Does your brain feel ill?

When we have been ill for a little while it is natural to feel "down", isn't it?
A bout of sickness, flu, or a bad flare-up of our chronic symptoms will often lead to feelings of lethargy and depression and we usually find our fellow humans' response to this is: "That's not surprising after being unable to do things normally - I would get depressed about it too!"
But this is a strange Western rationalisation of the brain as separate from the body. Obviously the brain is actually connected to the body, and the brain tissue can become ill as well.
New research has shown clearly that our brains actually respond to infection in the body to make us FEEL ill; it is not just a psychological after-effect of a physical event - the brain makes this happen.

Now some clear research studies have shown the process involved. The innate (initial defensive) immune system produces proteins called cytokines whenever they encounter a bacterial challenge.
This then signals to the brain, then the entire balance of "mini" hormones and different chemicals in the endocrine system undergoes a change. These signals run through the neurotransmitters and alter our mood and behaviour.
There is already enough evidence to show that the root of depression is in something called the subgenual cingulate of the brain.
When researchers watched the subgenual cingulate with an MRI scanner they found that patients who had mild inflammation from a typhoid injection showed activity here. And those who had the largest inflammatory cytokine response had the greatest problems with their mood and a slowing down of their normal responses.

Dr Neil Harrison of Sussex University told the World Service's Healthcheck programme that many different illnesses with a bacterial element and immune response cause this real physical action in the brain:"Cytokines can cross the blood brain barrier but can also bind to nerve endings and be signalled in the brain."

One thing he didn't touch on was why the body might want the brain to make it feel so bad. If your body feels confused, withdraws from social situations, suffers depression and slows right down, according to this research, that's because it is busy mounting an immune response to infection.
So, may I suggest, it might at times be healthy (for all concerned) to stay at home in bed and avoid others, instead of taking some tablets and making a psychological effort to get back in to the swing of things.

Dig deeper

Pandemic flu may have fallen off the news agenda but over the summer more scientific evidence has been gathering of how our underlying health could be a crucial factor in its severity.
Most people know about MRSA - and some avoid hospital out of fear they may get it there - but few people are aware of community associated MRSA.
CA-MRSA infections are known to be circulating among healthy members of the community and yet they have never been tested for in the UK population. The USA has undertaken studies and found that one in every 100 people carries CA-MRSA.
The SA in the abbreviation is Staphylococus aureus, a rather nasty family of microbes.
When the lungs of the young victims of the 1918 Spanish flu were studied, they were found to have been destroyed by a pneumonia which killed them within 72 hours. The weight of evidence since then has led infectious disease specialists to conclude that the extra factor in these swift deaths was Staph aureus.
One study by epidemiologists Noymer and Garenne of US 1918 flu deaths postulated that the Staph infection could have taken hold in the chest because apparently healthy people had undiagnosed tuberculosis, which makes little 'pockets' in the lungs.
Now two brand new studies by virologists - in Rotterdam, and Atlanta, Georgia - have found out exactly how different the pandemic H1N1 virus is from seasonal influenza virus - it particularly attacks the lungs.
Seasonal flu virus bound to the cells in the nose but they observed that pandemic H1N1 binds much deeper, in the trachea, bronchi and bronchioles of the lungs.
The US team also found the virus bound to cells in the intestine, explaining the nausea and vomiting associated with swine flu.
New Scientist magazine reported on this discovery: 'Individuals differ in the way they react to viruses. A virus that binds deep in the lungs can trigger potentially fatal pneumonia if the person infected mounts a strong inflammation in response to it.'
So where does that leave people with an autoimmune disease, like sarcoidosis or rheumatoid arthritis, where the immune system is apparently overreacting? Or people who always have sudden and severe reactions in the chest or gut whenever they take antibiotics?
These unknowns are part of the 'evolving threat' from community infections, and the NHS is ill-prepared for it, according to an expert.
Professor Richard James, director of the Centre for Healthcare Associated Infections at the University of Nottingham, said last month: 'It took the UK over 10 years to start to get to grips with the problems of hospital MRSA infections and we are still fighting this war. We are not yet ready to fight the next one against CA-MRSA infections.'
He complains that the NHS is: not testing for this known community health risk factor; has not got enough intensive care beds to cope with even a low number of cases of swift-acting pneumonia in swine flu patients; and has failed to invest in laboratories and advanced diagnostic testing.
He is trying to raise £1.4m in charitable donations to fund new research in to infections because of the lack of public funding.
Meanwhile 37,000 people have died in the last ten years from MRSA or another serious infection C.diff. That's twice as many deaths as those from road traffic accidents - and the extra treatment costs incurred by these infections in the NHS is £1 billion each and every year.
Infectious disease specialists have been asking for UK investment in advanced laboratory testing for a long time now.
Emeritus Professor at the University of Aberdeen, Hugh Pennington warned in a Radio 4 investigation last year that the current system of two main laboratories for the whole country, with results delivered at a snail's pace, was inadequate. The national Health Protection Agency lacks enough resources to track infections.
He told File on Four: "The scandal here is that we know what to do, the technology's there to spot these things as they are appearing and we know how to react to them. It would be quite wrong if we allow these things to develop and of course history tells us that if we do neglect these bugs, we neglect them at our peril."
Can someone in charge of NHS resources please wake up and smell the coffee?

