They’ve Got Us Surrounded

Note:  Our best wishes and prayers for a quick recovery to erp, who has surgery tomorrow. Get well soon, e!

We think that pathogens – viruses, bacteria, fungi, and protozoa – are, along with toxic and malnourishing diets, the main cause of human disease.

People who think we exaggerate the impact of microbes on health may not have fully appreciated the ubiquity of these pathogens. We live in a sea of microbes, many of whom would like nothing better than to live at our expense.

So today, let’s look at just how abundant microbes are.

In the Water

When you swim in the ocean, how many viruses are you swallowing?

… pause … time for reader to guess …

The answer is in a fascinating story in The Scientist:

Once thought not to exist in marine environments, scientists now realize that there are some 50 million viruses in every milliliter of seawater.

These viruses can not only infect cellular life, they frequently kill it:

Every day, marine viruses kill about 20 percent of the ocean’s microorganisms, which produce about half the oxygen on the planet.

It’s not just viruses: Vibrio cholerae, the bacterium that causes epidemic cholera, is widespread in ocean water, and is the most common cause of food poisoning from eating shellfish.

In the Air

What about the air?  How many microbes do you inhale when you breath?

… pause … time for reader to guess …

The Scientist once again came to my aid:

Every cubic meter of air holds upwards of 100 million microorganisms …

Lungs contain about 2.4 liters of air, of which 0.5 liters is expelled every breath. A cubic meter has 1,000 liters, so a single breath takes in 50,000 microorganisms.

Some more information for the curious:

Recent research published in PNAS suggests that the diversity of microbial life in the air is on par with the soil, at least in urban areas, yet the air remains vastly understudied in comparison.

“Just seven or ten years ago we didn’t realize bacteria existed in clouds,” said Anne-Marie Delort, professor of microbiology and organic chemistry at Université Blaise Pascal in France. Now researchers know microbes act as a surface for the condensation of water vapor in the atmosphere, thus forming clouds. Recent research publish in Science shows microbes also play the same role during snowflake formation and other types of precipitation.

Which Is More Dangerous, Air or Water?

Not all microbes flourish in the human body, but all have to be dealt with by our immune defenses. And some can, and do, establish lasting infections in humans.

Since both air and water have pathogenic microbes, it seems fair to ask which environment is more likely to make you sick.

Luckily scientists have done a controlled trial. [1] They sent two sets of people to the beach, and instructed half to remain in the air and the other half to venture into the water. ScienceDaily has details:

A yearlong beach study led by a team of University of Miami researchers suggests that swimmers at sub-tropical beaches face an increased risk of illness….

B.E.A.C.H.E.S. (Beach Environmental Assessment and Characterization Human Exposure Study) enlisted more than 1,300 volunteers, all local residents who regularly use South Florida beaches. Researchers divided study participants into two groups: volunteers who went into the water and those instructed to stay out of the water. The group that went in the water was asked to dunk themselves completely in the water three times over a fifteen-minute period. A few days later both sets of participants received follow-up calls from researchers, checking on their health and well being.

“We found that when swimming in sub-tropical beach areas with no known pollution or contamination from sewage or runoff, you still have a chance of being exposed to the kind of microbes that can make you sick,” said Dr. Lora Fleming …

The study found that the swimmers were 1.76 times more likely to report a gastrointestinal illness, and 4.46 times more likely to report having a fever or respiratory illness. Swimmers in the study were also nearly six times more likely to report a skin illness than those volunteers who stayed out of the water.

The obvious flaw in this study was the lack of a control group placed in a vacuum. It would have been nice to know if complete isolation from microbes would have improved health even further. Perhaps the scientists lacked funding for this third group.

(Warning: inside joke coming.) Of course, it may be impossible for this study ever to be replicated in the US, since after these results how can an ocean swimming group ever be permitted by an Institutional Review Board? It seems that follow-up studies will have to be performed on foreign beaches, perhaps in Rio, the French Riviera, or Tahiti.


It seems the microbes have us surrounded. Whether you venture into the air or the water, you have a chance to get sick.

Is there anything you can do to protect yourself, besides staying home and cowering under your bed? Possibly. We’ll look into that in upcoming posts.


