Germs in China: Immunity Training Ground?

31 Mar 2017

I got through this winter without getting sick (not more than a few sniffles, anyway), UNTIL two weeks ago, when spring arrived and I got hit by a horrible cough, condemning me to long coughing fits every morning and evening for over two weeks. It was the kind of cough that I thought was “getting better” every day, until evening hit. It was bad, but not bad enough that made me go see a doctor. And it’s now finally almost faded away, about 15 days since it started. (You’ll notice I haven’t been blogging for this same time period.)

But this got me thinking about my own immune system in relation to China. After 16.6 years in China, has my immune system been “trained” at all? I don’t think there’s any way to definitively answer this question, but I’ve got a few thoughts, and I’m hoping others might share their experiences.

fake germs

Growing up in Florida, I was a pretty healthy kid, especially once I got into my teens. My mom was fond of saying, “you rarely get sick, but when you get sick, you get really sick.” I barely remember getting sick at all in college, including the year I studied in Japan. After that I came to China.

My first year in Hangzhou, I had the obligatory newbie food poisoning incident and it was really bad, which ended with me getting an IV in a hospital (as so many illnesses in China tend to). And then as time went on, I would get colds more frequently in China than I had before. I still get hit by the “China germs sucker punch.”

I would expect, after moving to a new environment with a fairly dense population, swimming with a whole new world of germs, to get sick a bit more often than before. And I think this is what has happened, leading up to gradual new “China immunity” layer in my body’s defenses. And over a decade later, I feel that I do get fewer colds, provided that I don’t get too behind on my sleep. But I don’t feel at all confident anymore saying things like “I rarely get sick” now that I live in China.

All this leads me to a few questions I’ve been thinking about:

  1. Do most expats from the USA (or other relatively sparsely populated western countries) get sick more frequently after moving to China?
  2. Are most long-term expats able to build up a stronger immunity to Chinese germs?
  3. Does a long stay in China lead to a permanently stronger immune system in other countries?
  4. Do Chinese immigrants to the USA get sick less often in the USA than they used to in China?

It would be hard to answer these questions through research, and I realize there are quite a few variables involved (I’m no longer in my twenties, for example) but I’m interested in hearing my readers’ anecdotal evidence. So how about it: in your experience, is China an immunity training ground, or does it simply have its way with you until you’ve had enough?


John Pasden

John is a Shanghai-based linguist and entrepreneur, founder of AllSet Learning.


  1. I’m pretty sure the plural of anecdote is data, so here’s mine: I didn’t get sick much before moving to Shanghai, while in Shanghai, or after moving back to the US. I called in to work sick a lot, but that was usually just the Maoming Lu Flu. My wife claims she was almost never sick in China, and is still very healthy after moving to the US.

  2. I lived in China for three years and definitely got sick more often. Every spring and every fall I got a sinus infection. I’ve now been back in Texas for 5 years, and haven’t had a single sinus infection. My wife is from 舟山, and she never got sick either in China or in Texas. However, she does get really bad allergies here, which I seem to be immune to.

  3. An interesting question. Kinda, and kinda not. I think my immune system was more robust before I came to China. For example, I did not fear the wind. I did not fear getting chilled. And I drink cold stuff all the time. Only the last has stayed. Now I try not to have the wind blow on me too much, and I’ll put on a windbreaker or cover my head in a chilly bus or a/c at the mall. My stomach still responds well to ice and coke and ice water.

    It’s hard to say if this is part of getting older, or a response to China germs. My last trip to California, after about two weeks I did feel a bit better overall. Generally, I can hold off a cold/flu here, and/or self treat for a couple weeks. I refuse to do the IV drip thing. I have seen too many friends get scary hives after an IV drip. I think all of last year I didn’t have a cold, but did come down with a bout over CNY.

    Scientifically speaking, I don’t think the immune system will dramatically change in mid-life due to environment. My understanding is that the basic immune anti-bodies and how they will react are established when quite young. My mom did like to stick me around other sick kids, and it was pretty much just chicken soup, Vicks and rest if I came down with a cold.

    What I do think has happened is that my strong reluctance to go to a local clinic has made me very aware and conscious about staying fit, eating well, getting sleep, etc. Thus, I’d say I’m probably the healthiest I’ve ever been on-average if I was to compare overall time in China to overall times outside of China.


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