Article Update
January 2006

A recent report in the New England Journal of Medicine by Jeremy Farrar at Oxford University states that the H5N1 bird flu virus in the bloodstream of two patients in Vietnam rapidly developed resistance to Tamiflu. One patient appeared to be stable at first and then rapidly worsened as the virus mutated, and eventually died. The clinicians reported that the resistant form of bird flu developed in two of the eight patients being treated with Tamiflu. One of the two patients was treated at an early stage of infection, when Tamiflu is supposed to be most effective.

Medical experts and pandemic preparedness officials are dismayed and very concerned over these developments. The doctors reporting in the New England Journal of Medicine Article are urging changes to the global plans for fighting a flu pandemic, saying that other antiviral drugs are needed alongside Tamiflu.

An eminent professor at Cornell University in New York calls the report "frightening" in a commentary in the journal. Anne Moscona, from the department of pediatrics, microbiology and immunology at Weill medical college, says Tamiflu-resistant H5N1 "is now a reality", and calls for efforts to prevent individuals stockpiling the drug. Its misuse, she says - by people who, for instance, take too low a dose - will breed resistance and further undermine its effectiveness if a pandemic sweeps the world.

Information on Tamiflu alternatives is contained in the body of the original article below.

Article Update
November 2005

New in this November 2005 update is the latest information on possible H5N1 Tamiflu resistance, wild bird flu migration to Europe and possibly Canada, more complete information on homeopathic flu remedies, acid-alkaline balance, the potential for high dose vitamin C therapy for flu treatment, and a warning from one of the U.S.’s foremost influenza experts, Dr. Michael Osterholm, on the importance of stockpiling food for pandemic preparedness.

The updated article in October 2005 provided new information on the potential effectiveness of both prescription and non-prescription antiviral medications, including alternatives to Tamiflu.

Introduction and Background

What can the average person do, if anything, to prepare for the possibility of a global flu pandemic? There are many things that can be done to prepare ahead of time, and this article will discuss some options as well as guide the reader to additional resources. This article is not meant to instill fear or panic in readers. It is meant to let readers know that despite the dire predictions abounding in the news, there are measures that individuals can take to prepare themselves and their families at home in the event of a global flu pandemic.

Some may still wonder if it is worth preparing for a flu pandemic. By this time most have heard of the H5N1 avian influenza virus endemic to southeast Asia, and the fact that migrating birds have carried the virus to Europe. But many assume that in the end it will be similar to the SARS virus, which quickly fizzled out with very few cases occurring in the United States.

The reality of the situation, however, is that the H5N1 flu virus is not like the SARS virus (SARS was a coronavirus, not a flu virus), and there is a good chance that eventually, probably sooner rather than later, this virus or one like it will cause a global flu pandemic that may result in millions of deaths worldwide. Our government agencies will not be able to stop the virus from entering the U.S.

There are two major methods of fighting influenza – vaccine and antiviral drugs. It is widely acknowledged that a working H5N1 vaccine will most likely not be ready in time for the first wave of pandemic infection. There are many reasons for this, chief of which is the fact that the final genetic makeup of the pandemic strain will not be known until the pandemic actually begins, at which point it will take at least six months to manufacture the first batches of vaccine. Currently the U.S. is testing a vaccine based on the present H5N1 virus circulating in Southeast Asia; however, it is unknown how good a match this vaccine will be against the final pandemic strain, since H5N1 is continuing to evolve. Additionally, vaccine production facilities worldwide are very limited, and there are no production facilities in the United States.

The other flu fighting approach is the use of antiviral medications. It is already known that there are not nearly enough doses of effective prescription antiviral drugs to go around during a pandemic. It is assumed, but unproven, that these drugs will be somewhat effective against H5N1, but much is still unknown about the dose and duration of treatment that will work. Worrisome also is the fact that recent reports indicate that the H5N1 virus has shown resistance to Tamiflu, which up until now was presumed to be the most effective antiviral drug available. In addition to prescription antivirals there are also non-prescription antiviral medications and other medicinal substances that have been shown to be effective in clinical trials against human influenza, and these might be effective against H5N1 also.

Why is this flu virus so different and capable of causing so much more harm than ordinary flu? It is because this virus, unlike the usual flu viruses that we see every winter, has never been seen before in humans (prior to 1997) and therefore no one on earth has any type of acquired immunity to it. Bird or avian flu viruses are so named because they begin in birds and then mutate to be able to infect humans. They then further mutate to the point where they are capable of human-to-human transmission.

