10/3/2016 — I’ve revised the 2nd strategy for prevention (see below) and supplied a new link for obtaining Influenzinum.  I’ve also added a few comments here and there.  It will be best to just re-read the article.  The swine flu section immediately below is no longer relevant, but will be left in for historical purposes.

9/13/2009 — Update regarding Swine Flu:  Owing to the outbreak of SARS a few years ago, and the recent publicity about the Avian Influenza (“bird flu”) the entire world seems to be on high alert regarding control of epidemic disease.  This is certainly a good thing.  Now there is a huge amount of publicity regarding the “novel H1N1”  virus, otherwise known as “swine flu.”  This virus is now spreading in many countries, including the United States (particularly in the Southeast, and since colleges and schools have started receiving large numbers of students).

Rather than write a long article duplicating many other easily available sources of information, the following are the main points that I consider to have practical importance:

1.  Swine flu is very contagious, and a large number of cases can be expected.  It does NOT appear to cause serious illness in the great majority of people, however.  With some exceptions, the illness has been very mild.  But because it will likely be very widespread, we may expect more serious illness and death than with the usual seasonal flu.

2.  So far, the virus has not mutated in ways that could be expected to make the disease more serious.  For the same reason, the vaccine that has been developed will continue to be as effective as the early studies have demonstrated.  My understanding is the “effectiveness” in the vaccine trials is measured by antibody response, which presumably translates into immunity.  The ability to generate antibody response to vaccine (or the the flu itself, for that matter) depends on the state of one’s health.  The elderly, for example, tend to not generate a vigorous antibody response to influenza vaccine.  I suspect that the lack of antibody response is probably more related to poor health than simply to age.  More information on various aspects of the vaccine can be found at here.

3.  There have recently been a report that swine flu has been transmitted from humans to turkeysThe theoretical risk of such transmission is that swine flu and bird flu might combine to form a more lethal virus.  Fortunately, turkeys in Chile (where the report originated) have not been found to be infected by bird flu.

4.  There are also some reports of resistance to antiviral drugs. These drugs may have risks, particlularly in the elderly (a colleague working in a hospital and nursing home settings tells me that when these drugs are used, there is a greater tendency for the elderly to fall)  and in adolescents.

5.  Injectable vaccine does contain Thimerosal, a mercury based preservative, unless the vaccine comes in a single-use vial.  Other adjuvants (compounds that increase the immune response, such as aluminum and formaldehyde) may also be used, depending on the manufacturer.  I do not have official information regarding these issues at this time.  No safety problems have been noted so far, but the vaccine has only been tested on approximately 5000 individuals (to my knowledge).  This is not a sufficient sample to assess vaccine safety.  The supply of the H1N1 vaccine may arrive after the flu epidemic has already peaked.

There are reports, outside of conventional channels,  of safety concerns regarding the H1N1 virus.  Although I am unable to assess the significance of these concerns, those of you interested in alternative views might begin here and here.

6.  First priority for swine flu vaccination will be given to health care and emergency workers (so the medical and emergency systems are not disabled by illness), pregnant women (who are at higher risk for serious illness and death from the swine flu), everyone of ages 6 months to 24 years (who have less immunity to H1N1 flu than other age groups), and adults up to age 64 with serious underlying medical problems, and people caring for infants under the age of 6 months.

7.  Inhaled H1N1 vaccine will be available, although in relatively small quantities.  I like the idea of inhaled vaccine because in disease, the virus enters the respiratory tract and first encounters the secretory IgA arm of the immune system, and the inhaled vaccine more closely duplicates this process.

8.  The normal hygienic precautions will continue to be as effective as ever, provided people utilize them.  These are detailed later in the body of this article.  There is a lot more known about Vitamin D, and John Cannell, MD, of the Vitamin D Council proposes dosages of Vitamin D for the prophylaxis and treatment of flu which can be found here.  In brief, to build the body’s inherent resistance, he recommends that adults take 5,000 Units of Vitamin D (cholecalciferol), and that children take 1000 Units per 25 pounds of body weight (presumably up to 5000 units/day), both for 3 months, to build Vitamin D levels to 50 ng/ml.  These recommendations seem reasonable to me.

