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The 2009 H1N1 Influenza — A Greater Understanding

A new strain of the H1N1 influenza virus was first detected in the United States this past April. By June, the World Health Organization indicated that a pandemic of 2009 H1N1 flu was underway. Like most viruses, it is transmitted from person to person. It is spread through the air by a cough or sneeze, creating respiratory droplets that contain the virus and gets into the body through the eyes, nose, and mouth. More recently the H1N1 vaccination was made available to the public. Vaccinations have been a part of public health since the late 18th Century and have proven to be a valuable part of medicine at controlling pandemic diseases. Unfortunately with the CDC moving swiftly to prevent spread of the H1N1 virus along with the insurmountable hype on whether an individual should get the H1N1 vaccine or not, many questions still remain unanswered.

Currently the newly available vaccination is recommended for:
Pregnant women
− Health care and emergency workers – those in the “front lines”
− Caregivers and household contacts of children younger than 6 months
− Anyone from 6 months to 24 years of age
− Anyone younger than 65 with certain chronic medical conditions or a weakened immune system

The non-live injectable is recommended for the groups below over the live inhalable mist:
− Healthy young people from birth through age 24
− Pregnant women
− Adults 25 to 64 who have underlying medical conditions

As more vaccine becomes available, these groups will be recommended immunization:
− Healthy 25 through 64 year olds
− Adults 65 years and older

What You Should Know
The first available injectable vaccination contains thimerosal (mercury) as a preservative and squalene as an adjuvant, which helps to make the vaccine more potent and ensure efficacy. In my medical practice, I do not recommend vaccines that use thimerosal for anyone, but especially for children less than 2 years of age. The CDC recommends that children ages 6 months through 9 years receive two doses of the non-live H1N1 vaccine. For infants that are on the standard immunization schedule, this adds up to almost 16 vaccinations by 9 months of age. My concern is not only the high number of vaccinations, but many reports have shown that use of squalene as an adjuvant in vaccinations suggest an association between the vaccination and various autoimmune diseases.

According to the CDC, the 2009 H1N1 flu has caused greater disease burden in people younger than 25 years of age than older individuals. As a naturopathic doctor, I am inclined to think that the virus plagues unsuspecting, middle school through college-aged students putting them most at risk because of their diet and lifestyle. Typically their diets are made up of fast food, soda pop, snacks and quick meals that are packaged or processed to be easily prepared. They have social agendas and busy lifestyles that can affect sleep patterns, resulting in less hours of good quality sleep. Demanding school/class schedules can leave them stressed and depleted. Finally, less than perfect hygiene such as sharing drinking/water glasses, eating utensils, make up, lip balm, kissing, constant close contact, and poor hand washing or improper containment of their coughs and sneeze, all of which contribute to greater susceptibility.

Side Effects of the Vaccination
The H1N1 non-live vaccination insert warns that it can cause:
− Local injection site reactions (pain, tenderness, redness, swelling, warmth, ecchymosis, induration)
− Headache
− Fatigue
− Malaise
− Myalgia
− Chills
− Fever
− Sore throat
More adverse reactions include anaphylactic shock, Guillain-Barré syndrome, vasculitis, immune system disorders, paralysis, dyspnea (trouble breathing) and death.

Specific Populations: Pregnant and Lactating Women, Children, and Elderly
With the recent development of the new H1N1 vaccination, it probably goes with out saying that adequate research has yet to be completed. This is probably the most frightening aspect affecting many parents decision on whether to vaccinate their child or not. According to the manufacturer, reproductive studies have not been conducted. This proposes the greatest threat to pregnant and lactating women and children (< 4 years), yet according to the CDC recommendations, 2 out of 3 of those groups are considered most at risk and should be the first to receive the vaccination. The vaccination is labeled Pregnancy C, which typically means that animal studies have shown to have an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. As already mentioned, the 2009 H1N1 vaccination is very new and has yet to be tested on animals. The manufacturer insert further states that safety and effectiveness in pregnancy, fetus, and pediatric subjects have not been established.

A recent Consumer Reports survey found that 50% of parents are delaying the vaccination and 43% of parents are not concerned about their children contracting the virus. It also found that 14% of parents have ruled out giving their children the vaccination altogether compared to 35% who would immunize.

Prevention – A Possible Treatment
What are your options? Do you feel empowered by the information provided by your healthcare provider? As of right now, the risks of the H1N1 vaccination have not been clearly delineated and yet both the CDC and FDA believe that the benefits of vaccination will far outweigh the risks. The groups above or anyone who is not a candidate due to potential allergic reaction, has Guillain-Barré syndrome, autoimmune conditions or individuals who do not want to be vaccinated, may decrease their risk if they are properly educated on how to prevent spread through proper hygiene, dietary and lifestyle changes. Individuals who have a known high risk (asthma, severe allergies or serious health complications) should immediately begin working closely with their doctor to gain a full understanding of the H1N1 flu vaccine and ways to help them boost their immune systems.

Preventive Treatment Protocol: Diet, Lifestyle and Nutritional Support
Diet
Building a stronger immune system requires a diet rich in vegetables, fruits, whole grains, nuts, legumes, and seeds and avoiding refined sugar, caffeine, white flour, and highly refined or processed foods, is a great start. It has been well documented that sugar has an impact on the immunity where avoidance can help boost immunity and intake of a single sugary treat can actually depress the immune system for up to 48 hours after intake. Caffeine and the typical forms that it is consumed, coffee and soda pop, deplete the body of essential vitamins and minerals and also causes dehydration. Processed and refined foods are void of naturally containing nutrients and typically contain harmful toxins that leave the immune system less adept to fight outside invaders such as a bacteria or virus. On the other hand, a whole food diet with plenty of organic vegetables and fruits (see dirty dozen), whole grains, nuts, legumes, seeds and even some teas, provides your body with plenty of phytonutrients or phytochemicals, which the body uses to help build a healthy immune system.

