Swine Flu

September 11, 2009 by John Blank

How contagious is it? How serious if you get it? Can Chinese medicine help?

Here's John's take on it.

Notes on Swine Flu

by John Blank, L.Ac.

The swine flu (H1N1) panic button is being pushed continually by the media and government. Pregnant women are being urged to get the newly released vaccine, which has undergone less testing than the usual flu vaccines due to the proclaimed emergency status. Multnomah County is going to “aggressively pursue” vaccinations.

People who remember the “dreaded” Hong Kong flu in 1976 may feel skeptical about all the alarmist propaganda. The Hong Kong flu, even though it was genetically similar to the 1918-1919 flu that had killed millions, never became an epidemic, and the vaccine that was developed for it turned out to cause Guillain-Barre Syndrome in some people. In fact, the vaccine killed more people than the disease, and had to be withdrawn. [1]

According to a recent Oregonian article [2] the vaccine is still being tested. Although the article reports the U.S. Center for Disease Control as saying there is no reason to think this year’s virus causes Guillain-Barre, British opinion seems to differ. [3]

How dangerous is swine flu?

Short answer: it may be pretty contagious, but probably not serious or lethal. Here’s the reasoning:

When a virus mutates from animals to humans, it can be both very contagious and deadly, as our immune systems have not had a chance to evolve defenses against it, and because its initial form may be particularly deadly (as the SARS virus was in 2003).

The swine flu is genetically similar to the virulent 1918 flu (and to the Hong Kong flu). Since so many people alive today have never been exposed to this type of flu, a higher incidence of swine flu infection might be expected. But initially, it has not been very virulent, and the death rate has been rather low.

When the 1918 flu first appeared (in army training camps in the United States), it too was not very virulent. But it eventually evolved into a very virulent, deadly strain that killed its hosts rapidly.

The evolutionary biologist Paul Ewald, in his book Plague Time, explains how that virulence came about. If a person dies before the virus has a chance to spread itself to another host, that virus will have very low evolutionary chances of survival. If on the other hand the virus has plenty of opportunity to spread itself even if its host dies, it will tend not to “care”, evolutionarily speaking, if the host dies, and will tend to evolve into very virulent forms. This happened in 1918-19. When the virus first reached the Western front, it was not very virulent (early cases tended to survive); but with the super-overcrowded conditions of trench warfare, hospital troop-trains into which sick soldiers were stuffed to be transported to hospitals overflowing with every bed full and patients lying in blankets in the halls, the virus had an excellent chance to evolve into a lethal form. And it did.

The general rule seems to be: if a bug can easily find a great many new hosts even if the current host dies, it will tend to evolve in a lethal direction. On the other hand, organisms whose survival as a species depends on the survival of its hosts will tend to be less lethal. The common cold is a good example of the latter.

So far, the type of overcrowding that existed during World War I does not seem to have occurred, though of course there is always that possibility, especially as the virus appears in poorer, more overcrowded conditions in the Third World. However, the example of Mexico, itself a Third World country, is instructive. Mexico managed to contain the spread of the virus, without it becoming very lethal, without using vaccines, by basic public health measures such as quarantining sick patients. [4]

For an interview with Paul Ewald, click here.

Chinese medicine and the flu

Chinese medicine – acupuncture and, especially, herbs – are actually quite effective for flu viruses (rhinoviruses – that cause the common cold – too). Some of the typical herbal formulas I use in my practice are Yin Qiao San, Sang Ju Yin, Huang Lian Jie Du Tang, Shuang Huang Lian, Isatis 6, Belamcanda15. Which formula to use depends on the particular patient, the stage of the disease, and how the disease is presenting. This is an advantage of Chinese medicine: rather than targeting a particular bug (which changes from year to year), Chinese medicine is designed to treat various symptom patterns, no matter what the cause (so, for example, the same treatment may work for allergies and the common cold, which can share the same symptoms but have completely different causes). 

The key is to get treatment at the first sign of infection – an acupuncture treatment, plus the formula that’s correct for you. Chinese medicine can usually lessen the severity and duration of symptoms, and sometimes avert them altogether – if you get treated early enough. The first cough, the first sore throat – get treated!

Many Chinese herbs have proven antiviral effects; they actually kill various viruses (as well as some kinds of bacteria) in test tubes.  But I think these herbs (as well as others that don't kill viruses directly but are nevertheless effective) work in the body by increasing the body's inherent ability to fight off the bugs. During the SARS epidemic in China, the Chinese health authorities made several herbal formulas available. They conducted at least one study, among health workers in Hong Kong who were more likely to be exposed to the SARS virus, and the prescribed formula was found to be effective. [5]

To vaccinate or not?

Good question. For myself, I’ve decided not to. But I’m older, i.e., not in the supposed higher-risk category. As for you – well, check out the references in the notes; it’s your call.

Even if you do take the vaccine, you may want to institute some other protective methods. Some practitioners are recommending bringing blood levels of vitamin D up to 50-70ng/ML. From my reading, this also seems like a good option: you can check out the Vitamin D Council’s story yourself. [6]. And finally, Chinese medicine is certainly one option I recommend. I would use a low dose of some of the formulas mentioned above for prevention. And of course, at the first sign of flu, I would get treated with acupuncture and herbs. That’s my plan, anyway.

References

1. See the artice in Wikipedia, as well as the Daily Mail article cited below.
2. Neurologists urged to watch for rare swine flu vaccine side-effect.
3. British neurologists opinion. For reactions of UK doctors, see UK Doctors refuse to take the Swine Flu Vaccine and One in two GPs 'will refuse swine flu vaccine.
4. A perspective on the virus in Mexico.
5. For a review of the Chinese response to SARS, see The potential avian flu epidemic by Dr. Jake Fratkin. For the Hong Kong study, see A report on the Hong Kong study. For a more general discussion of flus and Chinese herbal medicine,see Chinese herb response to flu pandemic: Avian Flu and Other Epidemics.
6. The suggestions of the Vitamin D Council. I personally disagree with these folks about the dangers of vitamin A – in conjunction with sufficient vitamin D I don’t believe there’s a toxicity issue at reasonable dosages. Vitamin A is important for the health of epithelial tissue, e.g., the linings of the nose, throat and lung, where flu viruses attack. But that’s a story for another time. See also On the epidemiology of influenza, Virology Journal, Feb 25, 2008.

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