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 

October Blog Party: Bio-regional Herbs for the Cold and Flu Season

a literal medicine chest in a basket...i just harvested these today from the top going clockwise: honeysuckle flowers, wild cherry twigs, self heal, goldenrod and rosehips in the center.

this month's blog party is being hosted by rosalee of methow valley herbs. head on over there and check out everyone's postings that are participating!

it's so easy to get caught up in the latest and greatest new exotic herbs that are being promoted that it's hard to remember that sometimes, the best medicine is growing right in our own backyards! this blog party is a great reminder to run to our backyard instead of the nearest health food store to find our remedies. i am located in the midwest, near st. louis but most of these herbs can be found across the country.

first, remember the golden rule of health: an ounce of prevention is worth a pound of cure! i've written a post about what can be done to prevent the flu at not dabbling in normal.

beautiful solidago

one of my new favorite herbs that i've been dancing with this year is goldenrod (solidago spp.). i've tinctured him and admired him for several years but i've never tried him out until this late summer. and boy, am i glad i did! i was experiencing a headache that was created from sinus pressure and a voice kept whispering to me 'goldenrod.' after trying to ignore both the headache, sinuses and voice for 2 days, i decided to break out goldenrod and give him a try. and kicked myself for being a stubborn taurus herbalist and waited so long to try him out. the headache disappeared within a few hours of dosing (1 dropperful about every 30 minutes or so) and though it came back, it was less intense and as i continued taking goldenrod, the stuffy sinuses were gone and with them, the headache, all by the end of the day. goldenrod is astringent, diaphoretic, diuretic, antimicrobial and anti-inflammatory, making him an excellent choice for colds and flus. taken as a hot infusion, he will help you sweat out a fever. taken as a cold infusion (meaning after infusing the herb in hot water, let the infusion cool down) he acts as a diuretic and will flush out the kidneys and liver. to test any goldenrod found growing in your landscape, break a leaf off and chew. if he's bitter and drying, you've got an excellent medicinal herb growing in your backyard! harvest his flowering tops and leaves when the flowers just start to bloom and tincture immediately. you can also dry goldenrod. make sure that the flowers have not opened yet or he'll set seed in your drying room!

sambucus

another terrific flu time herb is elderberry! i cannot rave enough about this wonderful elder of ours. both sambucus nigra and sambucus canadensis are found in my area and both are equally useful. elderberry is prophylactic against flus and colds which means if you take her daily, she can help prevent you from getting sick. she also has antiviral properties which will be helpful for lessening the duration and severity of the flu. she's also full of vitamin c! elderberry is the first thing i reach for when my kids are getting the sniffles. richo cech's making plant medicine book is an excellent resource for making herbal remedies and he suggests making a glycerin tincture of dried elderberries to be the best choice for tincturing elderberries. this makes a delicious tincture that kids will readily take. don't forget elderberry syrup though. this medicine is easy to make and delicious to take. she can be taken daily by the teaspoonful or even used to flavor french toast, pancakes and waffles or even drizzled over some homemade vanilla ice cream! yum!!

to make a syrup, gently heat 2 cups of fresh elderberries with 2 cups of water. when it hits boiling, turn off the heat and mash the berries. cover and allow to infuse for about an hour. strain off the berries and add 2 cups of honey to the liquid and warm on the stove until the honey is thin enough to mix together. stir and pour into a bottle. label and keep refrigerated. to help preserve longer, you can add a bit of brandy (about 1/4 c.) and shake.

elderberry also contains diaphoretic and diuretic qualities. elderberry is also an expectorant, helping to relieve lung congestion.

elderflower is also a wonderful cold and flu herb to have on hand. the flowers of elder contain most of the same properties as the berries.

for treating coughs, i like to make a cough syrup or cough drop from our wild cherry bark. he is delicious and relaxing, helping to ease coughing spasms. among other things, wild cherry bark is analgesic and antibacterial which can help ease the painful chest congestion and help prevent a secondary bacterial infection from setting in. if i'm out of the syrup, i will often snip a few twigs from the tree and decoct them for about 10-20 minutes to make a quick cherry bark drink. sweetened with a dab of our raw honey, they will drink it down fairly quickly!

other herbs that grow around us that are helpful for treating colds and flus are bergamot (monarda fistulosa), st. john's wort and lobelia. lobelia i tend to be cautious with as it is a low dose botanical but bergamot makes a delightful tea that i enjoy immensely as a beverage and has great carminative, diaphoretic, diurectic and antibacterial actions. use of bergamot dates back to native americans who used her for treating bronchial ailments, sore throats, fever and headaches. any of the monarda species can be used but i prefer to use my wild bergamot that grows in my garden. i collected 1 seed head several years back and i now have three beautiful stands in my garden!

st. john's wort is most often known for his use in treating depression but he has antiviral abilities as well. he is also astringent and expectorant making him great to treat lung congestion. i have not had much experience in using him but i have lots tinctured up and will be trying him out this winter if needed. while st. john's wort grows wild around here, my tiny wild patch was choked out by honeysuckle last year and is slowly reemerging in another part of the woods so i'm using my cultivated st. john's wort which makes a lovely blood red oil and tincture. in the future, i hope to be able to use the wild st. john's wort since i truly believe wild is stronger than cultivated.

honeysuckle, the bane of master naturalists everywhere, is used a lot in chinese medicine and is great for stimulating circulation and removing inflammation. in traditional chinese medicine, she is used for clearing heat and removing toxicity. she is excellent for treating 'hot' sore throats and modern laboratory research has proven she has antibacterial qualities. it's best to harvest the flowers before they open and are great dried (for teas), tinctured or even honeyed or made into a syrup.

rose hips are high in vitamin c which is great to take to help fight off colds and flus and they are also antiviral. a rose hip elixir is a great way to get kids to take their medicine! a great preventative and a great curative as well.

prunella

and finally, self heal/all heal, prunella. i wrote all about her on a previous blog party (see my list of resources below for the link)so i won't go into much detail here. she has an amazingly long list of actions: alterative, antimicrobial, anti-bacterial, anti-viral, antipyretic, antiseptic, antispasmodic, astringent, carminative, diuretic, febrifuge, hypotensive, stomachic, styptic, tonic, vermifuge and vulnerary! as a preventative or treatment, she will work great. make her into a tea or use in tincture form.

some resources and more information:
for more information on goldenrod:
http://www.umm.edu/altmed/articles/goldenrod-000251.htm

for a great list of all the elders available around the world try this link:
http://en.wikipedia.org/wiki/Sambucus

trying to identify elderberry? read my recent post on herbal roots zine:
http://herbalrootszine.blogspot.com/2009/09/elderberry-identification-clarification.html

want to teach your kids more about elderberry? last month's issue of herbal roots zine was on elderberry:
http://herbalrootszine.blogspot.com/2009/08/herbal-roots-zine-september-2009.html

for more about honeysuckle:
http://www.botanical.com/products/learn/h/honeysuckle_flowers.html

more information on wild rose petals and hips elixir:
http://medicinewomantradition.org/pantry.html#Wild%20Rose%20Elixir

my blog party post on self heal:
http://fieldoftansy.blogspot.com/2009/06/july-blog-party-weeds-of-summer.html

preventing the flu...

...may not be a sure thing but i'm writing over at not dabbling in normal today about what can be done to try to prevent it or at least lessen the severity and duration of it.