The last major devastating global flu pandemic in 1918 was caused by the H1N1 virus and it is estimated that 50-100 million people died worldwide.²  If the current H5N1 virus has roughly the same mortality rate as the 1918 virus, then with today’s population figures that would translate to 1.7 million deaths in the United States and 180 million to 360 million deaths worldwide.³ 

Evidence so far suggests that a pandemic caused by the current H5N1 flu is more likely to mimic the 1918 pandemic mortality rate than other milder pandemics that occurred last century.⁴  The 1918 pandemic was especially cruel in the way it killed many who were healthy and in the prime of life, with more than half the deaths occurring among healthy adults between 18 and 40 years old.⁵ The flu viruses that we see every winter are rarely fatal to healthy adults with adequate immune systems. These flu viruses generally kill indirectly, mainly through opportunistic secondary infections such as pneumonia. People with weakened immune systems such as the elderly and chronically ill are the most susceptible to death from this type of secondary infection. In the 1918 pandemic, however, the H1N1 virus apparently caused many deaths directly, rather than indirectly, through a process called cytokine storm.⁵  A cytokine storm occurs when the immune system goes into overdrive and releases an avalanche of immune responders including cytokines and other immune cells. This too great immune response overwhelms and inflames the lungs, leading to acute respiratory distress syndrome (ARDS), with eventual death by suffocation. It appears that cytokine storm is also playing a major role in the H5N1 deaths in Southeast Asia today.⁶  The majority of H5N1 deaths to date have been in children and young adults. A May 2005 article in the New England Journal of Medicine entitled “Preparing for the Next Pandemic” includes the nearby graphic of the mechanism of cytokine storm.³

In early November 2005 the U.S. released the avian flu pandemic national preparedness plan.  This plan included funds for vaccines and medications, and the provision for possible quarantines and travel restrictions. However, Dr. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, and one of the foremost flu preparedness experts in the world,  said in recent interviews that once the avian flu begins to exhibit easy human transmission capabilities then it will be too late for vaccines and antiviral drugs.  He said that the flu will move too quickly for drugs and vaccines to be of much use and “ It doesn’t matter if we have a vaccine now or not. We can’t make it .“  He also expressed grave concerns that hospitals will be overwhelmed, and that there would be massive  food shortages because  the food supply system will be dysfunctional.  He advised people and communities to begin stockpiling food now.  He has also stated, upon returning from a trip to Southeast Asia, that the flu induced cytokine storm is not something that even our modern medical facilities can handle. He said that “cytokine storm even under the best of conditions is extremely difficult.  I don’t care if you’re in the intensive care unit at Johns Hopkins or the Mayo Clinic or in Hanoi.  It’s a very difficult clinical condition to manage.”  He also said that the U.S. would run out of needed medical supplies almost overnight once the flu hits.

How far away is the avian flu pandemic?  The truth is that nobody knows for sure. H5N1 is spreading quickly in birds, but slowly in humans.  News reports erroneously claim that only one or two cases of verified human-to-human transmission have taken place; however, scientists following flu events closely vigorously dispute that claim, and instead say that there have been quite a few cases of human transmission within extended family clusters.  This type of transmission is one mutation away from the type of rapid human transmission that would be present during a global pandemic.  This fall wild birds infected with H5N1 have been found across Europe. And in Canada very recently wild birds were found infected with the H5 flu subtype, with tests currently being conducted to determine if it is actually H5N1.  Experts in bird migratory patterns report that in the very near future H5N1 will be carried to every corner of the globe by wild bird migration.  From Europe migrating birds will spread the flu to Africa.  Also, in the spring of 2006 European migrating birds will intermingle with North American migrating birds in the Artic Circle.  When these birds return to North America the flu will inevitably spread in the U.S.

The good news is that there is still time for individuals to prepare.  And if a pandemic strikes, there is every likelihood that individuals may have to rely the best they can on their own resources and self-care.

Preparations for the Pandemic

For the individual trying to prepare in advance at home, it would be important to consider preparations on at least three fronts:

• Storing a quantity of the right antiviral or flu fighting medications.
   
• Maintaining optimal bodily health including maintaining the proper acid-alkaline body chemistry balance.
   
• Storing a quantity of food and other life necessities in the event a pandemic disrupts normal services for a period of weeks or months.

