Do you know someone who seems to get hit by every bug that’s going around?
Whether it’s a work colleague who is racking up sick days, or a spouse who takes to bed at their first sniffle, some people seem more susceptible than others to the usual winter colds and flu.
Obviously, some people may be ill to start with, or have a weak immune system, for instance, because of cancer treatments or taking certain medicines.
But putting those people aside, there can still be variation between different individuals’ response to the same pathogen that doesn’t have an obvious explanation.
Here are four factors that may influence why some people will be able to struggle into work while others need a duvet day.
Innate strength of immune system
There is natural genetic variation in most human traits, such as height, weight and intelligence. The strength of our immune response can also vary.
Unlike a characteristic like height, though, the immune system is highly complex, involving many different types of cells and proteins.
So, while an individual may have a more effective attack than average against one cold virus, they might have a weaker response to the next one.
This can also be the case for more serious infections. For instance, some people are immune to catching HIV because they have two copies of a certain gene that means they lack an immune cell protein called CCR5. But, those people were also more likely to die during a swine flu pandemic in 2009.
Sometimes a stronger immune response against a pathogen can lead to a worse illness. Research published last year suggested a key factor influencing how sick people got from Covid was whether the inflammation response against the virus went into overdrive.
Whether you have encountered that germ before
The immune system of mammals has the impressive ability to “remember” pathogens it has met before.
That is why, in a first encounter with a particular virus, it typically takes several days for our immune cells to become fine-tuned at killing that germ. But once the virus is gone, those cells become memory cells, resting in lymph nodes and other organs all over the body.
If we then meet the same virus again, the memory cells quickly start multiplying to make a clone army that kills the invader so quickly the second time round that we may not even notice the infection.
So, a big determinant of how you cope with any germ that’s going around is whether you’ve had a previous encounter – with either that or one of its close relatives.
When the Covid virus arrived in 2020, some people seemed to already have partial immunity to it, probably because they had recently been infected with a coronavirus relative that causes the common cold.
Your age
As we get older, our immune memories build, thanks to repeated infections. But once people reach middle-age and beyond, our immune strength starts to naturally wane, something doctors call immunosenescence.
That is partly because the thymus, a small organ in the chest that helps produce a key branch of the immune system called T cells, slowly shrinks with age and is replaced by fat. Another branch called B cells, which make important proteins called antibodies, also becomes less effective.
This is why doctors recommend that, regardless of your background health, everyone 65 and over should get a flu vaccine each year.
Unfortunately, older people tend to respond less well to the flu vaccine than children and those in middle-age, because of immunosenesence. But it is still worth them having the flu jab, because even if it doesn’t stop them from catching the virus, it cuts the chance of them getting seriously ill with the flu.
Despite recent concerns that the current flu strain has mutated more than usual, the vaccine is working about as well as in previous years, according to latest figures from the UK Health Security Agency. “Early data shows this year’s vaccine is continuing to provide good protection,” said England’s chief medical officer Dr Thomas Waite.
There may be biological reasons why men are affected worse by infections (Photo: Peter Cade/Getty)Your sex
Jokes about “man flu” aside, men do seem to be more susceptible to infections than women. Men were about 60 per cent more likely to die from Covid and they are more vulnerable to flu and TB.
For years this was thought to be due to sex hormones. The female sex hormone oestrogen broadly stimulates immune activity, while testosterone slightly weakens it.
But, the difference could also be due to sex chromosomes, the packages of DNA that determine whether we are male or female.
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Women have two X chromosomes, one inherited from their mum and one from their dad, while men have one X and one Y. But the X chromosome doesn’t just determine sex – it also carries several genes involved in the immune system.
As there are many possible variations of these immune genes, an individual woman has more different options for making antibodies and other proteins involved in immune defenses, said Dr Sharon Moalem, a geneticist at the US National Institutes of Health, who has written a book called The Better Half: On the genetic superiority of women.
“A woman could have two immune cells, one using the X from her father, one using the X from her mother. [Men] are stuck with just one X,” said Dr Moalem.
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