BIRD FLU MYTHS. Nyema Hermiston Adv Dip Hom ND RN

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1 BIRD FLU MYTHS Nyema Hermiston Adv Dip Hom ND RN This article, based on the presentation given at the recent National Conference in Fremantle, outlines the issues facing homeopaths on treating influenzas. Introduction Before the end of World War One, from the autumn of 1918 to the end of 1919, the Spanish Flu killed tens of millions of people. Due to a world grappling with the impact of a world war and being struck unexpectedly by influenza pandemic, records were not always kept. Developing countries did not keep any records, so the true number of deaths will never be known. Statistics vary depending on the source, but the majority of sources quote between 21 and 50 million deaths. In comparison, nine million lives were lost in the Great War. The impact of these figures may be remote to us, but if we remember the impact of the Boxing Day Tsunami of 2004, where there were 226,000 deaths, and many more injuries, we can only imagine the impact the Spanish Flu deaths in had, in a much smaller global population. While World War One has been remembered and commemorated for almost one hundred years, the event that took a far, far greater number of lives than World War One did, the I influenza epidemic, mysteriously remains largely forgotten in history. Homeopathic history books report great success in the treatment of the Spanish Flu. The current bird flu virus has been identified as H5N1, which is a close relation of the H1N1, Spanish Flu virus. This is of particular concern, because after reviving the N1N1 virus from corpses that died from the Spanish flu, scientists expect that the virility and symptoms of the H5N1 virus will be similar. If there is another human avian influenza pandemic, will the familiar homeopathic medicines be effective or are homeopaths relying on anecdotal information and basking in the successes of their forebears? MYTH # 1: THERE IS NO REAL RISK OF A HUMAN AVIAN INFLUENZA PANDEMIC BREAKING OUT It may be due to the global amnesia of the severity of the Spanish Flu, that it is difficult for many people to relate to the possibility of a pandemic occurring in our lifetime, and that it could be far more severe than any of us could imagine. Most of us in the developed world have lived safe and healthy lives for the past 60 years. However, United Nations officials warn that an avian influenza epidemic is a phenomenon that will happen, but because no one knows when, the risk of complacency leading to little or no preparation is high. Bird flu has now reached 55 countries, causing 220 million deaths in birds. So far, 143 human deaths have been recorded. The H5N1 virus will be at its most dangerous if and when it is transmitted between humans. The H5N1 virus is mutating rapidly, making it impossible to develop an effective vaccine. If a pandemic occurs it will take between three and six months to develop a vaccine. Of even greater concern, is that no one knows if a vaccine will work until there's a pandemic. The World Health Organisation centre in Melbourne is currently developing a flu vaccine and trialing it on Melbournians. If the Melbourne trial proves to be effective, the Federal Government will buy five million doses. Governments all over the world are developing contingency plans in the event of a Human Avian Influenza outbreak. (1) MYTH # 2: WE ONLY NEED TO ACT IF AND WHEN AN OUTBREAK OCCURS For people who have never experienced a public health crisis, it is difficult to grasp what the impact of any epidemic or pandemic might be. It stands to reason then, that most people are not necessarily compelled to do anything about it right now. If an outbreak of human-to-human transmission of avian influenza did occur, which scientists have clearly stated is inevitable, on-the-spot preparation will be almost impossible, due to the public panic that (history has shown) occurs when pandemics break out. As few of us living have experienced anything like this before, (living survivors were young children at the time, and report losing parents and siblings) it is difficult to imagine the reaction that will sweep through the community, as people fall ill and quarantine measures are imposed. As with any civil emergency, public gatherings would be banned, theatres, movie houses, schools and the like would be closed, and of course there would be panic buying of food, medical supplies, masks, gloves and so on. 1

