Arming ourselves for the second coming of SARS

In March 2003, a major outbreak of severe acute respiratory syndrome (SARS) occurred in Guangdong and Hong Kong.
Subsequently, SARS spread to more than 16 countries and evolved to become a global health threat. More than 2,700 cases have been reported worldwide, resulting in 111 deaths. This new scary, lethal pneumonia-like disease still has no cure and no vaccine. As far as is known, it has only been suppressed, not eradicated, and some fear it will rebound during this cold season, possibly in a more vicious form.

So, what can you do to build up your defenses to prepare yourself for the possible second coming of SARS? You need to keep a healthy immune system so that your body can be well-armed with white blood cells, antibodies, and certain proteins and other substances — that will keep the SARS virus in check, possibly by destroying, devouring or inactivating them. You can help keep your immune system strong by eating and exercising wisely, taking certain supplements if necessary, minimizing stress, and avoiding external assaults, such as overexposure to the sun, ingestion of some pollutants, and overuse of certain medications. Here are the details on what you can do to energize and maintain your body’s defenses against SARS and other diseases:

• Eat a nutritious diet. A diet rich in produce, whole grains, legumes and low-fat dairy products should provide an ample supply of most nutrients linked to healthy immunity. People who don’t consume a nutritious diet should take a daily multivitamin/mineral supplement.

But even with an ideal diet, everyone over age 50 should consume at least 2.4 micrograms per day of supplemental vitamin B 12, from either fortified foods or a modest B 12 or multivitamin supplement. That’s because many middle-aged and older people don’t produce enough stomach acid to adequately absorb that vitamin from food. And people who seldom get out in the sun may need supplemental vitamin D supplied by a multivitamin or a vitamin D pill, especially if they’re over age 65, when the skin’s ability to synthesize the vitamin from sunlight diminishes.

• Work out but don’t overwork. The more exercise you do, the more immune benefits you’ll reap, provided you stop short of exhaustion. Avoid workouts that cause uncomfortable shortness of breath, profuse sweating in cold or mild weather, feelings of unsteadiness, substantial fatigue or muscle pain. If you have a cold, ratchet down your workouts. Don’t exercise at all if you have a more serious infection, and avoid intense activity for one to two weeks after symptoms disappear.

• Relax and defend. Activities that help you relax or improve your mood will likely strengthen your immunity. These include relaxation training, maintaining a network of social support, developing a positive attitude, and having a regular massage. Whichever approach you take, find some time each day to unwind.

Four More Fortifiers

Recent research has identified other steps that may help bolster the immune system. These are:

• Get sufficient sleep. Most people need seven to eight hours of sleep a night. If you sleep less than that or are often tired during the day, try to change your sleep habits. Effective strategies include a regular sleep and rising time, avoiding naps, blocking out disturbances, reserving your bed only for sleep and sex, and limiting your liquid intake — especially of beverages that contain caffeine or alcohol — for a few hours before bed. If you don’t drift off to sleep within about 30 minutes, or wake up and can’t fall back to sleep, get up and do something quiet until you feel drowsy.

• Avoid excessive skin exposure. If you expect to spend more than about 20 minutes out in the sun from mid-morning to late afternoon, wear sun-protective clothing and sunglasses, and slather on sunscreen with a sun-protective factor (SPF) of at least 15.

• Limit exposure to pesticides and mercury. To reduce exposures to pesticides, thoroughly wash fruits and vegetables under running water; use a soft brush and a diluted solution of dish soap to scrub bell peppers, tomatoes, and other produce coated in pesticide-trapping wax. Consider buying organic produce when it’s available and affordable. To minimize exposure to mercury, limit your intake of fish that may be high in the metal, such as king mackerel, shark, swordfish, and, to a lesser extent, fresh-water bass, halibut, and bluefin or canned white tuna.

• Limit antibiotic use. Don’t use antibiotics to treat viral infections, such as the common cold. (The drugs won’t harm the virus, but they will kill lots of the helpful bacteria that live in the body. And needless use helps breed antibiotic resistance.)

Precautions For Vulnerable People

A number of diseases can severely weaken the immune system, notably certain cancers, diabetes, and HIV infection. So can certain drugs, such as corticosteroids, and those used to treat cancer, hepatitis, and organ transplant recipients. Anyone with a severely weakened immunity is especially susceptible to potentially deadly infections like SARS and should take the following precautions.

• Get vaccinated against the flu and pneumonia.

• Practice scrupulous dental hygiene to ward off periodontal infections.

• Cook meat, fish and eggs thoroughly to kill the germs that can lurk in food.

• Apply insect repellant assiduously when outdoors.

• Minimize hospital visits, since germs are especially plentiful and virulent there. If you’re hospitalized, insist that hospital staff follow the proper precautions to prevent the spread of infection.

• Consider donating your own blood before any surgery that may require a blood transfusion, to eliminate the possibility of a blood-borne infection.

• Ask whether you should take antibiotics before undergoing periodontal work and certain major operations, notably hysterectomy and cardiac, colorectal, or joint replacement surgery.

Immune-Boosting Supplements

Dietary supplements, ranging from garlic to ginseng, and mega-doses of various vitamins and minerals have all been promoted as boons to the immune system. There is little, if any, evidence, however, to back up most of those claims. Here are the results of recent research on two supplements:

• Echinacea. In test-tube experiments, extracts of this herb clearly enhance the ability of various immune-system components to kill or control germs. In humans, however, the benefits appear to be modest. For instance, in the few clinical trials done to evaluate whether echinacea can prevent colds, the results have shown no clear benefit from the herb. One possible reason: Other research indicates that echinacea’s immune-boosting power fades with extended use.

• Probiotics. Numerous studies have shown that ingesting the "good" bacteria in these pills can restore a healthy balance of organisms in the gut and activate disease-fighting antibodies there. Other research suggests that probiotics may strengthen the functioning of the immune system throughout the body. Indeed, one study found that the pills reduced the number of potential disease-causing germs in the nasal cavity. But it’s not known whether that reduction translates to protection against actual upper respiratory tract infections. So while the evidence is promising, it’s too preliminary to warrant taking probiotics for that purpose.

The evidence on whether mega-doses of vitamins C and E can enhance immunity has been contradictory, especially in people who eat adequately. Indeed, a recent large clinical trial found that well-nourished people who took extra vitamin E were sick longer and with worse symptoms during the 15-month study than those who took a placebo. As for extra vitamin C, there’s little evidence that it helps treat colds and virtually none that it helps prevent the same.

The take-home message is this: By strengthening your immunity, you develop less chance of getting SARS and other life-threatening diseases.