[1] Fleisher JM et al. The BEACHES Study: health effects and exposures from non-point source microbial contaminants in subtropical recreational marine waters. Int J Epidemiol. 2010 Oct;39(5):1291-8.

Leave a comment ?


  1. Paul, was this post designed to cheer me up? ;-}

    Just kidding.

    Thanks for your good wishes and the good wishes of fellow PHD’ers.

  2. e, I’m saving my post on hospital-acquired infections until you’re out!

  3. Water is deadly stuff. When I grow some gills, I’ll try swimming in it.

  4. Those are some amazing numbers, Paul. But there must be a silver lining to all this. From my understanding we need a lot of these bugs for a proper functioning immune system. Constantly challenging our defences only makes them stronger. In fact, it seems that our recent efforts to disinfectant everything has at least partly contributed to a rise in childhood allergies, due to a weakend immune system that lacks early exposure to the bugs that help it build lifelong defences. Of course, a poor diet, lack of sun etc proabably play a role in this too. But the reasoning behind chicken pox parties surely applies elsewhere!

  5. Hi Robert,

    The hygiene hypothesis is very clever and very interesting, but I have some competing hypotheses.

    One of my suspicions is that greater hygiene (sewage symptoms, water treatment) has made it harder for pathogens to spread, and this has led them to evolve toward chronic rather than acute infections.

    Thus, the increasing incidence of many chronic illnesses even as acute illnesses have declined sharply.

    If this is the case, exposure to pathogens won’t decrease the incidence of chronic illness!

  6. Hey Paul,

    That’s an interesting idea. Especially because we know pathogens are very good at adapting to new challenges.

    Have you looked much into the cancer-virus link? Any possible link to your theory? Up here in Canada the CBC recently broadcast a documentary called “Catching Cancer” summarizing the latest work on this, and a few scientists have won Nobel prizes for their discoveries linking some cancers to viruses. Some very interesting research being done!

  7. Perfect timing for this. I’ve been just pondering over the fact that I’ve managed to avoid even the common cold for the past few years, but after showing signs of a compromised immune system starting last November– I just came down with strep throat! (I hadn’t had that since I was a kid). This is one of the reasons why I purchased your book and stumbled across this blog. I asked myself what have I been doing different, to all of a sudden come down with strep, and 2 colds one right after another in a matter of a couple months. I questioned my diet (which is usually “clean”)– I did start eating more tortilla chips at a favorite Mexican restaurant (PUFA and corn) and maybe a couple extra sweets at Christmas/Thanksgiving? Oh and I had stopped drinking my beloved daily kombucha over the summer because of the recall (up to this point, had been drinking one daily kombucha for the last 2 years)…I don’t know, but it’s disturbing. And to top things off, since I’m on antibiotics now (HATE but necessary evil)– I’m afraid that a slight existing fungal issue might get more ammo. I hope to read how you overcame your fungal infection in the book. Just started reading it.

  8. P.S. Love the layout of your book. So far, it’s easy-to-read and engaging- I don’t want to put it down. Formatted so that we non-scientific folks can easily digest the material. There’s a hefty dollop of information in every sentence.

  9. Hi Robert,

    I do try to keep up with all pathogen-disease connections. There will be blog posts on the virus-cancer connections at some point. My wife is a cancer researcher so it makes sense for us to address cancer on the blog.

    Hi Ellen,

    Immunity is discussed in Step 4 and we’ll have more blog posts in coming weeks … The book isn’t about my specific problems, rather general principles applicable to everyone, but I’ll be doing a “My Story” series soon too.

    Thanks for the praise! It’s the book we would have wanted to read … but as authors you have to hope that others share your taste!


    I’m personally looking at saunas as a solution. Over 50C Virus proteins start to denature.

  11. You may have seen this already, but it augments today’s post, so I thought I’d send it over. Also from the Scientist.

    “…:Mice lacking normal gut bacteria show differences in brain development and behavior”


  12. This is interesting. I hadn’t had a cold for some time, about a year, and then I went on vacation in Hawaii. I swallowed some seawater when snorkeling, and had a stubborn case of bronchitis within a day or so. I thought at the time that it was probably the seawater, and this certainly reinforces that idea.