2 In his now famous speech on 2 nd May 2005, Tony Abbot, Federal Minister for Health, (2) spelt out how bad a pandemic could be. Perhaps 40,000 Australians dead. He painted a picture of hospitals with not enough beds or equipment to deal with the sick, people fleeing cities and riots. He said that his brief from the Chief Medical Officer made the stuff of daily politics and routine administration seem utterly trivial. Here are some points from his painted scenario : young adults appear to be the most severely affected, widespread panic begins because a vaccine is not yet available and supplies of anti-viral drugs are severely limited. Rates of absenteeism in schools and businesses begin to rise. Exaggerated accounts of illness are reported by the media. Citizens begin to clamour for vaccine but only ten per cent of the estimated need is available. Hospitals and outpatient clinics become severely short-staffed when the majority of physicians, nurses and other health care workers become ill. Intensive care units at local hospitals become overwhelmed and soon there are widespread shortages of mechanical ventilators for treatment of patients with pneumonia. Family members become distraught and outraged when loved ones die within a matter of a few days. As people leave cities to escape crowded areas, looting becomes a serious problem in major metropolitan areas due to shortages of police officers. Further deterioration in health and other essential community services occurs over the next six to eight weeks as illness sweeps across the country How many Australians noticed the speech? Although this issue has not been emphasised to its citizens, the Australian Government does have an extensive website on a potential Human Avian Influenza Pandemic, in which it outlines a preparedness plan. The plan s recommendations to Australians include acquiring emergency supplies, food stores, medicines, masks, gloves, garbage bags and so on. (3) MYTH # 3: A STRONG IMMUNE SYSTEM WILL PROTECT AGAINST AVIAN INFLUENZA In a society where living standards are high and governments provide health care systems, most of us can rely on either natural or artificial immunity to protect us against severe and life threatening disease. It is at this point of understanding where the characteristics of the Spanish Flu vary from the influenza we are most familiar with. Each year, the World Health Organisation releases a vaccination to protect nations around the world against the current influenza strain, advising that those with weaker immune defences, children and the elderly, will most benefit from vaccination. However, most who fell victim to the Spanish Flu were healthy adults between 20 and 40 years old. The more dynamic the immune system was, the more severe were the flu symptoms. Autopsies performed on humans who have fallen victim to the current H5N1 virus, show that this virus kills via a cytokine storm. The primary immune response attacks the virus, followed by, a secondary immune response, the cytokine storm. Cytokine storms occur when a virus is particularly vigorous, causing the waste products of the primary immune response, like macrophages and fluids, to accumulate in the lungs and eventually block off the airways, causing the pneumonias that potentially result in death. It was this pneumonic influenza that killed many of the Spanish flu victims. As the genetic makeup of the H5N1, or Avian Influenza virus, is the most similar to the H1N1 or Spanish Flu virus, those who have contracted flu from the H5N1 virus risk the cytokine storm response. As already stated, all influenzas since 1919 have had different genetic structures from the Spanish Flu, so there is currently no inherent immunity to the H5N1 virus in our global population. Due to the vigour of the H5N1 virus, scientists are saying that it could kill at the same rate as the Spanish Flu virus. Normal influenzas kill 0.1 per cent of the population is affected, whereas the Spanish Flu killed 2.5 per cent of its victims. (4) MYTH # 4: PREDICTIONS OF A PANDEMIC IS SCAREMONGERING Anyone reading Tony Abbott s speech might believe that it is an over reaction. It is of course important not to over-react to potential threats, but if, as scientists continue to warn the world, a deadly flu pandemic ever seems imminent, no preparations will be enough. The trick is to be afraid just enough to do something about it, or have fear in the right proportion. Based on current information, most governments around the world believe that it is essential to lay down preparations and plans to follow should an outbreak occur, but are being careful not to spread panic about something that may not occur for five, ten or more years. Some people believe human avian influenza will never happen and those who predict that it will happen, are spin doctoring for the benefit of just a few. Understandably, some people believe that the money spent on avian influenza preparedness plans might provide more benefit for countless people, many of them children, by 2

