HerbalEgram

FWD 2 HerbalEgram

HerbalEGram: Volume 6, Number 10, October 2009

International Report on Herbs and Swine Flu

More than 300,000 people around the world are estimated to have contracted Influenza A(H1N1) virus, and at least 3,917 people have died from it, according to the latest available data from World Health Organization (WHO) released on September 25, 2009.¹ While no H1N1 vaccination shortage is expected in the United States, many developing and heavily-populated countries around the world will not be able to vaccinate the majority of their citizens. Some in these nations 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, which has infected an estimated 14,581 people with the government reporting no deaths.² Though the Chinese health ministry hopes to provide H1N1 vaccinations for 65 million people, this figure covers only 5% of its total population of 1.34 billion. As preventative measures, the education ministry is planning to implement a national program to give students free traditional Chinese medicines (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) fruit, and honeysuckle (Lonicera spp.) flower.³

In Beijing, the Ditan Hospital reported that it used herbs to treat H1N1 patients and experienced a 75% success rate, with 88 of the 117 patients recovered.⁴ Patients were given a tea and mouthwash containing 3 grams each of 4 herbs, including Japanese honeysuckle flower, isatis (Isatis indigotica) (both leaf and root are used in TCM; the plant part for this formula was not specified), mint (Mentha spp.) leaves, and licorice (Glycyrrhiza uralensis) root. All of these herbs have documented uses in treating flu-related symptoms, such as fever, upper respiratory tract infections, headache, and sore throat.

Additionally, 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 This stage-4 interventional study is currently recruiting male and female participants from age 14 to 70 who have H1N1 flu.

“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) 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, is also using herbs to deal with the H1N1 virus. At press time, an estimated 277 people in India had died from the virus so far and the government says it is working on a vaccine, but that it isn’t expected to be available until April of 2010.⁷ The Indian government has decided to allow the local production of shikimic acid, a white crystalline compound of non-nitrogenous acid that is found in various plants and is 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), a deciduous climbing shrub with anti-inflammatory and anti-allergic effects, and immune-boosting properties.^9,10 The University of Agricultural Sciences sold a daily average of 5 to 6 Indian tinospora plants before the swine flu outbreak, but it is now selling as many as 1,000 plants each week. In the Indian tribal district of Dangs, where medicinal plants grow throughout the forests, the health department is giving tourists an herbal drink also containing Indian tinospora.¹¹ Prepared by local Ayurvedic doctors, the drink also contains holy basil (Ocimum tenuiflorum), which exhibits adaptogenic, anti-inflammatory, and antioxidant activities,¹² and ginger (Zingiber officinale) root, which has anti-nausea and anti-inflammatory effects and also aids digestion.¹³

Though people around the world are seeking to prevent cases of H1N1 through the use of herbs, WHO has advised the public 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 also noted that some dietary supplements “have much to offer in terms of enhancing general immune function,” but said the swine flu outbreak is a health condition for which the choice of self-care 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 50 warning letters to offending websites, which had been selling products such as a dietary supplement claiming to protect infants and young children from contracting H1N1, an echinacea (Echinacea spp.) extract, and Lian Hua Qing Wen, the same Chinese herbal formula recommended by China’s State Administration of TCM.

While most in the United States will likely choose to get the H1N1 vaccine, the national media continues to document individuals and healthcare practitioners who focus on natural H1N1 prevention as an alternative to vaccination.

The San Francisco Chronicle, for example, featured an article discussing a naturopathic doctor’s flu prevention strategies of getting more sleep, eating garlic (Allium sativum) and maitake (Grifola frondosa), shiitake (Lentinula edodes), and reishi (Ganoderma lucidum) 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) root, and ginger. If flu infection does occur, a physician featured in the article recommends taking a proprietary herbal extract made from the roots of Pelargonium sidoides used traditionally in South Africa to treat various symptoms of upper respiratory tract infections.^18,19

—Lindsay Stafford

References

1. Pandemic (H1N1) 2009 - update 67. World Health Organization website. Available at:
http://www.who.int/csr/don/2009_09_25/en/index.html. Accessed September 22, 2009.

2. China to have 26 mln swine flu shots by end-October. AFP. September 24, 2009. Available at: http://www.google.com/hostednews/afp/article/ALeqM5gNiJ4u3X2qkIB-tvvB3j-nm_K95A.

3. 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.

4. 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.

5. Capital Medical University. Chinese medicinal herbs treatment on novel influenza A (H1N1) : multi-centre, prospective, randomized controlled study. In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000- [cited September 25, 2009]. Available from: http://clinicaltrials.gov/ct2/show/NCT00935194: NLM Identifier: NCT00935194.

6. 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.

7. 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.

8. 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.

9. 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.

10. Oliff H. Indian tinospora shows positive results in treating allergic rhinitis. HerbalGram. 2006; 69:27 American Botanical Council. Available at: http://cms.herbalgram.org/herbalgram/issue69/article2921.html.

11. 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.

12. 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. Available at: http://cms.herbalgram.org/herbclip/359/review030383-359.html.

13. 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).Available at: http://cms.herbalgram.org/herbclip/075/review41630.html.

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

15. Industry coalition advises against use of dietary supplements as swine flu remedy, cure [press release]. Washington, DC: American Herbal Products Association; May 1, 2009. Available at: http://www.ahpa.org/Default.aspx?tabid=69&aId=527&zId=1.

16. FDA warns web sites against marketing fraudulent H1N1 flu virus claims [press release]. Silver Spring, MD: Food and Drug Administration; June 15, 2009. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm166801.htm.

17. Robbins N. Naturopath bridges gap in treatment, prevention. San Francisco Chronicle. September 21, 2009. Available at: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/09/20/DDCP19NQ32.DTL.

18. Lofholm N. Natural remedies are all the rage as flu fears increase. The Denver Post. September 7, 2009. Available at: http://www.denverpost.com/search/ci_13284305. Accessed September 22, 2009.

19. Neustadt J. Special extract of traditional African herb Pelargonium treats bronchitis in clinical trial. HerbalGram. 2006; 71:32-33. Available at: http://cms.herbalgram.org/herbalgram/issue71/article3003.html.