9.  Homeopathic prophylaxis is discussed below.  At this time I do not have any specific recommendations for a “genus epidemicus.”  The experience of homeopathic physicians in Mexico City has been described in various reports, but my own communication with them has not so far been helpful to sufficiently narrow down the treatment options to a few specific remedies.  I will update my website as further information is available.

End Update

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There are many viruses associated with “flu-like” illness, manifesting as fever, muscle and/or joint pains, fatigue, and upper respiratory symptoms (sore throat, laryngitis, cough, bronchitis, pneumonia). Strictly speaking, the term “influenza” refers specifically to those illnesses “caused by” a particular fam
ily of viruses, known as the Influenza virus. The presence of this virus can only be confirmed through laboratory testing, which can take weeks to complete.Influenza, as an epidemic illness, usually begins in southern China. It is thought that conditions in that area, in which humans, wild fowl, and pigs live in close proximity to each other, are ideal for the development of the virus. It then travels around the world, utilizing migratory wild fowl, and is also transmitted from human to human, traveling by air. During its migration around the world, the virus often mutates, making the preparation of a vaccine (which must be planned for and prepared months in advance) a chancy proposition. In fairness, however, the vaccine is often a reasonably close match, sufficient to promote immunity.

Influenza is most severe for the elderly, the very young, those with chronic respiratory diseases, those with other severe chronic diseases, or persons treated with immunosuppressive drugs (steroids, chemotherapy agents, radiation therapy, etc.) Should this year’s epidemic be severe, it is possible to use homeopathy both preventively and as therapy.

The effect of influenza vaccination on mortality (death) in the elderly was studied by Simonsen, L et. al. (Archives of Internal Medicine, 2005 Feb 14;165(3):265-72.), who concluded “Influenza vaccination coverage among elderly persons (> or =65 years) in the United States increased from between 15% and 20% before 1980 to 65% in 2001.” Despite this change, “we could not correlate increasing vaccination coverage after 1980 with declining mortality rates in any age group.”  A 2014 paper by the College of Family Physicians of Canada states that “For healthy adults, the flu shot reduces the influenza rate when the vaccine is well matched (number needed to treat [NNT] of 12 to 37). A poorly matched vaccine has diminished effectiveness. For community-dwelling seniors, the NNT to prevent 1 case of influenza is 40. The flu shot has not been shown to decrease hospitalizations. Evidence that the flu shot decreases mortality is likely biased.”  

The NNT (number needed to treat) here is the number of people who have to be vaccinated in order to prevent one case of flu.

My position, in general, on this vaccine is that while some may benefit, many do not, and so other precautions are indicated.

A further discussion of NNT in relationship to flu vaccine, with a more optimistic viewpoint can be found here.

Injectable influenza vaccine also contains small amounts of Thimerosal, a mercury compound of definite toxicity, and which accumulates in the body.  Other adjuvants (compounds to increase the immune-stimulatory reaction to the vaccine) may also be present, such as aluminum and formaldehyde.

It has been found that adequate levels of Vitamin D (in the 1,25(OH)2D) form, which is in effect a steroid hormone formed in the skin after exposure to sunlight, is a powerful preventative against influenza (and probably other diseases). Relevant information can be found at the http://www.vitamindcouncil.com/newsletter/2006-oct.shtml. Many people are deficient in Vitamin D, especially since there is widespread avoidance of sunlight.  Vitamin D-3 (cholecalciferol) is readily available, inexpensive, and safe to take in doses of 1000-2000 (or more) units daily for long periods of time.  It is also possible to measure the blood level of vitamin D.  More information can be found in the Vitamin D article on this website.