Lifestyle Factors: Exercise and Decrease Stress
Stress can play a major contributing factor in depressed immunity. Decreasing life’s stressors will contribute to improved immune function. Helpful techniques include guided imagery, which typically involves visualizing serene images or breathing techniques that focuses on relaxation. You can also try yoga or Qigong, which combine both mental and physical exercise, and can help heal the mind and the body. Regular exercise is known to protect and enhance the immune response. Moderate physical activity of 30 minutes support immunity, which results in fewer days of sickness with the common cold and other upper respiratory tract infections.

Nutritional Support
Vitamin D3 [1,25(OH) 2] is a steroid hormone and has profound effects on human immunity by acting as an immune system modulator. It stimulates the expression of potent anti-microbial peptides such as neutrophils, monocytes, and natural killer cells. It works directly the epithelial cells lining the respiratory tract, which play a major role in protecting the lungs from infection.

You can also get Vitamin D from the sun. If you live where you can get 20 minutes of unprotected sun exposure a day that should suffice. Individuals living in sunny climates should get Vitamin D test done to know their exact levels, as a recent survey done on Arizona residents found that almost 90% were Vitamin D deficient. Use of sunscreens, protective clothing, and darker skin pigment block the sun and decrease Vitamin D levels.
− After 2 months on Vitamin D therapy, a 25(OH) D blood test should be performed by your doctor

Colostrum with IgG serums: most common form found in body and new mom’s breast milk. Bovine colostrum delivers growth, nutrient, and immune factors to the offspring. It contains immunoglobulins or antibodies that are released into the bloodstream in response to infections and may help improve immune system functions. It has also been shown to be effective against certain types of bacterial and viral infections.

Vitamin C: As an antioxidant it helps to prevent and treat the common cold and other viral infections, bronchitis, and improves immune function. T-lymphocyte activity, phagocyte function, leukocyte mobility, and possibly antibody and interferon production seem to be increased by Vitamin C intake. Vitamin C is labile, and the amount in foods can decrease significantly with cooking and storage.

Probiotics: Lactobacillus is used to prevent respiratory infections in children attending day-care centers. A study found that children who took a probiotic with lactobacillus acidophilus and bifidus reduced their incidence of fever, colds, and cough.

Zinc: Supports neutrophil, natural killer cell, and T-lymphocyte functionality all of which aid in immune system support.

Use To Possibly Prevent or Treat The symptoms of Cold and Flu:
Oscillococcinum: Symptoms of cold and flu, chills and fever, body aches and fatigue.
GUNA Flu: Symptoms of cold and flu, chills and fever, body aches and fatigue.
***Remember there is no “magic pill” or antidote***

Transference: Bodily fluids and Entry of Virus
− Eyes
− Nose
− Mouth
− Touching the nose, mouth or a surface/object (door knob, counter top, bus seat) that someone who is infected has touched and then rubbing the eyes or nose or mouth.

H1N1 Flu infection cannot be transmitted by
− Properly handled pork or pork products
− Not controlled or prevented by killing unaffected animal

Lifestyle and Hygienic Recommendations:
− Wash hands with soap and warm water — You should sing the “ABC’s” as a guideline for length of time, which equivalent to 20 seconds
− Contain your cough or sneeze by using your hand or handkerchief
− Designate one caregiver to the individual who is sick

Signs and Symptoms of the H1N1 Flu Infection
A cough and high fever (over 100ºF) that come on suddenly. Should be tested with a nasal or throat swab. Additional symptoms include:
−Sore throat
− Body aches
− Headache
− Chills and fatigue
− Diarrhea and vomiting (less common)
− The incubation period for the flu is normally 24-48 hours, and the contagious period lasts for seven days after the onset of symptoms

If you suspect that you or a loved one is ill with H1N1 Flu Infection:
− Stay at home: the CDC recommends that you stay home for at least 24 hours after your free of fever
− High Fever: Seek medical attention if a child’s fever remains at or above 103 degrees for greater than 1 day; adults greater than 2 days.
− Consult with everyone you have been around and check on their status: this will be key to reducing further spread

References:

  1. Bernstein, J., al. Depression of Lymphocyte Transformation Following Oral Glucose Ingestion. American Journal of Clinical Nutrition.1997;30:613
  2. Cannell MD, John.  http://www.vitamindcouncil.org/newsletter/h1n1-flu-and-vitamin-d.shtml
  3. Influenza A (H1N1) 2009 Monovalent Vaccine Manufactured by Novartis Vaccines and Diagnostics Ltd. Suspension for Intramuscular Injection
  4. Kuroda Y, Nacionales DC, Akaogi J, Reeves WH, Satoh M. Autoimmunity induced by adjuvant hydrocarbon oil components of vaccine. Biomed Pharmacother. 2004 Jun;58(5):325-37.
  5. Kenney RT, Edelman R. Expert Rev Vaccines. 2003 Apr;2(2):167-88.
  6. Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC. Probiotic effects on cold and influenza-like symptom incidence and duration in children.
  7. Matthews, C.E., I.S. Ockene, P.S. Freedson, M.C. Rosal, J.R. Herbert, and P.A.Merriam. 2000. Physical activity and risk of upper-respiratory tract infection
  8. Psychopharmacology: Categorizing the Safety of Medications During Pregnancy and Lactation. Journal of Psychosocial Nursing and Mental Health Services Vol. 47 No. 4 April 2009.
  9. Sanchez, A., et al. Role of Sugars in Human Neutrophilic Phagocytosis, American Journal of Clinical Nutrition. Nov 1973;261:1180_1184.
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