Herpes - not so simple(x)?

Reading the latest Private Eye magazine column by M.D. (the comedian doctor Phil Hammond) on herpes simplex outbreaks has provoked bemusement.
I think M.D., despite his new role as patron of the Herpes Viruses Association, may have shown a disservice to the many people with cold sores or genital blisters as he wittered on about how, back in the olden days, people would panic unnecessarily about the herpes family of viruses being linked to a sexually transmitted disease.
He declaimed those who made a stigma out of the virus: 'Herpes does far more psychological damage than physical.' Then, continuing on his juicy theme, he helpfully put down transmission and cause of facial cold sores to...oral sex.
So much for trying to get rid of the stigma!
The HVA website is clear that, while all mucous membranes are particularly vulnerable, the virus can be passed through any skin to skin contact with friction, including via the hands. White lesions on the hands, caused by herpes simplex, are called whitlows.
Amid normal day-to-day conversation I have encountered no one of my generation or younger embarrassed to talk of obvious cold sores on their faces or of the known cause - herpes.
M.D.'s cheerful obsession with sexual transmission of herpes seems to say more about the stage of life reached by his (male) generation.
M.D. concludes of genital sores: 'They're only cold sores and they go away without treatment.' Really?
Other physicians in the US and elsewhere accept that a notable proportion of people continue to have chronic outbreaks of herpes simplex. A common suggestion is that it results from underlying suppression of the immune system.
Information on the HVA website tells us that 'three quarters of people with herpes simplex are unaware of it' and that the virus can cause - or the diagnosis be confused with - thrush, repeated cystitis-like symptoms, skin lesions on the buttocks, piles, lower back pain, nerve pain, flu symptoms and more.
Research worldwide has found herpes simplex (plus other viruses and bacterial infections) in patients with fibromyalgia and chronic fatigue.There are also several studies that have found herpes simplex surrounding plaques in the brains of Alzheimer's patients; findings which require further investigation.
Anyone with unexplained nerve pain at the neck, or persistent muscle pains might like to know these facts. Not that I am putting such conditions down to herpes - I don't give simplistic answers like M.D.
At the HVA's AGM the genitourinary specialist Dr George Kinghorn explained that the relationship between Type 1 (symptoms from the neck up) and Type 2 (from the waist down) of the virus is much less clear cut than previously thought. And he notes that symptoms and severity 'will also depend on a variety of individual susceptibility factors, our genetic make-up certainly has an effect'.
Inherited genetic factors could be one area of further study. So too could the genetic damage caused to human cells by forms of persistent bacteria like streptococcus and E.coli, which molecular scientists are now revealing to be much cleverer at changing their surrounding human environment than we first believed.
Investigation is needed in to what, I think, is a complex rather than a simplex subject.