In response to rising measles cases this year, some are claiming that measles is actually good for children—that fighting off the infection will make them stronger. 

These rumors are catalyzed by the overall sentiment that children in our modern era are less healthy than they used to be. While there are some types of disease where this is true—metabolic syndrome is on the rise, for example—infectious disease is certainly not one of them.  

Infections are not good for children—they have historically been the top killer of children—and our modern age is an anomaly, in a good way, when it comes to the ultimate marker of childhood health: not dying. 

The mythical “good old days”—when children had flourishing immune systems from their natural lifestyles and didn’t need antibiotics or vaccines—simply did not exist. Back in those days, a lot of children died. 

We have forgotten how many children used to die before their fifth birthday.

Today, the death of a child is considered unusual and especially tragic. For nearly all of history, this wasn’t the case. Death of children was extremely common. Until about the 1800s, roughly half of children died before reaching puberty.

In the early 1900s in the U.S., one in ten infants would not make it to their first birthday, and 30% of all deaths in the U.S. were children younger than 5 years old, compared to less than 1% today.

For most of history, infections were the top cause of death

Infectious diseases are not our friends. For the vast majority of human history, they were by far the leading cause of death:

• In the medieval era, aside from deaths only categorized by age (infants and “aged”), the top categories of death were overwhelmingly infectious diseases, including tuberculosis, “fevers,” and leprosy.

• In 17th century London, “consumption and cough” was the leading cause of death (consumption describes “wasting away” diseases and was later used to describe tuberculosis primarily), followed by “chrisomes and infants” (childhood deaths), “ague and fever” (fever/chills), and “plague.”

• In 1900 in the U.S., infectious diseases were still the top killer overall (pneumonia, tuberculosis, and diarrhea/enteritis topped the list). 40% of those deaths were in children under 5.

• At the end of the twentieth century, infectious diseases were still the most common cause of premature death worldwide.

Children today are undoubtedly healthier

Deaths from infectious diseases have plummeted with the discovery of bacteria and viruses, improved sanitation, pasteurization, the discovery of antibiotics, and the development of vaccines. Childhood mortality dropped astronomically, and life expectancy in grew by three decades in the twentieth century alone. The most dramatic increases are among children under 5 years old.

What about the hygiene hypothesis?

Towards the end of the last century, as the risk of death from infections decreased, the risk of other diseases increased, including allergies. In 1989, an epidemiologist hypothesized there may be a link. He published a study showing that children from smaller families had a higher incidence of “hay fever” (allergic disease). He postulated that children with fewer siblings may be at higher risk of allergic disease because they catch fewer childhood infections. 

This became known as the “hygiene hypothesis,” which states that overly clean environments are problematic and that children must be exposed to germs to develop their immune systems.

This hypothesis was just that—a guess based on observational data. It is now 35 years old, and more data has come out that shows it wasn’t quite right.

Commensal microbes are helpful; disease-causing microbes are not

The hygiene hypothesis was right that exposure to germs matters, but it was wrong about which germs. The original paper hypothesized pathogenic (disease-causing) germs—viruses and bacteria that make kids sick—were important for immune development. While research is still ongoing, the evidence to date doesn’t support this. 

Instead, the data suggest that the commensal “healthy” microbes—the good bacteria that make up our microbiomes—are beneficial.

• Early childhood exposure to microbe-rich environments like farms or pets is associated with a reduced risk of allergic problems, likely due in part to an impact on the child’s microbiome

• Pathogenic viruses like RSV are associated with increased risk of asthma

The hygiene hypothesis identified an important link between a child’s environment (like pets, farms, etc.), their exposure to germs, and the risk of allergic disease. But it got one part wrong—children don’t need infections to be healthy, they need exposure to “good germs” supporting a healthy microbiome.

What about building “immunity?”

