Preparedness: Treating Influenza

In this part of my preparedness series, I will talk about different common and uncommon diseases, illnesses and other health inflictions that wouldn't be easily treated during a long term crisis. This is not a replacement for medical advice, it is just my notes on how to cope with the situation using herbs if no medical help was available due to a long term crisis or other disaster scenario. It is intended for educational purposes only. All cases of influenza should be assessed and monitered by a medical provider when necessary.

What is it?

Also referred to as the “flu,” influenza is a virus caused by influenza viruses A, B and C that infect the respiratory tract of many animals, birds and humans. 

Types A and B are the most common and cause respiratory illnesses that are often epidemic and usually during the late winter though they are often seen year round in all climates. 

Type A viruses are divided into types based on two surface proteins, hemagglutinin (H) and neuraminidase (N). At this time there are 16 known H subtypes and 9 known N subtypes. The pandemic of 2009 was the swine flu, represented as H1N1 while the earlier avian flu was referred to as H5N1 and affected mainly birds. Type A infects humans, other mammals and birds. 

Type A viruses go through 2 kinds of changes. The first is a series of mutations over time which causes a gradual evolution of the virus which is known as antigenic drift. The second is an abrupt change in the hemagglutinin and/or the neuraminidase proteins known as the antigenic shift. In the second case, a new subtype of the virus will emerge rapidly, causing pandemics. 

Type B viruses change only by gradual processes and do not cause pandemics. They infect humans and seals.

Type C usually causes a very mild respiratory illness or none at all. They infect humans and pigs.

Why should it be feared?

Influenzavirus A has the capability to rapidly mutate and change, causing pandemics that can be deadly, attacking the lungs and turning the immune system on itself, effectively causing the body to attack itself. 

The pandemic flus have been known to attack young, healthy adults instead of the usual victims of influenza who tend to be infants, elderly or immune compromised individuals. The 1918 Spanish flu (H1N1) lasted for 18 months and is blamed for killing 50 - 100 million, or roughly 3% of the world’s population of 1.86 billion. 500 million or 27% of the world’s population were infected with the Spanish flu which spread to the Arctic and Pacific Islands. 

Tissue samples from frozen victims were used to recreate the virus for study which led to the discovery that the virus kills through a cytokine storm. A cytokine storm is a overreaction of the body’s immune system, the turning of the immune system against the body which explains the severe nature of the virus and the unusual set of victims. In this instance, a weak immune system is actually a good thing.

Transmission is primarily through large-particle respiratory droplet transmission such as coughing or sneezing.

Influenza can also cause a secondary infection such as pneumonia which can become life-threatening.

What should be done?

During normal times, many advise to be vaccinated though the vaccine is often only speculation as the strains of the virus are so quickly mutated. During a pandemic, it is doubtful enough vaccines could be made in time to prevent the virus from spreading. Isolation is the best prevention. Keep yourself and your family in the house, if mail delivery is still running, use protective measures (rubber gloves) and do not bring it in the house. Discard unnecessary mail and let all other mail sit in a spot for at least 4 days to ensure the virus is dead before bringing it in the house.

For those who show symptoms of the flu, antiviral drugs such as oseltamivir (Tamiflu) and zanamivir (Relenza) are taken. During a pandemic, these antivirals may not be available. Additionally, the antivirals amantadine and rimantadine may be given to prevent the virus from infecting cells but are only effective against viruses which possess the M2 protein. Viral strains are now showing resistance to these antivirals.

Make sure the patient stays in bed, warm, well hydrated and eats well. Discontinue the use of tobacco, alcohol, sugar and processed foods. 

Quarantine anyone coming into your household for 5 days. If they show any symptoms during this time period, treat them for influenza.

What are the stages?

Incubation Period: 1 - 4 days

Patient is infectious from 1 day before symptoms appear though children may shed the virus several days before symptoms appear.

Main Symptoms: 3 - 7 days up to 2 weeks for more severe strain

Initial symptoms are abrupt:

-Fever
-Malaise
-Myalgia
-Headache
-Nonproductive cough
-Sore throat
-Runny nose

Children may present other symptoms as well such as:

-Otitis media (earache)
-Nausea
-Vomiting

Some patients may only have respiratory symptoms without a fever. 

Patients are infectious until 5 - 10 days after the onset of symptoms. 

Complications:

Infections can cause secondary illnesses such as:

-Viral pneumonia
-Bacterial pneumonia
-Sinusitis
-Otitis media

or even death.

