I had a really interesting conversation with a friend recently who used to be in the military. We got to talking about some of the “friendly fire” incidents both in Afghanistan and Iraq, and it got me thinking of the biological equivalent.

This can be rather problematic, not just for our immune system but for soldiers as well. “Friendly fire”, the term given to cases of mistaken identity or itchy trigger fingers that cause soldiers to kill their own. We face a similar threat as humans when we are attacked by microbes. For the immune system, it works best to shoot first and ask questions later.

There are many parallels to our immune system which is charged with the duty of protecting us from the constant stream of invaders that we face at every moment throughout our lives. Just like most secret government agencies, we rarely know what the immune is up to until something goes wrong.

Unfortunately, the nature of modern warfare (the advent of fire by wire etc.) no longer requires a person to actually “see” their opponents. And so this becomes one of the added costs of modern warfare, having the ability to respond quickly, as easily as sending a thoughtless email, can in the end cost innocent lives.

The immune system normally detects invaders by what’s on their surface and uses it as a kind of bar code to identify friend or foe. So if you’re a sneaky microbe you can use some markers (such as those found on blood groups A, B or AB, type O lacks this) and hide out to avoid detection and cause infection.

Now there’s a condition that we unfortunately don’t know that much about called Multiple Sclerosis (MS), that exemplifies what happens when the body turns against itself. In the case of this condition, the body’s immune system (think armed forces) specifically strip the myelin off of certain neurons in the brain and spinal cord.

Symptoms of course vary depending upon how much friendly fire might be occurring, and can range from numbing to even loss of vision. It’s unknown why (certain genes have been implicated) but women and people of European descent seem to be particularly prone to MS.

Most of the treatments used such as the corticosteroid prednisone, modulate the immune system, dampening it’s response. Turning off the immune system completely of course may not be the most viable option because then that person is completely open to picking up any type of infectious agent and simply dying.

A unique balance needs to be struck, which for the most part can work such as the use of electronic devices that identify something or someone as “friendly”. In the case of MS it might be best to return to asking simple questions such as why does weather seem to play such a prominent role for some.

Super-bugs are everywhere. Once found mainly in hospitals, antibiotic resistant organisms are taking up residences wherever they can.

When I was a first year medical student a very astute infectious disease consultant warned us about the dangers of neckties.

Apparently, it’s quite easy for many health practitioners to forget that they shouldn’t straighten their ties before or after seeing patients. Fixing a tie can easily act as safe houses for unwanted germs transferring them to unsuspecting patients.

I also remember this doctor specifically because he wore a classic physicians long sleeved coat that looked two sizes too big. I kept wondering what all that extra material was for, and how it must get in the way while he was examining patients.

Not a good thing if you want to keep from spreading pathogens, especially since his bread and butter cases were infectious disease patients.

One superbug in particular is really good at hitchhiking on excess baggage, such as clothing, and its name is methicillin resistant Staphylococcus aureus or MRSA. To avoid having hospital staff shuttle MRSA around, infecting other patients, according to the Guardian (thanks for the link Matt), long sleeve coats are to be banned in English NHS centers.

Health practitioners are to be bare sleeved to promote proper hand/wrist washing to help stop the spread of germs like MRSA. I’ve always been a big believer in public health initiatives and wonder how long it will take for other countries to join the “sleeveless club”.

I think if hospitals want to get their staff excited to implement such changes they should start by giving away Hawaain shirts.

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Multiple Sclerosis (MS) and the Cost of Friendly Fire

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