Finally, some argue infections are beneficial because they allow children to build immunity against the infection. While having immunity is good, this does not mean infections are “healthy” or should be sought out — seeking immunity in this way is a risky bet. Some infections don’t provide long-term immunity (like RSV and COVID), other infections can wipe out immune memory from previous infections (like measles), and all infections carry a risk to the child. It is much better to get the immunity without getting the infection. That’s what vaccines do.

Bottom Line

Infectious diseases are not good for children. If you want to help your child’s immune system, get them vaccines and a puppy, not a virus.

Sincerely, Dr. P

This is the first post in a new section of YLE called Health (Mis)communication!

The flood of health rumors, confusion, and flat-out lies we now encounter daily is a giant problem—and it won’t be going away. Misinformation was named the top global concern in 2024. In the latest YLE survey, you expressed substantial interest in this topic. We are launching this new section focused on misinformation and more importantly, the antidote: health communication that actually works. 

Dr. Kristen Panthagani, rockstar physician-scientist, scientific communicator, and creator of the medical blog You Can Know Things, will lead this section and bring the latest to the YLE community. You may recognize her name—we’ve written on viral health rumors together from rumors about sudden deaths after Covid-19 vaccines to the recent misguided public health advice for the Florida measles outbreak. I have learned so much from her, particularly on approaching rumors with empathy. 

Stay tuned for more posts from Kristen!

Love, YLE

Kristen Panthagani, MD, PhD, is a resident physician and Yale Emergency Scholar, completing a combined Emergency Medicine residency and research fellowship focusing on health literacy and communication. In her free time, she is the creator of the medical blog You Can Know Things and author of YLE’s section on Health (Mis)communication. You can find her on Threads, Instagram, or subscribe to her website here. Views expressed belong to Dr. P, not her employer.

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It will come as a surprise to exactly zero regular readers that I have been contemplating the concept of obscenity lately. What may come as a surprise to you, however, is exactly why I have been thinking about that. And friends, it’s not because medieval people are being prudes – it’s because we are, now.

This actually comes up for me rather a lot because of my book. You see, the very excellent One and Future Sex (which is available now in paperback! So if you haven’t got a copy yet I am choosing to interpret this as a personal slight!) has a very gorgeous fifteenth-century image on it which features both the Virgin Mary and Eve. (Yeah, it’s that one up there at the top. Nice right?) I chose it because it does a great job encapsulating medieval and modern conceptions of women. In that we can either be perfect virgin mommies are we are temptress sinners who will drag all of humanity to its ruin. (Freud referred to this as the Madonna-Whore complex when it exhibits itself in individuals, but this is a Deulezian blog, and also I don’t believe in the individual, and society already expressed these concerns historically, so hey ho.)

Anyway, great image! Historical! Religious! It also means that I cannot advertise my book online, and that it gets flagged as obscene imagery on social media sights. I am being serious.

This has happened because of a really bad piece of legislation in the United States called FOSTA/SESTA. It’s one of those gross paternalistic attempts to “save” women from sex work, which of course only makes the lives of sex workers dramatically less safe.[1] As a part of this, anything that mentions sex, or any images which show nudity – more particularly nude women – get flagged as potentially part of a sex trafficking scheme or something. (Fun fact – most trafficked people work in the agricultural sector, or also very commonly in nail salons. But apparently that is all fine and we need to focus on what some idiot thinks sex trafficking is because they’ve seen Taken.)

I want to be as clear as possible – the primary victims of SESTA/FOSTA are sex workers, who have a harder time advertising, see themselves criminalised, and miss out on ways to organise, find each other, and work more safely as a result of it, but there are knock on effects as well. It is, for example, almost impossible to do online sex education. And also I can’t sell a book with a picture of Eve that is half a millennia old because it’s just TOO DAMN SEXY.

This would be incredibly funny if it wasn’t affecting my livelihood, because it just shows how here in the twenty first century, we are way more prudish than medieval people were. Medieval people a) can absolutely handle a picture of Eve being naked, and b) also understand it in a religious context which, in theory, should nullify the who sexy thing.