3 being spent on current health crises, which kill millions every year, like HIV AIDS and malaria. However, it is the scientists, not pharmaceutical companies, that have been sounding the warning for many years, in a similar way that predictions of global warming have been made in the past 20 or so years. Many experts believe it is only a question of time before the next pandemic strikes. (5) MYTH # 5: TREAT THE H5N1 VIRUS LIKE ANY OTHER FLU Each year influenza sweeps around the world, with some annual viruses having more severe effects than others. The great concern about the H5N1 virus is its similarity to the Spanish flu or H1N1 virus. Since the Spanish Flu pandemic, there have been two severe influenza pandemics. In the Asian flu (H2N2 virus) killed two million people and in , the Hong Kong flu (H3N2 virus) took one million lives. (6) All three influenza outbreaks have been causes by Influenza A viruses. Human pandemics result when a new influenza A virus mutates and emerges with the capacity to spread between humans and can infect a completely different animal species. The 1918 Spanish Flu was caused by an adaptive mutation of an avian influenza A virus and the current bird H5N1 virus is a sub-type of it. (7) Of all influenza viruses that circulate in birds, the H5N1 virus is of the greatest concern for human health because of has caused the greatest number of human cases of severe disease and deaths. It has crossed the species barrier to infect humans on at least three occasions: in Hong Kong in 1997 (18 cases with six deaths), in Hong Kong in 2003 (two cases with one death) and in the current outbreaks that began in December 2003 and were first recognised in January (8) Since then, 149 human deaths have been recorded. The Spanish Flu is the most virulent influenza virus known to science and spread faster than any plague the world has known. Killing at 25 times the rate of common influenzas, it decimated indigenous populations and killed more people in less time than all the plagues in history. Although children and the elderly are usually the most susceptible to influenza, Spanish Flu mostly killed year olds. It killed quickly, within 2-3 days and sometimes less than 24 hours from the first onset of symptoms. (9) The clinical features of the recent cases of human avian influenza are well described in the World Health Organisation Avian Influenza Fact Sheet (see Ref no 8) have been collated with international collaboration and are well worth becoming familiar with. If the H5N1 virus mutated sufficiently to enable human-to-human transmission, as scientists fear, the flu symptoms that patients would present with would be unlike anything practitioners of any discipline have ever experienced before. Effective homeopathic treatment of avian influenza would require knowledge of the specific virus and the range of symptoms it produces. MYTH # 6: THAT TUB AVIARE AND OSCILLOCOCCINUM WILL PROVIDE IMMUNITY AGAINST HUMAN AVIAN INFLUENZA After following avian influenza reports for the several years now, I have wondered how homeopaths as a profession will respond to the growing concern voiced by governments and the scientific community about a potential pandemic. When I heard ideas being put forward by some homeopaths that the H5N1 virus could be treated in the same manner as other influenzas, and saw literature in the public arena along the lines of build up the immune system to protect against bird flu I was prompted to research this topic in more detail and present it to my peers. According to the homeopathic doctors attending the World Medical Conference on Homeopathy and Avian Influenza held in Paris, 19 th November 2005, (10) the best approach for any influenza is prevention, using a nosode that contains the genetic structure of the current influenza virus, which, for this potential pandemic, needs to include the H5N1 virus. The nosode that contains the closest epidemic structure of the H5N1 virus, and the most likely to be preventative, is the Influenzinum derived from the flu pandemic. At the above-mentioned conference, doctors from eight countries concluded that the two nosodes for general use to treat flu, but are not preventative, are: Pyrogenium; suitable for a number of symptoms common to all influenzas. 3

