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2015dec_logoIf ever there were a perfect name for a malady, it’s the ‘common cold.’ Common indeed—upper respiratory tract infections are the most common infectious illness in the US, and the leading reason for missing work or school.1 Acute bronchitis—is close behind.2 About 5% of adults and 6% of children have at least one episode of acute bronchitis each year.3 The diagnosis of acute bronchitis should be made only when there is no clinical or radiographic evidence of pneumonia, and the common cold, acute asthma, or an exacerbation of COPD have been ruled out as the cause of cough.  Finally, add influenza, which can afflict up to 20% of the population in a given year and you can see that many people suffer.4

journalFor some years the notion that adverse responses to environmental triggers may be increasing due to a change in the ongoing exposure to mild immune activating bacteria has been gaining credibility. From Strachans first proposals to now there has been a continuous evolution of the hygiene hypothesis.[1],[2]

  • Hygiene hypothesis – criticised as being too vague, including by Professor Strachan himself
  • Microbial hypothesis (avoiding an overemphasis on cleanliness) and the
  • Old friends hypothesis (implying that microbes that were beneficial for immune system development have been eliminated or replaced).
  • Biodiversity hypothesis expands the hygiene hypothesis to the living environment in general,
  • Biome depletion model views the hygiene hypothesis as an evolutionary mismatch that works in tandem with other mismatches, such as inflammatory diets or vitamin A, D or K deficiency, which undermine immune function in westernised societies.
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The recommendations to be vaccinated for Influenza are at first sight straight forward, individuals at risk of severe complications from the virus are recommended to prime their adaptive immune system to be better equipped to meet the influenza challenge. A small but growing body of evidence suggests that the materials used to support this proposal may be flawed and that industry promoted research papers may be instrumental in suggesting that the benefits to human health are not as significant as the commonly supported model suggests.

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