It should be kept in mind also that the CDC says that flu pandemics last longer than most other emergency events, and that flu activity usually comes in “waves” of infection separated by months.⁷ In the last century the second wave usually came 3 to 12 months after the first wave. It has also been noted that the second wave can be more devastating than the first wave. So individuals should bear that in mind when making preparations, and not expend all resources on the first wave alone.

Antiviral Medications

What type of antiviral medications or substances are available, and will they actually work against the H5N1 flu virus? It had been assumed until recently that some of the current antiviral drugs, the neuraminidase inhibitors oseltamivir (Tamiflu) and zanamivir (Relenza), would be effective against H5N1.  In recent weeks, however, reports have emerged of patients with a Tamiflu resistant H5N1 virus.  There have been cases in Southeast Asia where patients were treated with Tamiflu early in the course of the disease but still died. Much is still unknown about the correct dosages, duration of treatment, and eventual resistance levels to these drugs. No medication, either prescription or non-prescription, has been tested in a clinical trial for efficacy against H5N1 infection in humans, mainly because of the small number of identified patients so far. But a search of the medical literature does yield other research studies, case reports, and expert opinions that shed some light on the potential for each drug or substance to work against H5N1 infection in humans. These prescription antivirals and  non-prescription medications for which clinical research are found are discussed below.

When contemplating preparations involving antiviral medications, two questions may enter the reader’s mind. First, why not just wait until illness strikes and then go to the doctor and get a prescription? In a pandemic situation this may not be so easy. All antiviral medications must be started almost immediately after the onset of symptoms (within first 36 hours) in order to be effective. In a pandemic situation it may be difficult to get a medical appointment in time, and in addition there will most likely not be enough doses of antivirals to accommodate all flu victims. The second question is why should anyone consider non-prescription antivirals when the virus is as deadly as H5N1? The answer is that some of these non-prescription medications may just work, having been clinically studied and found to be effective against normal human influenza. And, more importantly, they are readily available over-the-counter for home storage (at least at the current writing). Each of the antivirals are discussed below.

When this article was originally published in July 2005, it was still possible for individuals to obtain any of these drugs discussed below.  The prescription antivirals were available in local pharmacies and over the internet.  Since that time, it appears that U.S. physicians are reluctant to write prescriptions for individuals wishing to prepare in advance, and internet sources of these prescription medications are scarce and expensive. None-the-less, information on the effectiveness of the prescription antivirals is presented below.  At this writing, November 2005, the non-prescription medications discussed below are still available at stores and on the internet.  Some of the online stores have begun to limit the quantities of Sambucol in each order, however.

Prescription Antiviral Drugs

The four antiviral medications prescribed in the U.S. are oseltamivir (Tamiflu), zanamivir (Relenza), amantadine, and rimantadine. Tamiflu and Relenza are neuraminidase inhibitors and they work, in simplified terms, by inhibiting a structure on the surface of the virus and interfering with virus replication and spreading. The World Health Organization (WHO) has recommended that Tamiflu be the drug that nations stockpile in preparation for a flu pandemic.⁸ Relenza is effective also, however it is an inhaled drug which makes administration difficult in patients in respiratory distress. Relenza could be very useful as a prophylactic. It is estimated that the U.S. has enough Tamiflu stockpiled to cover less than 1% of the population.

Tamiflu has been shown to be effective against human influenza illness (not H5N1) with the duration of illness being shortened by about 30 hours when the drug was administered within the first 36 hours of illness.⁹ Another study showed that treatment begun within the first 12 hours of illness onset is more effective than at 48 hours, so treatment with Tamiflu needs to begin as soon as possible after infection.¹⁰ Bear in mind that these studies did not involve patients infected with H5N1.

Tamiflu has been shown to be effective against H5N1 in mice, and a recent study using a current, very virulent strain of H5N1 showed that mice survival was significantly increased with 8 days of treatment instead of the standard 5 days.¹¹

Case reports of H5N1 patients in Southeast Asia have also been published. These show that so far Tamiflu has not proven to be very effective in fighting actual H5N1 infection in humans; however, in most of the reported cases the drug was started later than the proven time period of effectiveness.^{12 13 14} The WHO reports that there have been a few cases of patient deaths when Tamiflu was started immediately, however.¹⁵ Physicians treating these patients have recommended that Tamiflu be started as soon as H5N1 infection is suspected, and that duration of treatment be extended to longer than the standard 5 day course. Reports from Southeast Asia also warn of atypical presentations of the disease (diarrhea and coma) that may make diagnosis and early treatment difficult.¹⁶

Zanamivir, brand name Relenza, works in the same way as Tamiflu and is probably equally effective. It has been shown to be effective in fighting human influenza (not H5N1), decreasing the duration of illness by about 24 hours.¹⁷ Several studies have shown Relenza to be effective against H5N1 in mice and in vitro.^{18 19 20} The downside to Relenza is the fact that it is only available as an inhaled drug, however, this would not affect its usefulness as a prophylactic. Like Tamiflu, it is expensive and in limited supply.

