Swine flu / H1N1 virus

More than 340,000 people around the world have contracted the Influenza A(H1N1) virus, and at least 4,100 people have died from it, according to data from World Health Organization (WHO) released in October 2009.1 While hundreds of thousands die each year from seasonal flu, WHO warns that swine flu could cause more infections, as people have no immunity to it. The organization is therefore stressing the importance of an effective vaccine.2 Many developing and heavily-populated countries, which will likely not be able to vaccinate the majority of their citizens, are turning to medicinal herbs with immune-boosting properties in attempts to help protect against the virus commonly known as swine flu.

Across China, the most populated country in the world, several plant-based initiatives are taking place to address H1N1; China’s health ministry expects to vaccinate only 5% of its total population of 1.34 billion. As preventative measures, the education ministry is planning to give students free Traditional Chinese Medicine (TCM), and the State Administration of TCM is recommending people take the Chinese herbal mixture Lian Hua Qing Wen, versions of which contain forsythia (Forsythia suspensa, Oleaceae) fruit and honeysuckle (Lonicera spp., Caprifoliaceae) flower.3

In Beijing, the Ditan Hospital reported that it used herbs to treat 117 H1N1 patients and experienced a 75% success rate.4 Patients were given a tea and mouthwash containing 3 grams each of Japanese honeysuckle flower, isatis (Isatis indigotica, Brassicaceae),* mint (Mentha spp., Lamiaceae) leaves, and licorice (Glycyrrhiza uralensis, Fabaceae) root.

Capital Medicinal University in Beijing is conducting a clinical trial to assess if the roots, stems, and flowers of more than 10 Chinese medicinal herbs are effective and safe for treating H1N1 infections.5

“Such herbs has been used for thousands of years in China to treat flu and pandemic flu,” said Cao Bin, MD, the principal investigator of the study (e-mail, September, 25, 2009). “But it is the first time we try to prove the safety and efficacy of Chinese herbs in the treatment of pandemic (H1N1)2009, following the principles of evidence-based medicine.”

Researchers in neighboring Taiwan, meanwhile, have found that compounds from the roots of the Asian plant asafetida (Ferula assa-foetida, F. foetida, Apiaceae) are more effective at killing the H1N1 virus than prescription antiviral drugs.6 Also commonly known as devil’s dung or giant fennel, asafetida roots were used against the Spanish influenza in 1918, and researchers are now saying that these compounds “may serve as promising lead components for new drug development against this type of flu.”

India, the second most populous country in the world, isn’t expecting a vaccine to be available until April of 2010.7 The government has decided to allow the local production of shikimic acid, a compound of non-nitrogenous acid found in various plants and used to make the antiviral drug oseltamivir (Tamiflu®). While the health ministry is recommending people with serious flu symptoms go to the hospital for treatment, it is suggesting that others with no-to-mild H1N1 symptoms can use traditional medicine to increase the strength of their immune systems.8

In Bangalore, known as the Garden City of India, an increasing number of people are purchasing Indian tinospora (Tinospora cordifolia, Menispermaceae), a deciduous climbing shrub with anti-inflammatory and anti-allergic effects and immune-boosting properties.9,10 In the Indian tribal district of Dangs, where medicinal plants grow throughout the forests, the health department is giving tourists an herbal drink that also contains Indian tinospora,11 as well as holy basil (Ocimum tenuiflorum, Lamiaceae), which exhibits adaptogenic, anti-inflammatory, and antioxidant activities,12 and ginger (Zingiber officinale, Zingiberaceae) root, which has anti-nausea and anti-inflammatory effects.13

Though people around the world are seeking to prevent cases of H1N1 through the use of herbs, WHO has advised the public to not purchase any medicines to fight or prevent the virus unless prescribed by a healthcare practitioner.14 Likewise, a US dietary supplements industry coalition advised consumers that “therapies for the treatment of swine flu should only be recommended by qualified healthcare professionals or public health authorities.”15 The coalition recognized that some dietary supplements “have much to offer in terms of enhancing general immune function” but said self-care for swine flu should be actively discouraged.

The US Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) issued a warning that they will aggressively identify, investigate, and take regulatory or criminal action against individuals or businesses that wrongfully promote products as treatments for H1N1.16 FDA has since sent more than 136 warning letters to offending websites that have promoted products using unapproved swine flu-related claims (such marketing was not necessarily promoted by the manufacturers of the products). FDA’s “fraudulent product” list includes 4 herbal extracts, 2 teas, and at least 64 supplement products. The majority of the offending websites have since changed or removed the swine-flu related health claims from these products’ marketing.

While most Americans will likely choose to get the H1N1 vaccine, the national media continues to document individuals and healthcare practitioners who focus on natural alternatives to vaccination for seasonal flu and/or swine flu.