Children may experience febrile seizures (about 6 - 20%)

What are my options?

The first step is preventing influenza from invading your home and family. Take all precautions to avoid coming in contact with those infected. In the event of a threat of a pandemic, it is wise to keep children home from school and adults to stay home from work if at all possible. Wear N95 respirator masks and latex gloves when forced to be in public. 

Step 1: Prevention

During the winter, keep healthy by getting plenty of sleep and fresh air, eating healthy, minimally processed foods and supplementing with a good source of vitamin D3. From the Fall Equinox until the Spring Equinox, all family members should take a daily dose of vitamin D3:

0 - 2 should take 1,000 - 2,000 IU

2 - 12 should take 2,000 - 5,000 IU

12 to adult should take 5,000 - 10,000 IU

Our primary source of vitamin D3 is through sunlight. However, during the winter months, the angle of the sun does not give those in the northern hemisphere enough exposure to supply us with enough D3. This is why most people become sick in late winter. 

Step 2: Boost or Modulate the immune system

Before getting sick, boost your immune system to fight off infections. Daily doses of these herbs can assist with this but should be stopped if it is known or suspected that the virus operates using a cytokine storm:

Garlic (Allium sativum)

Take lots of  garlic (3 - 4 raw cloves a day). Continue to take even if symptoms appear as garlic can reduce cytokine storm.

Echinacea (Echinacea purpurea, E. angustifolia, E. pallida)

Take 1 drop for every pound of body weight once a day. 

Astragalus (Astragalus membranaceus)

Drink 1 cup of root decoction daily or take 1 - 2 droppersful daily. 

If symptoms of the flu appear, discontinue taking the above herbs and switch to any of the following:

Elderberry (Sambucus nigra)

Syrup or elixir, 1 tablespoon 3 - 5 times per day

South African Geranium root (Pelargonium sidoides)

Tincture of root, 1 dropperful 3 times per day.

Holy Basil / Tulsi (Ocimum tenuiflorum)

Tincture, 1 dropperful 3 times per day.

Step 3: Support the Fever

Do NOT suppress the fever. Do not take acetaminophen or NSAID’s such as ibuprofen or aspirin. The fever’s purpose is to burn off the virus. Adults can go up to 108° F before human cells begin to die. For children, exceptions are for infants up to 1 month, 101.4° F may be critical which rises to 102° F at 2 months of age. As long as the patient is comfortable and the fever is below these critical points, allow the fever to burn.

Keep the patient well hydrated, offering herbal teas often. Herbs that will support the fever and help the body to burn and kill off the virus include:

Thyme (Thymus vulgaris)

Ginger (Zingiber officinale)

Cayenne (Capsicum annuum)

Osha root(Ligusticum porteri)

Peppermint (Mentha peperita)

Catnip (Nepeta cataria)

Yarrow (Achillea millefolium)

Lemon Balm (Melissa officinalis)

Goldenrod (Solidago spp.)

Elderflower (Sambucus nigra)

Honeysuckle Flower (Lonicera japonica, L. sempervirens and other Lonicera spp.)

Of the above listed herbs, use what you have available and offer hot tea often. Keep an insulated pump pot (see supplies section) by the patient’s bed to have a supply of hot tea on hand at all times. Diaphoretics work by being dispensed hot.

Boneset (Eupatorium perfoliatum)

Antiviral, febrifuge; general and severe aches and pains “bone break” sensations caused by fever. Tincture 30 - 60 drops in warm water or tea every 2 hours. Infusion of herb (2 tablespoons per quart of water) frequently sipped (every 1 - 2 hours).

Step 3: Reduce Cytokine Storm Activity

The following herbs will inhibit influenza symptoms and  inflammatory cytokines.

Garlic (Allium sativum)

Take lots of  garlic (3 - 4 raw cloves a day). Continue to take even if symptoms appear as garlic can reduce cytokine storm.

Baikal Skullcap Root (Scutellaria baicalensis)

Tincture 2 - 3 droppersful 3 times daily.

Cannabis (Cannabis sativa)

Infused oil, taken in capsule form. 1 00 capsule daily.

Ginger (Zingiber officinale)

If available fresh, 4 slices per 8 oz. water. Powdered root add 1/2 teaspoon to 8 oz water. Bring to boil, turn off heat, cover and let steep for up to 1 hour. Strain and drink 3 cups daily. Tincture 1 dropperful 3 times daily. 

Red Sage Root (Salvia milthiorrhiza) 

Tincture dosage: 50 drops 3 times daily.