Both Tamiflu and Relenza were thought to be less likely to become resistant to the virus than the older antivirals on the market; however, according to the WHO a resistant variant of H5N1 has been recently detected in several patients treated with Tamiflu.¹⁵ The fact that Tamiflu resistance has been seen in H5N1 patients already indicates that resistance may become any even bigger problem than anticipated as the pandemic progresses. It has also been reported that general viral resistance to Tamiflu has been growing in Japan, where it is routinely prescribed to fight common flu. Countries may have to alter their pandemic antiviral stockpiling plans in case Tamiflu resistance increases.

The two older antiviral drugs in the U.S. market are amantadine and its sister drug rimantadine. According to the CDC and WHO, both of these drugs were tested in vitro against the strain of H5N1 circulating in Southeast Asia and found to be ineffective.⁷ The resistance of H5N1 to these drugs has been blamed on their veterinary use in Southeast Asian countries. It is alleged that in China these drugs have been sold cheaply to farmers and given to poultry both as a treatment and prophylactic since the 1990’s; however, no firm link between China’s use of the drug and resistance to amantadine has been established.²¹ Based on these studies showing H5N1’s resistance to amantadine, many experts and officials have eliminated amantadine and rimantadine from serious consideration for use in a pandemic. There are some reports emerging, however, that the H5N1 found in birds in both Qinghai province China, as well as Russia is indeed sensitive to amantadine.^{22 23} If these reports are verified then public health officials may need to rethink their usage in a pandemic. Amantadine and rimantadine are cheaper and more readily available then Tamiflu and Relenza.

Non-prescription Antiviral Medications

Several non-prescription medications have been subjected to clinical trials in order to gauge their effectiveness against normal human influenza (not H5N1). These are Sambucol, a proprietary medication made from an extract of black elderberries that was developed by an Israeli virologist, and resveratrol, a naturally occurring compound found in grape skins and other plant sources which is extracted and sold by various manufacturers under various brand names in the U.S. Also in the non-prescription realm are homeopathic remedies, in particular Oscillococcinum, which is a medicine specific for influenza treatment. Clinical trials have also been conducted on the efficacy of this treatment for human influenza.

A note of caution is in order regarding all non-prescription medications and substances that may be touted as cold and flu remedies and as general immune boosters. It may be advisable to use with caution any substance that is advertised as having immune boosting properties without any proven antiviral mechanism. The reason for this is that boosting the immune system alone may actually put the patient more at risk for cytokine storm, since cytokine storm is essentially the overreaction of a strong immune system. The prescription antiviral drugs on the market work by interfering with viral structures, not by simply boosting the immune system. The non-prescription medications (Sambucol and resveratrol) discussed below have demonstrated antiviral properties. But some non-prescription substances on the market, such as Echinacea and many others, are primarily immune system boosters and therefore should be viewed with caution.

On the other hand, some researchers speculate that boosting the immune system prior to flu infection would actually be beneficial, because then in theory the total viral load carried by the individual would be lower and the immune system might more effectively fight the virus and cytokine storm might never occur. It can’t be emphasized enough just how speculative these hypotheses are right now. Perhaps the safest rule of thumb should be to exercise caution with non-prescription medicinal substances, and if possible choose among those that have proven antiviral properties, such as the substances discussed below.

Sambucol

Sambucol is a non-prescription proprietary medication made from an extract of black elderberries by an Israeli company, and marketed in the U.S. It was developed by Israeli virologist Madeleine Mumcuoglu. An in vitro study showed that Sambucol neutralized the hemagglutinin spike on the flu viruses and inhibited viral replication.²⁴ Two separate randomized double blind control trials of the efficacy of Sambucol against human influenza showed that the Sambucol treated group had a duration of illness about 4 days shorter than the placebo group.^{24 25} These results show that Sambucol actually decreases illness duration more than the prescription antivirals on the market.

