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out and sterilizing the cities came inevitably with In the years that followed and with the “cause” With improved
unintended consequences. In its usual ecological known, the “race for the cure,” went into full
setting, prior to these public health experts at swing. However, some bright epidemiologists sanitation
work, polio rarely struck infants younger than six looking at the incidence province by province fewer children
months old, most commonly infecting children noted that Keshan’s was only to be found in were exposed
between six months and four years of age when epidemic proportions in certain areas, leaving
the disease usually presented in its “common others, sometimes adjacent to the danger zones, to the disease,
cold” form. With improved sanitation—which free of the disease. Since the affected provinces more adults
included spraying poor areas with DDT, a potent were not necessarily geographically isolated were, and the
nerve poison—polio tended to hit at later ages, from the Keshan-free regions (by mountain
even into adulthood, when it was quite a differ- ranges for example) physical separation seemed results in
ent, far more aggressive illness. So, with im- not to be an issue. Further, since the Chinese are adults were
proved sanitation, fewer children were exposed a relatively genetically homogeneous population, disastrous.
to the disease, more adults were, and the results bizarre DNA defects were not thought to be at
in adults were disastrous. In “unclean” urban fault.
areas, early exposure mitigated the severity of Surprisingly, since conventional research-
the illness, with the added benefit of providing ers usually discount environmental causation,
lifetime immunity. With improved sanitation the some of the scientists began studying the soil in
disease became far more deadly. In this context I the high-incidence and low-incidence regions,
am reminded of more recent studies demonstrat- looking for an ecological solution. To their as-
ing that children allowed to play in the mud and tonishment, in every high-incidence area they
muck—as I was as a child before germ-phobia studied the soils were significantly deficient
became itself an epidemic —and who attend day in the trace mineral selenium, needed for the
care centers where they are exposed to all man- generation and regeneration of glutathione so
ner of drippy noses and minor infections, tend critical in modulating free-radical reactions. In
to have far less asthma, far fewer allergies, and areas of low incidence, the soils were selenium
far stronger immunity, than their over-protected replete. Apparently, only in the context of sele-
peers. nium deficiency did the normally well-behaved
and only mildly virulent Coxsackie virus mutate
KESHAN'S DISEASE into a highly aggressive, cardiac-toxic organism.
Keshan’s disease provides another interest- When the simple solution of selenium
ing take on another seemingly “catastrophic” supplementation was enforced in endemic areas,
infectious disease, salvation from which, it was the disease has become for China a rarity, largely
believed, required the ingenuity of our best a non-issue—as long as the population in vulner-
microbiologists and vaccinologists. Though able areas “takes their vitamins,” or in this case,
Keshan’s is more obscure than polio, the lesson takes their minerals.
is as striking. Named after the province in China Here is a case of an “infectious disease”
where the syndrome had been first identified, with an incidence and fatality rate in affected
Keshan’s would strike with a progressive cardio- provinces higher than polio ever was in the U.S.
myopathy that often ended in rampaging deadly At the height of its reign, Keshan’s was a very
heart failure and fatal cardiac conduction defects. disabling, very deadly disease. And of course
It could afflict children, young adults, old men the same expert forces mobilized, as they do, to
and women, and no one seemed immune. create the ideal Coxsackie virus vaccine to end
During the 1960s, before China had opened this modern-day plague. But as it turned out, all
to the world, the disease became so significant the Chinese needed was more selenium.
a problem that the government invited Western
researchers to help find Keshan’s cause and cure. THE HIGHLY VACCINATED GENERATION
Subsequently, these smart scientists honed in on a Most of us, that is, most “alternative” practi-
new and particularly virulent strain of Coxsackie tioners, have a vague belief that it is the “terrain”
virus that appeared to be the definitive culprit. that determines the nature and severity of infec-
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