4 Oscillococcinum; Studies show that Oscillococcinum does not confer immunity against influenza, but is most effective if given within 48 hours of the onset of influenza symptoms. (11) They did not include Tub Aviare or Oscillococcinum in the prevention strategy The work of Dr Antoine Nebel was outlined at the Paris conference by Dr Jennifer Jacobs, from the USA, using the writings of Dr Georges Demangeat. (12) At the peak of the Spanish flu epidemic, Dr Nebel created an influenza nosode by combining the potentised blood of a dying flu patient with Eupatorium. The resulting Influenzinum Hispanicum saved thousands of lives in the hands of homeopathic doctors. Dr Nebel subsequently prepared an Influenzinum adapted to each year s epidemic influenza structure, and used his preparations for prevention and cure of the flu. The original Influenzinum Hispanicum no longer exists, but Nelsons and Ainsworth s pharmacies in London state that their Influenzinum 200 is derived from the Spanish Flu. Given that it is unlikely that a sample of the H5N1 virus will become available to homeopaths, the most similar nosode we have is the Influenzinum, which descends from Influenzinum Hispanicum. Homeopathic Pharmacies in Australia stock Influenzinums from a range of influenza epidemics. Some pharmacies stock Influenzinum 200, which derives from Influenzinum Hispanicum. It goes without saying that prevention against any influenza using specific nosodes would be a priority. Having hopefully debunked some myths surrounding the potential threat of a human avian influenza pandemic, we can now consider how, as homeopaths we might respond to the potential situation. The National Centre for Homeopathy in the US has an online Genus Epidemicus project for the homeopathic treatment of epidemics. (13) The following remedy information has been gathered from the information presented at the World Medical Conference on Homeopathy and Avian Influenza held in Paris, 19 th November Doctors from eight countries attended, with the aim of developing a preparedness plan and strategy for the homeopathic prevention and treatment of human avian influenza. The most commonly prescribed medicines in the 1918 pandemic were Gelsemium, Bryonia, Eupatorium Perfoliatum, and Aconite. The US homeopaths seemed to favour Gelsemium. The French homeopaths used more Eupatorium. The big question is, would the symptoms resemble Spanish Flu if an H5N1 pandemic broke out? The World Health Organisation s reports of recorded cases of Avian Influenza in humans have shown a wide variety (and therefore challenging to treat with homeopathy or allopathy) of symptoms: The H5N1 virus follows an unusually aggressive course, with rapid deterioration and high fatality. The incubation period varies from two to 17 days. Symptoms vary enormously, from diarrhoea, vomiting, abdominal and chest pain, to bleeding nose and gums. Not all confirmed cases have had respiratory symptoms. Most do have lower respiratory tract manifestations, sputum is often blood stained and a secondary pneumonia is common. Some patients have primary viral pneumonia, which is unresponsive to antibiotics. Some present with acute encephalitis. Others begin with fever and diarrhoea. Many of these symptoms may be treated by looking at the main medicines that were used by homeopaths in the Influenza Pandemic: Arnica Montana & Phosphorous viral pneumonia, & haemorrhagic symptoms: bleeding from gums & nose, multiple organ failure Baptisia Tinctoria flu with diarrhoea and other digestive elements Bryonia Alba fever, cough, inflammation of serous membranes Eupatorium Perfoliatum - muscle & bone pain, headache & eye pain Gelsemium & Apis Mellifica flu and encephalitis, headaches Oscillococcinum Pyrogenium septic states, aching, bruised, sore, pulse abnormally rapid, out of proportion to fever, or opposite 4

5 Rhus Toxidendron if another infection is involved, such as herpes. Sulphur More recently, medicines being considered are: Crotalis Horridis Echinacea Angustifolia Thymuline 1 Veratrum Viride Yersin Serum 2 PROPOSED STRATEGY: In the event of an epidemic: - use isopathy as a preventative. Look for a group remedy according to Hahnemann Methodology: 9, 14, 32, 56, 82, 186, of The Organon. (14) As soon as first patients fall ill, prescribe medicines proven to stimulate body s natural defences: Influenzinum, Oscillococcin, Yersin serum (see footnote 2) The homeopathic treatment and prevention of a potential Avian Influenza epidemic can be done by applying in a modern way the treatment for the epidemics stated by Samuel Hahnemann more than 200 years ago ; the carefully observing physician can, however, from the examination of the first and second patients, often arrive so nearly at a knowledge of the true state as to have in his mind a characteristic portrait of it, even to succeed in finding a suitable, homeopathically adapted remedy for it. Prescribe the medicines for all our patients without waiting for the appearance of first symptoms. As the epidemic virus is stronger than the individual reaction, patients will tend to