Prevention through homeopathy is accomplished by any of three strategies:

  1. The classical strategy is to take, prior to getting sick, the remedy or remedies that are the most useful (eg that are commonly successful) in treating the current epidemic. This works well but has the disadvantage that we don’t know which remedy to use until several cases have been successfully treated. At that point, the epidemic is already upon us. 
  2. If you know your constitutional remedy, and it has worked very well, it is likely that it will work well for you if you should become ill with influenza.  This, however assumes that certain “constitutional” aspects of your case do not change during the acute influenza.  The most useful of these traits are the “thermals” (whether you in general prefer warmth or cold) and your level of thirst.  For example, if you are usually averse to heat, preferring cooler environments, and are generally a thirsty person, but when you are sick you want warmth and have a significant reduction in thirst, you will probably need a different (but often traditionally related) remedy.
  3. The use of “nosodes,” which include remedies made from disease causing agents, in this case Influenzinum. During an epidemic, this is a strategy that the experience of homeopaths around the world suggests can be quite effective. I would recommend that a 200th potency be used once a day for 3 successive days (assuming no reaction) and then once a month during “flu season,” or once weekly in a severe epidemic. This may be obtained from Homeopathic Labs (800 4663672). They will dispense, to my patients only, a 160 pellet vial (32 doses at 5 pellets each) for a cost of approximately $15, including shipping.

I noted that several people, when they felt that they were becoming ill, took Influenzinum to treat the acute illness. Although no one became very ill, I cannot connect this to taking the remedy, and I do not recommend this remedy for the treatment of influenza.

Prevention, in a hygienic sense, involves the following:

  1. We should all be using good hand washing technique, especially after being in crowded environments where people are sneezing. If we ourselves have an upper respiratory illness, we should wash our hands before serving food to our families, changing diapers, or having any kind of hand contact with our families, friends, etc.
  2. During an epidemic, avoid crowded areas. If you must, using a mask (like surgical mask, or even a dust mask available at hardware stores) may help. Gloves can also be useful for the same reasons. The flu virus is passed through droplets from the nose and lungs.
  3. We should all sneeze, if necessary, into the crook of our elbow, or into a good sized handkerchief, rather than into our hands. Wash the hands afterwards, certainly before touching anyone else. (The bird flu is also passed through feces, apparently).
  4. If you have chickens, or have close contact with live chickens, then please keep close track of the spread of avian flu. While there are many types of avian (bird) flu, the type causing such concern now, known as H5N1, has not appeared in the western hemisphere as yet. Because of the close surveillance being mounted world-wide, we will probably learn of its arrival in a fairly timely fashion. In that case, and if you have chickens, you will have to be especially vigilant.

Prevention through vaccination: Flu vaccine should not be hard to come by this year, and is to be given to those considered at high-risk:

  • persons aged 2-64 years with underlying chronic medical conditions (diabetes, kidney disease, etc.)
  • all children ages 6-23 months
  • all women who will be pregnant during the flu season
  • adults aged 65 or older
  • resident
    s of nursing homes and other chronic-care facilities
  • children aged 6 months – 18 years who are on chronic aspirin therapy
  • health care workers involved in direct patient care
  • out-of-home caregivers and household contacts of children younger than 6 months

Avian (Bird) Flu: Of interest lately is the “bird flu” (avian flu) which, though similar to the other strains causing problems this year, is only transmissible directly from live chickens. There have been several cases reported from a variety of Asian countries, approximately half of them fatal. There have been no documented cases of human-to-human transmission so far. There is, however, a danger that the avian flu might combine with other flu viruses which can be transmitted from human to human, and cause a widespread influenza epidemic with a high mortality rate. Avian flu was the cause of the 1918 pandemic which caused millions of deaths across the world.

One class of conventional anti-viral (including Amantadine) is ineffective against this type of flu. Tamiflu, made by the Roche corporation (from an extract of a Chinese herb) is helpful in reducing the length and severity of avian flu, though it provides no protection from the infection itself. There are efforts being made to synthesize the chemical present in the herb so as to reduce the cost and increase the availability of this drug.

