more exercise , a little less food and a little less tobacco and alcohol ” was one of the famous quotes by William Osler , a renowned physician more than a century ago .

He recognised the detrimental consequences of alcohol on health and observed increased risk of pneumonia or lung infection among alcoholics . In Malaysia , the National Health and Morbidity Survey ( NHMS ) in 2019 stated 11.8 per cent of the population are alcohol drinkers with almost half binge drinkers . The most prevalent alcohol-related deaths are road traffic accidents , followed by liver cirrhosis and cancer , based on report by the World Health Organisation ( WHO ). Alcohol use , especially heavy alcohol use , is associated with various health issues . Most notably , it increases the risk of infection through its indirect but toxic effect on the body system .

Autoimmune phenomenon

We are constantly exposed to microorganisms that are present around us . Some microorganisms are possibly harmful while others have beneficial effects such as promoting the healing process in the body . Our body has its own mechanism of protecting itself from pathogens and this is called the immune system .

There are several innate cells and highly specialised cells involved in this intricate network of the immune system . Alcohol consumption weakens this

sepsis Alert

By Dr Nurul Huda Ahmad

and Assoc Prof Dr Tan Toh Leong

immune system either by destroying the cells or by altering its functions .

While it is true that the effects correlate with the amount and duration of alcohol consumption , there are studies showing significant effects on the immune system even with a single episode of binge drinking . An impaired immune system provides the opportunity for harmful pathogens to thrive and increase the risk of infection . Metabolism of alcohol in the liver releases a by-product called aldehyde , which binds and mutates cell proteins in the body . These mutated cells known as neo-antigens are perceived as abnormal cells and cause development of antibodies that attack these altered normal cells leading to the autoimmune phenomenon .

The effects of this phenomenon can be seen in alcoholic liver disease . Progression of the disease continues despite the absence of alcohol in the body . Over time , less and less exposure to alcohol is needed to cause liver inflammation and the severity worsens with each repeated occurrence .

Long standing inflammation causes the cells to die and lead to a condition called cirrhosis . Patients with liver cirrhosis are highly predisposed to infection with up to 50 per cent of deaths in cirrhotic patients accountable to infection .

Other effects of alcohol

One of the direct effects alcohol has is on the gastrointestinal system where nutrition absorption takes place . Not only does it disrupt the symbiotic relationship between microorganisms in the gut and intestinal immune system , alcohol also

impairs the cells in the intestinal lining and cause leakage of microorganisms from the gut into the body circulation leading to infection .

Similarly , alcohol also cause disruption in the lungs . It weakens the lining of both the upper and lower airway as well as interrupt the function of immune cells . All these damages may go undetected until one develops respiratory infection .

For those with chronic alcohol consumption , even a simple respiratory infection may lead to more severe lung diseases owing to the coexisting immune impairment .

Statistics has shown binge drinking is a worrying prospect among Malaysians . The percentage of binge drinkers in Malaysia in 2019 exceeded the proportion seen in other countries such as the United Kingdom and Indonesia .

Adding to this concern is the fact that the majority of binge drinkers are young adults , leading to a much-reduced life expectancy . A more active national movement is necessary to draw attention to the causes and effects of alcoholism .

Awareness on alcoholism needs to be strongly disseminated within our society . — The Health

Dr Nurul Huda Ahmad is a Lecturer and Emergency Physician at Universiti Teknologi MARA ( UiTM ) and also vice secretary of the Malaysian Sepsis Alliance ( MySepsis ) while Assoc Prof Dr Tan Toh Leong is Senior Lecturer and Consultant Emergency Physician at Universiti Kebangsaan Malaysia Medical Centre ( UKMMC ) and President and Founder of MySepsis .