LESSONS FROM THE ARCTIC
(chilling, chicken pox and shigles)
We can learn a lesson from the arctic with regard to chilling and catching cold. Spitzbergen, located in the arctic, has a permanent population and is about as far north as the northern tip of Greenland. Prior to air travel Spitzbergen was inaccessible for several winter months each year due to pack ice; but the inhabitants caught no colds until the first ships started to arrive in the spring bringing new germs. The locals, with no outside visitors, had already become immune over the long winter to all the cold virus strains that had been circulating on the island.
We have a thermostat in the hypothalamus which is located at the base of the brain. When our body temperature rises above the set point, we perspire. When our body is below the set point, we shiver. Evaporating perspiration cools us; muscle effort (including shivering) warms us. An infection raises the set point with the result that we feel chilly at our normal body temperature. So, the chill that we blame as the cause of a cold is really just the first sign of the infection.
A related lesson we can learn from the arctic is to avoid perspiring in extreme cold, especially if there is no access to a warm place, because clothing damp from perspiration will continue to cool us long after we are dangerously chilled. Perhaps this explains why the sauna and its uninhibited perspiration are so popular in Scandinavia.
The arctic can also offer us some insight into chicken pox and shingles (Herpes zoster), two distinct diseases caused by the same virus. This fact was discovered by clinical observation in a snowed-in community in Alaska more than 50 years ago. Modern virology had not yet been invented. A chicken pox epidemic occurred in spite of the winter isolation. The resident physician noted that the first infected child had a grandmother who was just recovering from shingles. Chicken pox is so contagious that once everyone in the village had acquired it, the disease might have died out completely. Shingles permitted it to skip generations. When a person comes down with shingles, the chicken pox virus, which has been in the body since childhood infection, breaks out; but only in the distribution of the nerve the virus had been sequestered in. It cannot spread elsewhere because of antibodies in the blood. When shingles is contagious, it produces only chicken pox.
For several years chicken pox vaccination has been required for applicants for U.S. citizenship. Many of these people must have had chicken pox as children; but they can’t prove it so they get vaccinated anyway. (Government regulations for you.) When I wondered if such an unnecessary vaccination might be harmful, it occurred to me that the booster shot might end up preventing shingles years later. Sometimes shingles in older people can be prolonged, painful, and debilitating. When I wrote to the manufacturer of the vaccine regarding this possibility that a booster shot of chicken pox vaccine might prevent shingles later, I was told that they had already organized a research project to test this same idea. Now I don’t feel so bad about the “unnecessary” chicken pox vaccinations that I order.
I mentioned this same idea about the possibility of preventing or mitigating shingles through a chicken pox “booster” vaccine to a retired colleague. He showed up with his wife requesting chicken pox vaccinations for both of them. I predict that such booster shots for adults will be a common practice in a few years. Addendum, June 24, 2005: The New England Journal of Medicine had an editorial this month recommending such vaccination to prevent shingles, and stating that it is going to be very cost-effective.
John A. Frantz, M.D.
Chairman, Monroe City Council Board of Health
February 21, 2002