St. John’s Wort (Hypericum perforatum)

Tincture of flowering tops, 3 - 4 droppersful 3 times daily.

Turmeric Root (Curcuma longa)

Powdered root add 1/2 teaspoon to 8 oz water. Bring to boil, turn off heat, cover and let steep for up to 1 hour. Strain and drink 3 cups daily. Tincture 1 dropperful 3 times daily. 

Step 4: Soothe and Support the Cough
Teas are helpful for coughs as they are soothing and warming though tinctures are also beneficial and can be added to an herbal tea. The herbs below may be mixed together or used singly according to their availability. 

Honey 

Although not an herb, honey is an excellent treatment for soothing coughs. Adding powdered herbs such as turmeric, ginger and other mild tasting herbs can also help heal sore throats and irritation caused by coughing spasms. Honey can also be added to an herbal tea to increase the herbal tea’s power. 

Use raw honey from a local source. “Honey” purchased from a store may not be live, rendering it useless for medicine. Honey may contain botulism spores and should be used with caution for babies under the age of 1. 

Herbs for dry, spasmodic coughing:

Lobelia (Lobelia inflata)

Antispasmodic, mild expectorant. Tincture 10 drops to 1 dropperful every 3 hours as tolerated. If nausea develops, cut back dosage. Start with lowest dosage amount and increase if necessary. 

Pleurisy Root (Asclepias tuberosa)

Expectorant, demulcent, relaxant, mild diaphoretic. Good for coughs with burning sensation, coughing up blood (indication of cytokine storm). Tincture 1 - 2 droppersful 3 - 4 times daily. 

Licorice Root (Glycyrrhiza glabra)

Demulcent, antiviral. Decoction take 1 - 2 tablespoons every 3 hours. Tincture 1 - 2 droppersful every 3 hours. 

Wild Cherry (Prunus serotina)

Antispasmodic, expectorant, antiviral. Syrup take 1 teaspoonful as needed. Tincture take 1 dropperful every 20 minutes until coughing eases then lower to every 2 hours or as needed. 

Peach (Prunus persica)

Antispasmodic, expectorant, antiviral. Syrup take 1 teaspoonful as needed. Tincture take 1 dropperful every 20 minutes until coughing eases then lower to every 2 hours or as needed. 

Balloon Flower root (Platycodon grandiflorus)

Anti-inflammatory, bronchial dilator, anti-tussive, expectorant.  Take 1 - 3 droppersful 3 times daily.

Mullein (Verbascum thapsus)

If using leaves to make tea, strain through muslin and drink 3 cups daily or sip as needed. 

Marshmallow (Althea officinalis)

Root or leaf can be used. If using root, make a cold decoction. Demulcent, ant-inflammatory. Drink 3 cups daily or take 1 dropperful 3 times daily. 

Herbs for moist, hot coughs:

Hyssop (Hyssopus officinalis a.k.a. H. decumbens)

Especially helpful for later stages of influenza. Tincture, 1 dropperful or 1 cup tea 3 times daily.

Elecampane root (Inula helenium)

Expectorant, anti-tussive. Tea can be made from the dried root but it will be bitter. Sucking on honeyed roots can be very helpful (see recipes). Tincture can be taken, 1 dropperful every 2 - 4 hours. 

Plantain (Plantago lanceolata, P. major)

Astringent, expectorant, antispasmodic, tonifying for mucous membranes. Hot tea works exceptionally well, especially when combined with Thyme. Drink 3 cups daily or as needed. If using tincture, take 1 dropperful 3 times daily or as needed. 

Thyme (Thymus vulgaris)

Antiseptic, antibiotic, expectorant. Hot tea works exceptionally well, especially when combined with Plantain. Drink 3 cups daily or as needed. If using tincture, take 1 dropperful 3 times daily or as needed. 

Goldenrod (Solidago spp.)
Drying, astringent, anti-inflammatory. Drink 3 cups daily or as needed. If using tincture, take 1 dropperful 3 times daily or as needed. 

Sources

The Practice of Traditional WesternHerbalism by Matthew Wood 

Back To Eden by Jethro Kloss pgs. 355, 357, 498 - 499 

http://aradicle.blogspot.com/2009/09/herbal-support-for-influenza.html

http://www.medicinenet.com/influenza/article.htm 

http://www.herbcraft.org/fever.html 

http://www.herbalcountrydoc.com/2/post/2012/01/balloon-flower-ornamental-with-medicinal-punch.html 

http://www.henriettesherbal.com/faqs/medi-3-12-cough.html