  13. Thanks, Charlie and Matt. Good links. I’m afraid 50 C would kill me before my viruses though!

    Mike, I hope it was a good vacation anyway!

  14. very interesting! (as always of course 🙂 especially your theory on increased chronic disease due to increased hygiene… looking forward to hearing more! best, claire

  15. Will this series include the lemon juice you keep mentioning?

  16. hey Paul,

    Do you have any opinion on lactoferrin supplementation for acute or chronic infections?

  17. Hi Justin,

    It should be helpful for gut infections.

  18. @Paul; no, 50C is quite tolerable in a sauna or steam room.

    Remember rhino (as well as corono and flu) virus are heat sensitive enough they can only live in your nose and nasal passages.

    15 minutes in a 120 degree steam room (or 180 degree sauna) should do a number on them. And tolerable to humans.

  19. Thanks, charlie. I’ll read the paper. I’ve never cared for saunas but I know they are supposed to be health-improving.

  20. wow, this is going to be a great series, I can’t wait to read what you have to say.
    Do you know of biologist Paul Ewald ( who is saying that we can decrease our illness by coaxing milder strains of infectious organisms by manipulating their environment…what a fascinating idea, and maybe so important to leave competing (manageable)organisms (rather than eliminating/leaving an opening for new strains)…

    Do you have any opinion on the premise that it is ‘unhealthy’ to not get colds/general illnesses. There is talk of colds being considered as detox instead of a response to an organism. Meaning, when you have cold symptoms it is not a reaction to any one bug, it’s your body getting rid of toxins on it’s own. (I know about koch’s postulates and all that, but I keep pondering this possibility).
    I have a raw vegan friend with children (8y/o) who have never had a runny nose, no colds, no illness.
    Some would say that is not healthy, because the body is not responding properly.
    I wonder about that, and I wonder if the raw vegan does keep well due to the impact of that diet on the gut flora (no processed food, no grains)?

  21. Speaking about seawater and steam rooms, I had the pleassure to regularly use the gym and adjacent spa -with steam room – of a big hotel when I was working in greece for 3 years. I was living 400-500m from the beach and naturally was swimming quite often in the sea, probably every second day from may until october.
    I don’t remember to ever have any sinusitis (I am/was very prone to it) except once and it was after I changed gym to one without steam room!

  22. Kriss,

    I don’t believe in the detox-thing, at least not as the sole reason for colds. There are definetly virus’ envolved.
    But you can indeed get cold-like symptoms if you stress your body too much. For me that’s rather after a day of strength training very intense with too much volume(for me) then from diet. It isn’t too severe and goes away after one day though.

  23. Thanks, Franco, besides the stress, there are the ‘die-offs’ that can manifest as colds…but I know bugs have to play a role, especially when you watch one family member get ill after another.
    Yours/Charlie’s steam room/saunas remind me of the hearty Scandinavians, taking a sauna and jumping into a snowbank afterward. (:

  24. Well, Kriss, there were no snowbanks in greece naturally but ice-cold showers do very much the same.
    I think I wrote it in another post here somewhere but I enjoy a few minutes of very hot followed by 1-2 minutes of very cold shower every morning. I’m not sure it is that health improving like some people do it make to seem but it’s great for waking up and energizing for sure!

  25. Hi Paul- I’m reading in your book about short chain fats but so far nothing about medium chain fatty acids (which I always thought coconuts consisted mostly of MCFS). Are short chain and medium chain similar in composition?

  26. Oh and please forgive me if you cover MCFS later in the book– I’m just starting your book and thought I’d ask (while it’s relevant) and I want to know the answer now 🙂

  27. Anand Srivastava

    I came across the following article on a possible cancer cure.

  28. @paul; well, to each their own!

    I’d like to think my sauana and cold showers are healthy, but probably just on the margins.

    Did see a report that Baltic and Scandinavian states are very very high for cholesterol and blood pressure, and that is sauna-homeland.

    Flu season now peaking in the US. Be careful!

  29. Hi kriss,

    Paul Ewald will be mentioned in the next post.

    Personally I think it’s great to not get colds. As this post showed, everyone is exposed to microbes all the time, regardless of what you do. If you don’t get colds it shows your immune function is taking care of them properly. A cold means your immune function is off somehow, and it let the microbes get out of control. That’s a bad sign.

