Intended for healthcare professionals

Rapid response to:

Papers

Exposure to foodborne and orofecal microbes versus airborne viruses in relation to atopy and allergic asthma: epidemiological study

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7232.412 (Published 12 February 2000) Cite this as: BMJ 2000;320:412

Rapid Response:

Hygiene and Health - towards a balanced approach

Over the last century, medical science and hygiene have dramatically
increased length and quality of life by protecting us from harmful micro-
organisms. Vaccination, antibiotic development, water purification,
improved food production and improved personal and environmental hygiene
have all played their part.

This article highlights a crucial question: if increases in allergy
are associated with some of these elements of our current protection
against infectious disease, how can this be avoided without jeopardising
the benefits? Indeed, as our ability to treat infectious disease with
antibiotics is under threat, better prevention of disease, even in western
society, remains a high priority.

Sadly, the public often hears simplistic reporting of such studies –
that increased allergy is an inevitable consequence of being too clean.
The clear caution, given by the authors of this article, that we must
improve hygiene to reduce the impact of infectious diseases - but at the
same time we must learn how to train our immune system, especially during
infancy, in order to prevent allergy, is thus most important.

Despite the past, current and future contribution of hygiene in the
domestic and community setting to the fight against infectious disease,
the underlying science and practice has been less well studied here than
in other settings.

This realisation led a group of scientists to form the International
Scientific Forum on Home Hygiene (IFH), which is working to develop an
evidence-based approach to infection prevention in the domestic setting in
situations where an infection risk exists, and offers a useful forum for
evaluating issues such as hygiene and the immune system. The work of the
IFH can be found at www.ifh-homehygiene.org and interested colleagues are
encouraged to contact us.

Competing interests: No competing interests

18 February 2000
IFH Secretariat
Communication Co-ordinator
IFH