Caitlin Whyte: Welcome to BayCare HealthChat, the official podcast series where BayCare professionals discuss essential health and wellness topics for you and your family. I'm your host, Caitlin Whyte.  

Today, I'm joined by Dr. Claudia Espinosa, a renowned specialist in pediatric infectious diseases. She is currently an associate professor at the University of South Florida with a rich research background in neonatal and perinatal infectious diseases.

Well, Doctor, my first question for you today is, what is the immune system and what does it do?

Dr. Claudia Espinosa: So the immune system is very complex. It's difficult to pinpoint only one organ because it's a combination of organs, cells, proteins, but basically what they do is defend our body from infections and also from our own cells when they are not working well. So it's one of the most important systems that we have in our body and it's very important to have it working well so we have a healthy life.

Caitlin Whyte: And how does one build immunity?

Dr. Claudia Espinosa: Yes, that is a great question because there is not exactly a therapy or a medicine that is going to build the immune system. It's really more of building up over time. Your child's immune system really changes constantly, and in order to be healthy, then many things have to happen. But baseline, we do it with following a really healthy diet and training our immune system with vaccines and promoting healthy lifestyle.

Caitlin Whyte: Well, Doctor, why are some children more prone to illness or have weakened immune systems?

Dr. Claudia Espinosa: We sometimes have problems with our immune system from  when we are born.  Other times it's because children don't have a healthy lifestyle. So, for example, they don't get enough nutrients, they don't eat well, they don't sleep well, and they don't do exercise.

So, all those things, having a healthy life is going to make our immune system to be healthy. Kids that do not follow those interventions are going to be more prone to have infections. The other thing is the vaccination. We see a lot of kids now not being able to respond well to infections because they are not vaccinated. So, they will have more infections than other kids.

Caitlin Whyte: Well, can you tell us about the medications that are currently available and their effect on patients? 

Dr. Claudia Espinosa: So, we have changed a lot over time in terms of our possibilities to prolong life, to identify diseases. There are many medications now that we know are affecting our immune system. Some of them, we really need to give it to treat other conditions. For example, children who have malignancies, children who have leukemia, children who have tumors, they may need medications to suppress those tumors.

They are going to need part of the medications that are going to be those that will make our immune system weak. So, the medications can act properly and kill the tumor, for example. So, steroids, chemotherapy, all those medications can decrease the activity of our immune system.

Caitlin Whyte: And how can we mitigate and avoid exposures if we have that weakened immune system?

Dr. Claudia Espinosa: It is very important that we keep a healthy lifestyle, healthy diet, healthy habits, sleep well, get plenty of rest, avoid stress, increase exercise and then decrease exposures to certain pollutants, for example, that can increase the risk of infections. For example, smoking has been noted for many years to cause a lot of problems, decreases the activity of your immune system, specifically in the respiratory system.

So those are exposures that parents can  decrease, in order to increase the activity of the immune system.

Caitlin Whyte: And on that note, what effect do those environmental factors like stress, sleep, and nutrition have on our immune systems?

Dr. Claudia Espinosa: Yes, they are very important. Sometimes we think that it is a cliché to say that your child needs to sleep well and you need to have enough hours of sleep and it's very important to have a healthy diet. But the reality is that it is true that if we don't get enough sleep our immune system is going to be stressed. 

If we don't get enough nutrients, let's say for example, a kid that is a picky eater. They maybe are going to have nutritional deficiencies and those nutrients are going to play an important role in the cells that compose the immune system. So, it's a myriad of things that we need to do in order to increase the activity of our immune system. 

Another thing that you mentioned is stress, right? Well, that's very important too. We don't realize how sometimes kids get really stressed.  For either, you know, school, with their friends, even when they are just playing video games, they can get stressed. Stress is a very important problem that can decrease the activity of the immune system.

And the problem with some of those, stress, for example, is very difficult to control in some patients. With recent years, we have seen an increase in mental health problems, and with those, we have seen increased levels of stress, and children who do not sleep, for example, are going to keep those levels of stress also elevated , so not sleeping enough.

We see this problem really often in teenagers, especially, where they have the schedule for sleeping not really well put together. They like to stay up at night and they don't realize that the next day they are going to be stressed even if they don't know it. And nutrition, like I said before, there are many nutrients that are in our regular food that we should use in our everyday so we can keep our levels of those vitamins and other nutrients to be able to have healthy cells that are going to be able to fight infections.

Caitlin Whyte: And to wrap up today, Doctor, after the pandemic, why may some people still wear masks?

Dr. Claudia Espinosa:  With the COVID pandemic, we had a lot of lessons to learn.  There are some occasions in which masks are  necessary. For example, if your child has a problem with the immune system, if they are immunosuppressed, if they are using chemotherapy because they have  cancer, a malignancy, then those patients, which I explained before, they are going to have less immune system activity. Their immune system is going to be weak.

Then, they should use masks, especially when they are going to places where there are a lot of people. You know, one of those things that I always put as a example is planes, right? In a plane, you are breathing the same air of a hundred and something people at the same time and their air is circulating.

And it's the same air, right? So, if somebody has an infection there, then it's going to be easier to be transmitted during that trip. If patients know that their immune system is not competent, that it’s weak, then they should probably use masks, especially when they are going to be in situations where they are going to be with a lot of people.

On the other hand, right, immunocompetent children and immunocompetent people may not need to do this  . In any case, the decision to use the mask, it's very specific for every person. Some people really don't need it, but we always need to think about the rest of the people that we are in contact with.  If you know that your child is sick and they have had fever, don't send them to  they need rest and they should stay at home and just rest and have all the support at home. And second, the spread of diseases is  possible in that scenario if you send your child that is sick to school. And so same with the health care workers. So in general, we should try to protect all the people that do not have an immune system that is working that can definitely get much more sick than we are going to get, if they get any of the common infections.  

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