It turns out that Mum's cautions weren't always on the mark - Mummy didn't know best after all. We needed those bugs - they help us stay healthy. Jessica Sachs guides us through the findings of scores of scientists' work that has revised the approach we were taught about "germs" in our childhood. Eating mud, something many of us were at least verbally chastised for, turns out to be a good thing, even a necessity. From birth, the introduction of certain microbes initiate processes the body needs to keep going. For most people today, it's well known that microbes in our tummies are part of the process of digestion. Escherichia coli is known to be a true friend - in controlled numbers and certain strains. What's less known is how many other bacteria the body relies on to get certain jobs done. One of those jobs is keeping the immune system properly tuned. A lazy immune system is unresponsive or unable to react to invasion. An overly ambitious one can turn on its own body and destroy it. Both friendly and destructive bacteria live in our mouths, eyes, skin and elsewhere. Over millions of years, the body has come to an accommodation with those creatures, generally striking a balance ensuring survival. This balance has been severely offset in recent years, due to a "cleanliness" obsession that arose when it became clear that some germs were responsible for diseases. This idea was effectively demonstrated by UK researcher David Strachan, whose research led to what is now called the "hygiene hypothesis" - respiratory illnesses result from lack of cross-microbe activity to build immunities. In short, rich, small families were more prone to allergies than large, poorer ones. As Sachs points out, humans in our society overreacted to the new knowledge about disease-causing germs and sought to eliminate them all. The imbalance has led to many tragic situations, and initiated a guarantee that

I've read a number of books on microbes in recent years, including Bakalar, Nicholas. Where the Germs Are: A Scientific Safari (2003) Biddle, Wayne. A Field Guide to Germs, 2nd ed. (1995, 2002) Ewald, Paul W. Plague Time: How Stealth Infections Cause Cancers, Heart Disease, and other Deadly Ailments (2000) Heritage, J., and E. G. V. Evans, R. A. Killington Microbiology in Action (1999) Karlen, Arno. Biography of a Germ (2000) Murray, Patrick R., et al. Medical Microbiology (2002) Oldstone, Michael B. Viruses, Plagues, and History (1998) Shnayerson, Michael and Mark J. Plotkin. The Killers Within: The Deadly Rise of Drug-Resistant Bacteria (2002) Tierno, Philip M. Jr. The Secret Life of Germs: Observations and Lessons from a Microbe Hunter (2001) What sets science journalist Jessica Snyder Sachs' book apart from these fine books is the intense detail and focus that she brings to the work and the fact that her book is up to date with reports from the latest research. Written for a general educated readership, it gets a little dense at times and there's a lot to keep in mind and to understand. But I think the time and effort are worth it. I must warn you however, it does get a little scary. If you are prone to hypochondria or to paranoia, I would suggest you skip reading this since it appears that we are teetering on the edge of any number of possible microbial disasters. At the same time there is also the promise of a level of understanding of how drugs, bacteria and our immune systems work together, or are at odds, that will lead to healthier lives for all of us. Some of the topics covered: --A bit of the history of medicine before the germ theory of disease rose with Pasteur to the balmy times circa 1960 when some authorities were predicting the end of infectious disease, to the rise of antibiotic resistant bacteria that characterizes today's world. --The interaction between bacteria in our intestinal tract and the fact that we could not digest our food or even live without the benign bacteria that help us. Sachs quotes Nobel laureate Joshua Lederberg in this regard: "'It would broaden our horizons if we started thinking of a human as more than a single organism. It is a superorganism that includes much more than our human cells.' Lederberg calls this cohabitation of human and microbial cells the 'microbiome...'" (p. 238) --The "hygiene hypothesis," in which certain diseases such as allergies, asthma and immune system disorders are thought to arise because we keep our homes too clean, and our children do not have the exposure to common germs early and often enough to build up a proper immune response. In the case of allergies and autoimmune diseases, apparently exposure when very young to would-be allergens "teaches" the immune system to regard them as harmless. Without this exposure the immune system may go wild. Sachs' treatment of this murky subject is the best I have read. --Bacterial mutations, including the exchange of

The author uses her considerable journalistic and literary talents, in this remarkably sourced and current book, to make sense of our bacterial world. It's a world somewhat out of kilter. News coverage of MRSA, allergies and asthma reaching epidemic proportions, and unexpectedly toxic produce and meats, attests to that. But there is also positive news linking bacteria to good health, even a sound heart, head and waistline. In short order, Jessica Snyder Sachs pulls together many and until now seemingly unrelated stories and issues of epidemiology, microbiology and immunology to explain human-microbial symbiosis, eons in the making. The stories include fall-out from our ignorance and disregard of the essential roles played by bacteria, as well as new and positive directions in research to re-establish our healthy co-existence with microbes. The science, lessons, and research, all fascinatingly chronicled in Good Germs, Bad Germs, make for interesting and informative reading. For me, a moderately health-conscious former medical professional, it was full of counterintuitive discovery. I think it would be a worthy read for those interested in personal health, for science historians, and for anyone needing or wanting to understand our necessary life with bugs, the prokaryotic kind.

Good Germs, Bad Germs: Health and Survival in a Bacterial World by Jessica Snyder Sachs, is an up-to-date summary of what we know about how bacteria interact with humans. It's a fascinating story, because after a lifetime of "fighting germs" it seems that scientists are coming to learn that the interaction between bacteria and our bodies is far more complex than was ever realized and we have to work with germs and make alliances with "good germs" in order to survive. The book starts out with several chapters that explore in greater detail than I've seen elsewhere, the research that has been establishing "The Hygiene Hypothesis." This is the idea that the huge rise in autoimmune disease we are currently experiencing is being caused by too much cleanliness. It is starting to look like we are not being exposed to enough of the right bacteria very early in life or as we go through our daily lives, thanks to changes in water treatment, how we get our food, how we medicate illness, and how we clean our homes. It turns out that our bodies are complex ecosystems in which maintaining populations of billions of bacteria of various kinds is essential for preserving our health, particularly in the digestive system, where, if our population of bacteria are killed off, the digestive system fails to function properly. Children absorb the good bacteria they need to have populating their own digestive tract from birth on. A caesarian birth, for example, results in a baby who is not exposed to the bacteria found in the mother's perineal area, which raises the risk of developing autoimmune problems like asthma and Type 1 diabetes. Children who are given antibiotics early in life which kill off the developing populations of healthful bacteria also develop more autoimmune diseases, particularly asthma. And all of us who drink filtered water (which the book mentions was not common until the last 25 years of the 20th century) and eat packaged, preservative-filled foods, may not be maintaining the colonies of soil and fecal bacteria which our bodies depend on to regulate our immune systems and fend off dangerous bacterial invaders. An important point that Sach's raises in Good Germs, Bad Germs, is that while in the past many people, including those opposed to vaccination, have argued that exposure to disease is required for the development of a healthy immune systems this is not, in fact, true. More recent research suggests that it is not infection with disease that protects children. Disease, is NOT good for people. What is good for people is acquiring populations of benign non-disease causing bacteria that live on skin, on mucous membranes, and within the digestive tract. This is because these populations of benign bacteria do two things. One is that they fill up the ecological niche your body represents, making no room for the more dangerous bacteria which cause disease to move in. The other, which is just starting to be understood, is that by their very pre