In medicine, especially in pediatrics, we tend to treat all viruses as if they're all bad, all the time. Might we be treating "illnesses" that are actually beneficial to their hosts?
The most common reasons for visits to pediatrician's offices are all related to viral infections. Colds, coughs, ear infections, fevers - an overwhelming percentage are viral. The bulk of after-hours phone calls I get are also along these lines. Parents are panicked about infections. And why not? When you read in the news about flesh-eating strep or staph infections (MRSA), deaths from flu, hospitalizations from rotavirus - how could a parent not freak out? Our society has developed a veritable army of over-the-counter and prescription soldiers to fight the evil viruses that lurk among us. I'm playing this up, of course, and I do understand that viral infections can contribute to serious illness, including cancer and neurological disability. However, reports today on the harm of viral TREATMENTS got me to thinking - is the cure worse than the cause? And are some viral infections actually good for us?
From the FDA MedWatch:
1. Long-Acting Hydrocodone-Containing Cough Product (marketed as Tussionex Pennkinetic Extended-Release Suspension)
- [Posted 03/11/2008] FDA informed healthcare professionals of life-threatening adverse events and death in patients, including children, who have received Tussionex Pennkinetic Extended-Release Suspension (Tussionex). Tussionex is contraindicated for use in patients less than 6 years of age because of their susceptibility to life-threatening and fatal respiratory depression.
- 2. Tamiflu (oseltamivir phosphate)
- [Posted 03/04/2008, UPDATED 03/04/2008] Roche and FDA informed healthcare professionals of neuropsychiatric events associated with the use of Tamiflu, in patients with influenza.The label has been revised as follows: Influenza can be associated with a variety of neurologic and behavioral symptoms which can include events such as hallucinations, delirium, and abnormal behavior, in some cases resulting in fatal outcomes.
So, a medication prescribed for colds and coughs can be fatal, and an anti-flu medication is associated with severe neurological adverse effects, including death. Clearly, in these cases, the treatment is worse than the disease. This is one of the lessons in "treating" childhood illness - and for all of medicine - first, do no harm - right? Yes, these illnesses can be uncomfortable or even severe. But in the vast majority of cases, children, when left to their own devices, heal quite nicely.
And might some viruses actually be better left alone?
Researchers at Washington University / St. Louis reported these findings last year:
ST. LOUIS . - Mice with chronic herpes virus infections can better resist the bacterium that causes plague and a bacterium that causes one kind of food poisoning, researchers report in this week's Nature.
Scientists at Washington University School of Medicine in St. Louis attributed the surprising finding to changes in the immune system triggered by the long-term presence of a latent herpes virus infection. In latent viral infections, the virus is present for the lifetime of the host in a relatively quiescent form that does not cause overt symptoms.
While presenting their results, researchers stressed that they did not want to minimize or in any way disregard the human suffering and health risks caused by disease-causing herpes infections. But they noted that several strains of herpes viruses found in much of the human population remain symptom-free throughout the host's lifetime.
"Our results suggest that we should look at whether humans receive similar advantages from these and other chronic infections that do not cause active disease," says senior author Herbert W. "Skip" Virgin, M.D., Ph.D., head of the Department of Pathology and Immunology. "If so, that has public health implications because we would want to very carefully weigh the risks and benefits of eliminating a virus that our bodies have established a symbiotic relationship with."
And from Johns Hopkins:
PHILADELPHIA -- Researchers have found a way to activate Epstein-Barr viruses inside tumors as a way to identify patients whose infection can then be manipulated to destroy their tumors. They say this strategy could offer a novel way of treating many cancers associated with Epstein-Barr, including at least four different types of lymphoma and nasopharyngeal and gastric cancers.
In both of these cases, it appears that viral infections may indeed confer some sort of protection or health benefit to the host. Is this true in all circumstances? Of course not. But the converse - that these viruses are always a health threat in all people, is equally unlikely. It behooves us to be very, very careful when considering eradicating viruses from our bodies, particularly when the cure is potentially worse than the infection.