present very similar symptoms. A medical core needs to collaborate and come up with a treatment model: eg Gelsemium, Bryonia, Apis Provide all colleagues with a specific Avian Influenza medicine package. Include necessary instructions for a therapeutic preventative and treatment strategy. Also, homeopaths must participate in a network to ensure rapid exchange of the information needed to choose the best treatments and the distribution of such information. An efficient network of homeopaths connected around the world rapidly working online is absolutely required. It follows that the prescription of the correct remedy as a preventative therapy be given to as many people as possible, as well as the selection of a suitable treatment for affected patients. The work should be monitored in cooperation with the national and local health authorities in order to evaluate the efficacy of the homeopathic intervention. IN THE EVENT OF AN OUTBREAK: The only starting point we as homeopaths can have, is to meticulously study the symptoms of the first cases that appear. This same method could be used in a variety of epidemics: whooping cough, cholera, typhoid, where homeopathy has succeeded and acquired its best reputation. Despite its complexity, a well-conducted observational study should allow a comparison to be made with data published by recognised institutes. Homeopaths need to form, in each country, small groups for studying the symptomatology, which may vary from country to country, depending on the stage of the mutating virus. This may mean going to the emergency departments of hospitals to analyse a number of cases. These observing groups can quickly 1 Nonathymulin a thymus-dependent polypeptide (nonapeptide) found in normal blood serum. Also known as serum thymic factor or, in the French context, Facteur Thymique Serique (FTS), a synthetic nonapeptide according to Martindale. It is understood to be involved in, or able to induce, lymphocyte (T-cell) differentiation. Available from Boiron / Dolisos from 4C. 2 Yersin Serum is the nosode made from the antitoxic serum of the Bubonic Plague. It was named after the Russian doctor Alexandre Yersin, who discovered how The Plague was transmitted to humans in the late 1. 5

6 communicate and exchange information, then publish and circulate details, so the vast majority of homeopaths can use them. We can hope for an exchange of global experience via the Internet for the Avian Influenza pandemic. This could help find not only preventative measures for flu, but also for other winter seasonal illnesses like coryzas, bronchitis, sinusitis etc. This strategy could also document the new flu virus each year and build a body of experience and communication in the homeopathic community internationally, years before any pandemic may occur. SO, DO AUSTRALIAN HOMEOPATHS NEED TO MAKE PREPARATIONS? An overall strategy would need to consider prevention first, and then treatment as needed. As there is a Genus Epidemicus project (14) already underway, it would be a logical step for the Australian homeopathic community to become aware of the details of this project. It is reassuring to know that there is a plan being developed. The crucial point to grasp is that today s human race has no antibodies and therefore immunity to defend itself against the H5N1 virus. As it would take time to develop vaccines, homeopathy could play a preventative role. A treatment plan would need to include a battery of medicines that would stimulate innate immunity, as Dr Jennifer Jacobs has proposed. (15) In the event of a pandemic, it is of course impossible to say with certainty, which will be the wisest standard homeopathic treatment, but the few historical documents there are, tell us that some medicines, will find themselves in the spotlight, as indicated in W A Dewey s now famous article A Chorus of Fifty in Harmony, published in Clinical Medicine in (16) A reasonable and logical balance between individualised and standardised treatment, both for prevention and cure, should lead to a standardised protocol. (17) In October of last year, the AHA posted on the website, (18) its position statement on Avian Influenza, which is as follows: Inform yourselves of the symptoms of the anticipated pandemic as events progress & provide appropriate homoeopathic treatment. Make yourselves aware of current Health Department protocol about dealing with the Bird Flu. Inform patients of the potentially rapid course of the disease and the serious consequences if left untreated. Recommend that patients also seek the advice of their GP as soon as possible. Record all advice given to patients in your patient case notes. Keep checking the website for updated information