To be fair, this does not always work, and is part of the reason that Protestants went all iconoclast, but fundamentally medieval people erred on the side of “if you are finding yourself turned on by this painting of Eve that is a you problem.” We, apparently are unable to do that, and have decided that Eve must be protected from being sex trafficked and also your sensitive eyes must never behold her shameful sexy boobs.

So, obviously this is something that I think about a lot because I am constantly pinching the bridge of my nose as I am once again told that my attempts to promote my book have been flagged as a sensitive image. But, I thought about it again the other day when I was in Bologna.

One of the primary reasons I was eager to get back to Bologna was to see the so-called Chapel of the Magi in the Basilica of San Petronio. And, yes, the Magi are cool and stuff. But in my opinion? It has one of the most incredible Hell frescos ever created. Painted by Giovanni da Modena (c. 1379-c. 1455) in the fourteenth century, it is incredibly detailed, and features recognisable local figures. (LMAO, get their asses Giovanni.) They are all suffering ironic punishments in the hereafter based both on whether they fell prey to one of the seven deadly sins, or if they are one of the sinners against God.

For those not in the know, the seven deadly sins are of course, Lust, Gluttony, Sloth, Pride, Wrath, Envy, and Greed. The more esoteric sins punished up top in the realm of sins against God include the punishment of the schismatics, idolaters, and enchanters.

If you are enjoying this post, why not support the blog by subscribing to the Patreon, from as little as  £ 1 per month? It keeps the blog going, and you also get extra content. If not, that is chill too.

Now this fresco made an incredible impression on me when I first saw it is a bright young thing back in the mists of time, and I was eager to get back and have a stare at it with the benefit of my big brain and a PhD in medieval history. After all, it played a role in my decision to ruin my life by dedicating it to the study of the medieval, so, surely, I should check back in with it these years later and see if it missed me.

In the intervening years, the good people at San Petronio had decided that a good way to make some extra money for the upkeep of their fine and excellent church was by cordoning it off and putting it behind a curtain. Fair enough, in my opinion! We are all out here trying to survive and keep ourselves afloat in late-stage capitalism, and medieval churches need to be maintained! If it was going to cost me five euro to visit my friend, five Euro they shall have! However, as I bought my ticket I was also informed that photos of the fresco weren’t allowed. This made me slightly sad, but once again I thought, well, fair enough! They want to sell me some postcards of it afterword, so I guess they win this round.

I am a bit of a stickler for rules at historical sights, so while I had photographed the fresco from the church floor outside the curtain which was allowed, I duly followed the rules inside the chapel. I was very very busy going “Oh! LOOK!” and pointing at various things anyway, so hey ho.

When I emerged half an hour later I popped back to the gift shop and bought a whole book on the fresco for a further sixteen Euro, so eager was I to get hold of an entire picture of the thing, and also contribute to its upkeep.

Anyway queue me and my charming boyfriend having an aperitivo outside the church afterwards, me pulling out the book to have a look, and flipping immediately to the close ups on the images of the sin of Lust, only to find that they are incomplete.

Readers, I lost it.

I mean, of course what I wanted to look at was the bit about Lust. That’s my whole job! That’s it! It dominates the bottom right corner of the fresco, so it’s closest to eye level for people actually in the chapel. It also means that when you are behind the curtain outside you can’t even see, let alone photograph, a little bit of it.

And baby let me tell you, it is worth photographing. See, you know how above, I was like “medieval people thought it was weird if you were turned on by a picture of Eve”? Well the painting of Lust is like, a dare. The sinners being tortured for it are all naked, as is standard for any soul being pictured after death, because souls don’t have clothes. What is not standard is that their ironic punishments for their sins could also be described as S&M. I am talking about spiked snakes coiling about thighs, or in one case a demon straddling a blond-haired beauty and choking her. This is interesting because it’s not a standard punishment of the lustful, who we often see just being boiled in cauldrons, though the also sometimes seem kinda into it. For example:

Now here you can say, “I mean sure Eleanor, but isn’t S&M a modern thing and aren’t you reading a lot into this?” To this I say, go read the blogs on medieval kink again if you are going to be contrary like that. And secondly, the thing about specifically the beautiful women who are being punished for lust is they are breaking the fourth wall, looking directly at the viewers, and smiling.

