Swine Flu: : Our State of Uncertainty

[Guest guest]

Swine Flu

Schor ND FABNO

May 1, 2009

We returned from Washington, DC earlier this week and I promptly took ill. It is

just a typical spring flu similar to the ones I suffer through yearly. Yet given

the current news about Swine Flu, I admit to being a little nervous about this

year?s illness. Though the odds are like a million to one against my having

caught Swine Flu, the worry has inspired a bit of reading on my part.

The Centers for Disease Control and Prevention has a H1N1 page that is updated

regularly. I go to this page all too frequently to watch the daily tally of

cases by state. As I type this, Colorado is still has had only two confirmed

cases. See:

http://www.cdc.gov/h1n1flu/

There are reasons why we are frightened by this flu outbreak. Probably the

biggest is how little we actually know about how this disease will behave.

??This is a rapidly evolving situation.? Said Dr. Besser, acting

director of the Centers for Disease Control and Prevention. ?It is a situation

filled with uncertainty.? [1]

The worse case scenario of course is that we will see a repeat of the 1918 flu

pandemic. That too was an A(H1N1) strain that went pandemic, killing people from

the arctic to remote Pacific Islands. Current estimates say somewhere between 20

million to 100 million people died from this flu between March, 1918 and June,

1920.

The 1918 virus was called the Spanish Flu because early reports suggested it

originated in Spain. More credible evidence now suggests it originated at an

army base in Kansas. The virus that caused the 1918 pandemic has persisted in

pigs until the present time but only rarely caused human infection. In rare

instances it would infect individuals working in close contact with pigs but did

not appear to spread person to person.

The Spanish Flu was distinct in that mortality rates were highest among the

healthy. Typically with flu, the young and old are more likely to die but in

1918 more than half the victims were between 20 and 40 years old, 90% younger

than 65. It is this tendency to disproportionately kill the healthy that led

Mexican health officials to suspect the swine flu and identify it. Typically

10,000 people die of seasonal flu infections in Mexico each winter season. With

a population of 110 million people, even those cases do not stand out. That they

noticed these relatively few cases of fatalities among an atypical population

group and tested for the new strain is impressive.

This tendency to kill the healthy is theorized to be the result of a phenomenon

called a ?cytokine storm.? Cytokines are inflammatory chemicals released by the

immune system in its efforts to combat infection. In theory the

Spanish/Swine/H1N1 flu strains do an exceptionally good job at triggering a

sudden and rapid release of cytokines causing a wave of intense inflammation

that overwhelms victims. The healthier a person is, the more powerful a cytokine

storm that is triggered. Despite all the articles written on cytokine storms in

the last few days, there still isn?t conclusive evidence that the Mexican

fatalities have suffered from these ?storms.?

Yet this hasn?t stopped anyone from running with the idea. Yesterday?s article

on MedPage Today, followed up on the rationale that if cytokines cause

inflammation, any anti-inflammatory drug might be useful. They quote Dr.

Fedson as suggesting that, ?? Statins, fibrates, and glitazones " could be used

to modify the host response, [making it] more like that of the children who

lived in 1918, not like that of the young adults who died. " [2] Even if it may

sound like it, Fedson isn?t trying to drum up more business for the drug

companies. [Perhaps the website is] In truth, Dr. Fedson has been a long time

proponent for finding generic and inexpensive flu treatments, not necessarily

the prescription drugs suggested in this MedPage article.

A more in depth interview with Dr. Fedson quotes him suggesting herbal anti

inflammatory agents as well as those drugs by Big Pharma, including curcumin and

resveratrol. [3][i just took 3 grams of curcumin after typing that]

If indeed our current version of the Swine Flu does turn out to trigger cytokine

storms, this puts an interesting color to our selection of treatments. In a

typical year, like other naturopathic doctors, we treat a fair number of flu

cases among our patients. Typically we employ a combination of herbal extracts,

vitamin supplements and homeopathic remedies with a degree of success. If

cytokine storms prove to be part of the new virus? presentation we need to

rethink some of these choices.

A colleague of mine in Ireland, Nicolas Kats raised this question this morning

when he wrote, ??. I'm accustomed to treating deficient immunity systems. But

how do I understand & treat when the immunity system is overactive, killing the

robustly healthy person?...?

In other words, we will need to discriminate in our treatments between those

things that bolster and strengthen the immune system and those that are directly

anti-viral. We want to favor the later and avoid the former.

In simpler terms, Echinacea, because it stimulates immune function, might

backfire on us, while licorice, because it is directly anti-viral, may be

valuable.

The old homeopathy books review data from the practices of homeopathic doctors

during the Spanish Flu Pandemic and suggest that their patients had a far lower

death rate from the flu than others. [4] Back then the homeopathic remedies most

useful were Bryonia and Gelsemium. These remedies are still often useful in

treating seasonal flu though response varies each flu season. As the flu season

progresses we often get a hint from colleagues which homeopathic remedies are

proving most useful in their practices as the infections move across the

country. In recent years Eupatorium has been commonly indicated. Keep in mind

that homeopathic remedies are not prescribed by specific disease but by the

symptoms a patient presents with. At this point, we are in the midst of a very,

?uncertain? situation. Time will tell.

In his Op-Ed piece in today?s New York Times, Julio , current dean of the

Harvard School of Public Health writes, ??Viruses are sensitive to seasonal

temperature change, and this one, like the 1918 influenza, may reappear more

robustly in the fall.? [5] Our regular readers will know that I will take

exception to that statement. As I?ve written about in the past, the seasonal

fluctuation in flu infection is best correlated with changing ultraviolet light

exposure. In recent years the accepted explanation is that greater exposure to

ultraviolet light in the summer increases vitamin D levels. If you want more

information on this idea a good place to start are our past newsletters:

Influenza and Vitamin D, November 2006

http://denvernaturopathic.com/news/influenzaandvitD1.html

I confess that in the last few days I?ve taken nearly a quarter a million IUs of

vitamin D, just to be on the safe side, and will no doubt do so again before

next fall?s flu season.

At this point we are getting phone calls and emails from patients asking what to

do. At this point, I?m not eager to make strong suggestions aside from the basic

ones of good hygiene [that means wash your hands frequently] as found on the

CDC?s website.

We are also getting countless emails from people and company?s eager to sell

their ?flu cure? to us and through us to you. As time progresses and we

understand this phenomenon better we will have more specific information to

offer.

In the meantime these past newsletters have addressed general strategies for flu

prevention and might prove worthwhile to read:

http://denvernaturopathic.com/flu.html

http://denvernaturopathic.com/news/fluprevention.html

http://denvernaturopathic.com/fertilefield.htm

References:

[1] Grady. Flu Spreads to 12 states; uncertainty continues. New York

Times May 1, 2009 pg A10

[2] IVW: Strong Immune Response Could Be Behind Swine Flu Deaths

By Todd Neale, Staff Writer, MedPage Today

Published: April 30, 2009

[3]

http://afludiary.blogspot.com/2009/03/flutrackers-interview-with-dr-david.html

[4] http://www.naturalnews.com/026148.html

[5] Julio Frenk. Mexico?s Fast Diagnosis. New York Times May 1, 2009 page A21

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