    It’s possible that the high gut bacterial populations in vegans keep the immune system especially active.

    Hi Ellen,

    Yes, our “short-chain” or “shorter-chain” encompasses medium-chain fats in the standard jargon. We thought the standard terminology was unnecessarily complex, since the key division is in which fats go into the body and have structural use and which don’t and get sent to the liver for disposal. Since we only had 2 categories, we thought using descriptive names rather than the jargon would work best.

    Hi Anand, thanks, I’ve seen that on the Internet before but don’t know how seriously to take it. Most cancers are not accessible so it’s not easy to load them up with bicarbonate.

    Hi Charlie, I’m open to saunas, and now that my heat tolerance is much better than it used to be maybe I’d enjoy them more. But at the same time I haven’t had a cold or flu in a long time, so I’m not sure it’s necessary.

    I would suspect low vitamin D and alcohol would have more to do with cardiovascular issues in Scandinavia. Saunas would be very low on my list of suspects!

    Best, Paul

  30. Paul– do you consider green beans legumes or pulses? still legume though, right? Would you avoid them (as toxic)?

    • Hi Ellen,

      The immature low-calorie legumes, like green beans and peas, I would consider vegetables; they’re comparable to other vegetables in toxin levels and much lower than the high-calorie mature legumes like kidney beans or soybeans. So I wouldn’t avoid them, no.

      Best, Paul

  31. Paul, I know this is off-topic bit I would like to ask a question with respect to fruit vers. starches with respect to micronutrients: I am the mother to a 19 months old daughter who is very fond of fruit. Intuitively I think she needs way more carbs than my husband and I do so I am not conderend with the carb count of fruit. She doesn`t like sweet potatoes/potatoes but eats rice noodles (as she insists on feeding herself, rice grains are out). My concern is that I try to offer her food that is as nutrient-dense as possible (she doesn`t eat large amounts of food, its still growing etc.). So if I offer her rice noodles (even with added butter) they are practically void of micronutrients. If I give her an extra banana she will have some extra vitamins. But, on the other hand, I find your concerns with high fructose intake absolutely plausible… What should I do as a mother who tries to offer her toddler the best nutrition possible??

  32. Ooops, all my questions were off-topic in this blog entry. Thanks for answering my questions Paul. Appreciate it.

  33. Hi Iris,

    She does need more carbs than you and your husband; a toddler does best around 40% carbs, adults around 20%.

    The best sources are safe starches, so rice noodles are great for her. You should let her eat as much as she wants.

    Although rice isn’t micronutrient-dense, glucose is a nutrient too and she needs it.

    If you’re concerned about micronutrition, I would give her a multivitamin. You can mix it into her food if she doesn’t like to take it. Other things you can do to improve micronutrition: give her vegetables with the noodles; use egg yolks in place of butter; make soups. Rice noodles plus vegetables will be more nutrient-dense than fruits.

    Best, Paul

  34. Perfect Health Diet » Jaminet’s Corollary to the Ewald Hypothesis - pingback on February 11, 2011 at 11:19 am
  35. Hi Paul,

    I thought I would pass this link along for light reading. I LOL’d just a little bit because I’m not much for consipracy theories (although I do like the X-Files), but it does make one pause for a moment.

    An update from me – I talked my MD into following the MIRA protocol for RA (100 mg of Minocyclin 2x day). Been doing this for three weeks and I think I can tell a difference.

    As always, enjoying your posts.

  36. Hi Szara,

    I’m so glad you’re getting antibiotics and they may be working. Everyone with arthritis should try it (after getting on good diet and nutrition first); we can’t know how many arthritis cases are bacterial, but many probably are.

    I don’t have time today to read that but I’ve put it in my notes. Mycoplasma is a germ I need to study up on anyway … One certainly can’t rule out human folly upfront!

  37. Hi Paul,

    Just saw this article and thought this post might be a good place for me to refer to it.

    IBM Semiconductor Nanotechnology ‘Breakthrough’ In MRSA Fight

  38. Thanks, Jim! That is exciting indeed. Anti-microbial medicines are where the big health gains will come, and it’s great to see creative approaches.

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