Obsessed doesn’t begin to cover it.

I absolutely love this because Giovanni da Modena is essentially engaged in a sort of dare with viewers. This was his chance to paint something sexy and … he has. And you as a viewer can’t admit that it is sexy because if you do then you yourself are falling prey to the sin of lust! It’s an elaborate bluff! If you think it’s sexy, then you have admitted to being a damnable pervert. So, you can’t. So, there it is, on the walls of the church.

Now of course plenty of people wouldn’t be aroused by this and can just relate to it as a beautiful piece of religious art and a stirring warning of those things that await the lustful. This is absolutely true. However, what is also true is that the church itself which has photographed every inch of this painting flat out refuses to allow you to take a picture of this section now. Because it’s hot. They don’t want people like me taking pictures and saying “AWOOOGA” online or something. So they have contrived to censor only the sexual bit of this painting.

This to me is very funny because there are plenty of bits that are incredibly violent and they are more than happy to provide you with detailed pictures of them. Personal favs of mine is the gluttonous guy who is impaling his head on a spike attempting to get to a roast chicken, as well as the greedy who are pushing each other out of the way to have molten gold poured down their throats. Violence? You can see that. Sex? Absolutely beyond the pale.

And here again we see the difference between medieval and modern attitudes to sex. Sure, yes, as I say, the reason that this image was allowed at all is that you would need to admit it was sexy to put a stop to it. However, there was also an understanding of it, as with the image of Eve, that sexiness was permissible to show as a part of spiritual exempla. You need to understand that Eve’s inherent sensuality and folly led to the downfall of all humans. You need to know if you go around thinking about sexual acts you will end up in Hell. Audiences were trusted to understand the message within the context.

Now, however, we can apparently not be trusted to see Eve or contemplate Lust because we must be protected from our unstoppable horniness. Someone – whether it’s the American federal government, or the officials in a church in Bologna has to save you from yourself and stop you from viewing what I cannot stress enough are religious images.

Anyway, guess what? I am very stubborn and I am afraid the nice people at San Petronio are gonna have to take an L this round. After having spent twenty-one Euro trying to photograph this thing so I could show you pictures I became incensed enough at the audacity of this censorship that I just went and bought a high-resolution image of it from Alamy, with the attendant rights to put it on the blog. So here it is in all its glory:

And, more particularly, here are the Lustful who are absolutely hoping you will notice them from across the church and dig their vibes.

And since I mentioned it? Here’s the gluttonous and their chickens and shish kababs.

The morals of this story are several. The most important is that paternalism like this can’t really succeed and is harmful in general. People don’t need to be protected from pictures of nudity and should instead be trusted to interact with art as they see fit because its none of your business how they feel about a particular piece of art.

A less important rule is that I am very strong willed, and if you tell me I can’t show people something medieval I will find a way to do so. …even to the detriment of my own bank account. So, uh, subscribe to the patreon I guess?

[1]  D Blunt and A Wolf, ‘Erased: The impact of FOSTA-SESTA and the removal of Backpage on sex workers’, Anti-Trafficking Review, issue 14, 2020, pp. 117-121.

For more on sexuality in the medieval period see, IDK the whole damn blog? Try these:
On medieval kink part 1 and part 2
On women, pleasure, and semen
On semen retention

Support the blog by subscribing to the Patreon, from as little as  £ 1 per month! It’s the cool thing to do!

My book, The Once And Future Sex: Going Medieval on Women’s Roles in Society, is out now.

© Eleanor Janega, 2024