The San Francisco Chronicle, for example, featured an article discussing a naturopathic doctor’s flu prevention strategies of eating garlic (Allium sativum, Alliaceae) and maitake (Grifola frondosa, Polyporaceae), shiitake (Lentinula edodes, Tricholomataceae) and reishi (Ganoderma spp., Ganodermataceae) mushrooms, and taking additional herbs to support health.17

Additionally, The Denver Post has featured several medical doctors’ prevention advice, which also included taking astragalus, as well as vitamin D and probiotic supplements, turmeric (Curcuma longa, Zingiberaceae) root, and ginger. If flu infection does occur, a doctor in the article recommends taking a proprietary herbal extract made from the roots of Pelargonium sidoides (Geraniaceae) used traditionally in South Africa to treat various symptoms of upper respiratory tract infections.18,19

—Lindsay Stafford

* Both leaf and root of isatis are used in TCM; the plant part for this formula was not specified.

References

Pandemic (H1N1) 2009—update 68. World Health Organization website. Available at: http://www.who.int/csr/don/2009_10_02/en/index.html. Accessed October 6, 2009.

What is the new influenza A(H1N1)? World Health Organization website. Available at: http://www.who.int/csr/disease/swineflu/frequently_asked_ questions/about_disease/en/index.html. Accessed September 30, 2009.

Juan S. H1N1 could hit tens of millions. China Daily. September 12, 2009. Available at: http://www.chinadaily.com.cn/china/2009-09/12/ content_8684701.htm. Accessed September 21, 2009.

Margolin C. Swine flu cured using Chinese herbs. Alternative Health Journal: July 25, 2009. Available at: http://www.alternativehealthjournal.com/ article/swine_flu_cured_using_chinese_herbs/3705. Accessed September 18, 2009.

Capital Medical University. Chinese medicinal herbs treatment on novel influenza A (H1N1): multi-centre, prospective, randomized controlled study. NLM Identifier: NCT00935194. ClinicalTrials.gov. Available at: http://clinicaltrials.gov/ct2/show/NCT00935194: Accessed September 23, 2009.

Dawson J. Ancient Chinese remedy may work for flu. Inside Science News Service. September 10, 2009. Available at: http://www.livescience.com/ health/090910-flu-remedy.html. Accessed September 18, 2009.

India to produce raw material for swine flu drug, toll touches 220. Indo-Asian News Service. September 17, 2009. Available at: http://www.hindustantimes.com/India-to-produce-raw-material-for-swine-flu-drug-toll-touches-220/H1-Article3-455026.aspx. Accessed September 18, 2009.

Chatterjee S, Chopra A. Cow urine, herbal remedies gain as India swine flu deaths climb. Bloomberg News. September 4, 2009. Available at: http:// www.bloomberg.com/apps/news?pid=20601091&sid=arn2dLln.SPU. Accessed September 18, 2009.

Venugopal J. Amrutha Balli demand creeps up in flu time. Diligent Media Corporation. September 2, 2009. Available at: http://www.dnaindia.com/ bangalore/report_amrutha-balli-demand-creeps-up-in-flu-time_1287147. Accessed September 18, 2009.

Oliff H. Indian tinospora shows positive results in treating allergic rhinitis. HerbalGram. 2006; 69:27.

In Dangs, herbal drink to ward off H1N1. The Times of India. August 31, 2009. Available at: http://timesofindia.indiatimes.com/NEWS/City/Surat/ In-Dangs-herbal-drink-to-ward-off-H1N1/articleshow/4956006.cms. Accessed September 18, 2009.

Henson S. Health benefits of holy basil. HerbClip. August 31, 2008 (No. 030383-359). Austin, TX: American Botanical Council. Review of Basil as the holy Hindu highness by Duke JA. Altern Complement Ther. 2008;5-8.

Monograph on Ginger. HerbClip. December 29, 1995 (No. 122652-075). Austin, TX: American Botanical Council. Review of Zingiber officinale by Reading G. ATOMS. 1995;1(1).

World Health Organization. Warning on purchase of antivirals without a prescription, including via the Internet. Information Exchange System Alert No. 122. May 14, 2009. Available at: http://www.who.int/medicines/publications/drugalerts/Alert_122_Antivirals.pdf. Accessed September 21, 2009.

Industry coalition advises against use of dietary supplements as swine flu remedy, cure [press release]. Washington, DC: American Herbal Products Association; May 1, 2009.

FDA warns web sites against marketing fraudulent H1N1 flu virus claims [press release]. Silver Spring, MD: Food and Drug Administration; June 15, 2009.

Robbins N. Naturopath bridges gap in treatment, prevention. San Francisco Chronicle. September 21, 2009;C1.

Lofholm N. Natural remedies are all the rage as flu fears increase. The Denver Post. September 7, 2009;A-01.

Neustadt J. Special extract of traditional African herb Pelargonium treats bronchitis in clinical trial. HerbalGram. 2006; 71:32-33.