As of January, 2006, there are reports suggesting that Tamiflu is no longer effective against the avian influenza virus. This is being looked into, and definitive data is not yet available.

Of interest, I ran across an article describing a pilot study in which Sambucol, a proprietary elderberry extract was found to be very effective against avian flu, reducing the amount of virus inside the cells by 99%. I found this at http://www.ejpress.org/article/news/western_europe/5398.

The World Health Organization has called for intensive research into possible vaccines. A vaccine has been developed and has gone through preliminary testing, and found to be capable of inducing an antibody response in humans (although at higher than usual doses). It is not known, however, whether this vaccine will be effective in preventing an epidemic. Another problem that may limit the effectiveness of any vaccine made at this time is that the avian flu virus will have to mutate from its present form to cause an epidemic, and those (or other) mutations may make the present vaccine ineffective.

An interesting article appeared in the New York Times (Science Times section) on 11/8/2005. It appears that the current avian flu virus may have been circulating in some areas of China for a number of years (possibly a dozen), without having developed the ability to be transmitted from human to human. If this is true, then there may be much less danger from the current bird flu virus than is feared. In addition, there are significant genetic differences between the current avian flu virus and the bird flu virus which caused the 1918 pandemic.

this time, it appears unlikely that avian flu will be a problem in the near future. The situation is being monitored carefully, in particular regarding the genetic changes that would be necessary for the avian flu virus to infect humans and to cause an epidemic.
There are recent, but unconfirmed reports that
Avian flu has recently mutated to become better able to survive in the
human upper respiratory tract (which is cooler than that of birds). 

This would increase the likelihood of it being able to cause an
epidemic or pandemic..

If history is any
guide (and it usually is), there will be another severe influenza
pandemic in the next several years. The avian flu is a prime candidate
as a causal virus.  

Another interesting article appeared in the NY Times in late March ’06, describing the genetics of the current Avian Flu virus, why the virus is not very communicable from human to humans at this time, and the possibilities for it to mutate to a form which would be much more dangerous.

UPDATE 11/10/2007:  Although I have started to receive calls regarding the flu, there are a very few cases reported in this country as yet .  In Connecticut, as in some but not all neighboring New England states, flu activity is indicated to be “sporadic.” You many start using prophylaxis, but it is too early to be aggressive about it..

The type A virus strains so far reported by the CDC are covered in the vaccine that has been prepared.  Type A virus is more dangerous than the Type B (which this year’s vaccine does not match).

To take the vaccine, or not to take the vaccine: There are risks on either side of this question. In a very mild flu season, healthy persons do not run a substantial risk from contracting the flu. Occasionally, individuals may have severe reactions while the great majority of others do not. A colleague of mine had a severe and rapid course of illness and was fortunate enough to be hospitalized and treated successfully with anti-viral drugs.

During the run-up to the Swine Flu epidemic (which never arrived) during Gerald Ford’s presidency, there were many cases of paralysis (Guillaume-Barre syndrome) from the vaccine against Swine Flu. Since the disease never materialized, this was indeed a tragedy. Imagine, however, that a vaccine with some effect was available to ward-off infection with an influenza with a high attack rate (percentage of those exposed who become ill) and a high mortality rate (percentage of those infected who die of the disease). It would indeed be foolish to not take the vaccine.

Accordingly, and in keeping with my usual recommendations on conventional treatments, you must make your own decision. I will not tell anyone to not take the vaccine. If Avian flu becomes an epidemic, I will advise everyone to be vaccinated (if possible).

Should the vaccine contain Thimerosal (a mercury based preservative), this poses an additional problem for those contemplating taking the vaccine.  Injected vaccine generally does contain Thimerosal, while the inhaled vaccines do not.

The Centers for Disease Control website, www.cdc.gov/, is a good source of continuing information as the flu epidemic progress

The National Center for Homeopathy has compiled an interesting set of articles about influenza. I recommend them to you for further information.

My recommendations are the same: be in good health, use common sense hygiene, and use influenzinum as indicated above. Keep watching this space for more updates.