DO WE WAIT UNTIL AN EPIDEMIC OCCURS? No one can say there wasn t enough time to prepare. It is neither expensive nor time consuming to make some basic preparations. Hopefully as health professionals, we would not place ourselves in such a situation as having to respond without adequate preparation. Would Australian homeopaths connect with the international community, or develop its own internal structure? With or without a national strategy, as individual practitioners, there are some basic preparations we can make, which are based on the Australian Federal Government s Preparedness Plan. (19) Clinic: Consider how you might immunise yourself against bird flu Become familiar with infection control measures 6

7 Have facemasks and gloves available Order extra stocks of unmedicated pilules, bottles, bags, labels menstruum Ensure adequate supplies of appropriate medicines Provide a flu information sheet to your patients Provide patients with main flu remedies to keep at home Inform patients that phone consults can be done if quarantine measures are imposed. Know how to contact the Health Department in your state if you suspect a case of avian influenza. Home: Know basic hygiene measures Have personal protective equipment available Purchase necessary medicines Have emergency stores portable radio, batteries, matches, candles, tissues, garbage bags Have food supplies to last at least one week. (Some authorities recommend four weeks supply) If you live alone, identify a person who you can contact or check on you Know the state or territory information line Know how to find pandemic information in your state via phone or Internet. What is learned from early preparations can be applied to other epidemics, caused by any infectious disease, long before any pandemic may arise. Only benefits can come from developing a network between homeopaths, nationally or internationally, in order to treat epidemics. If you are interested in developing an Australian preparedness plan for the homeopathic treatment and prevention of human avian influenza, please nyema@bigpond.net.au REFERENCES (1) Background Briefing: Bird Flu Risks, Laws, Rights. ABC Radio July (2) Health Minister Tony Abbot s address to Australia October 2005 Bracing Ourselves for the Worst 4/$File/ABBSP251005a.pdf (3) The Australian Health Management Plan for Avian Influenza (4) 1918 Influenza Project Winnebago County, WI UW-Oshkosh study w/community (5) New Scientist: Frequently Asked Questions: Instant Expert: (6) Centre for Disease Control and Prevention: (7) Australian Government: Avian Influenza: Key Facts (8) World Health Organisation Fact Sheet (9) 1918 Influenza Project Winnebago County, WI UW-Oshkosh study w/community 7

8 (10) Notes from World Medical Conference on Homeopathy and Avian Influenza held in Paris, 19 th November 2005 (available on request) (11) Oscillococcinum in patients with influenza-like syndromes: Papp, Shuback, Beck, Burkard, Bengel, Lehrl, Belon - British Homoeopathic Journal April 1998 Vol 87, pp (pdf available on request) (12) Collection Of The Publications of Dr. Georges Demangeat Influenzinum, A Critical Study &oi=translate&resnum=1&ct=result&prev=/search%3fq%3ddemangeat%2binfluenzinum%26hl%3den%26l r%3d%26client%3dsafari%26rls%3den (Long URL because of French English translation. Will this reference on request) (13) National Centre for Homeopathy Genus Epidemicus Project (14) The Organon, 6 th edition Samuel Hahnemann (15) Notes from World Medical Conference on Homeopathy and Avian Influenza held in Paris, 19 th November 2005 (available on request) (16) Homeopathy in Influenza A Chorus of Fifty in Harmony W A Dewey MD University of Michigan (PDF available on request) (17) Notes from World Medical Conference on Homeopathy and Avian Influenza held in Paris, 19 th November 2005 (available on request) (18) Australian Homoeopathic Association Website (19) The Australian Health Management Plan for Avian Influenza FURTHER REFERENCES: WEBSITES There is Evidence that the Spanish Flu did have Haemorrhagic Symptoms Homeopathy and Influenza: Real Research, Real Results Dana Ullman MPH BOOKS Homeopathic Treatment of Influenza - Bird Flu Edition Surviving Influenza Epidemics and Pandemics - Past, Present and Future with Homeopathy Sandra J. Perko PhD CCN American Homeopathy in the World War Frederick Dearborne AB, MD Clarke s Dictionary Practical Materia Medica Influenzinum Monera: Kingdom Bacteria and Viruses Spectrum Materia Medica Volume 1 Frans Vermeulen MORE DETAILED INFORMATION is contained in the Conference Proceedings Manual from the AHA National Conference, 28 th 29 th October 2006, Fremantle WA. (Available on request.) 8

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