Sambucol has also been shown to raise cytokine levels in a scientific study using healthy humans.²⁶ It may be that Sambucol has two mechanisms for fighting normal flu and cold viruses – a direct antiviral action as well as an immune boosting action.. These studies involved flu patients experiencing normal human influenza, not H5N1, of course, and in normal human influenza the possibility of cytokine storm is not usually considered an issue.

Will Sambucol work against the H5N1 virus? No one knows for sure, but there is the possibility that its antiviral activity would be very helpful, even though it does also appear to raise cytokine levels somewhat. It may also be a good preventative and might be useful for helping people reduce their total viral load before they are exposed. And if no Tamiflu is available, or if H5N1 becomes even more resistant to Tamiflu, then it probably would not hurt to try Sambucol.

Sambucol is available in health food stores and on the internet. As of this writing some of the online stores are beginning to place limits on the number of bottles of Sambucol per order, which probably means people are beginning to stockpile it. An online check found a low price of around $12.89 for the 7.9 oz size. Sambucol comes in both sugar and sugar-free formulas, in liquid and lozenge, and also with Echinacea. It may be a good idea to buy Sambucol without the Echinacea, since Echinacea is thought to raise cytokine levels and does not have a proven direct antiviral mechanism of its own. As has been stressed before, no one knows for sure what will work against H5N1 and what the effective dosages might be.

Resveratrol

Another non-prescription substance with potential for fighting H5N1 is resveratrol. Resveratrol is a natural compound found in the skins of grapes, wines, peanuts, and a few other plant sources. There is research showing that resveratrol has antiviral effects against human influenza. In a recent study at the University of Milan, researchers found that resveratrol could stop the replication of the influenza virus in cell cultures.²⁷ These researchers also gave resveratrol to mice that had been infected with the influenza virus and found a 40% increased survival rate compared to controls. Also significant, they report that resveratrol acts by inhibiting a cellular (host) function, rather than just a viral function, and because of this could be a particularly valuable antiviral influenza drug due to the fact that it would be difficult for resistance to develop, and also it would be effective regardless of the invading virus’s type, strain, or antigenic properties. They also believe that resveratrol increases survival by two mechanisms, both an inhibition of viral replication and a reduction in inflammatory cytokine levels. Along these lines other studies have found that resveratrol has significant anti-inflammatory and cytokine inhibiting properties.²⁸

Given these latest research findings that resveratrol has both direct antiviral and cytokine and inflammation reducing properties, it certainly could be worth investigating. No studies have been done, of course, of effectiveness against the H5N1 virus. There are also no guidelines in this regard for dosage and length of treatment.

Resveratrol is manufactured from a variety of plant sources under several brand names. It is probably important that the consumer makes sure that an independent laboratory has verified that a product has the amount of the active ingredient that it claims it does.

Some people may prefer to try to obtain their resveratrol by drinking red wine and eating grapes, raisins, peanuts, and peanut butter, which are all natural sources of the substance. Much caution should be exercised in using this approach, however. The levels of resveratrol found in grape products varies considerably, but an individual would most likely have to consume quite a bit of these foods to obtain a significant amount. Peanut products contain even less resveratrol than grapes, and many people have a mild food allergy to peanuts which may not become apparent until large quantities are consumed regularly. Too much wine, grapes, and raisins on a regular basis can raise blood sugar levels in many people.

Wine on a regular basis can also put the body out of the proper acid/alkaline balance, as will be discussed further in the next section. The end result of attempting to get resveratrol through large quantities of food and drink could be a weakening of the immune system over time if this induces allergies, blood sugar fluctuations, or pH imbalance. More study is needed in this area but for now caution is warranted.

Homeopathic Medicines  

 Homeopathy is a form of medicine that is over two hundred years old, and is based upon the theory of “like cures like”. There are tens of thousands of homeopathic practitioners all over the world, many of them also physicians also trained in conventional medicine.   A homeopathic remedy is an extremely dilute quantity of a substance that is deemed to have similar properties to the condition or illness of the patient. With homeopathic medicines, the more dilute the concentration, the more potent it is.  This is sometimes very hard for practitioners of conventional medicine to understand, especially since in the very dilute concentrations there is not even one molecule left of the original substance. The nearest familiar comparison would be to modern vaccines. Regardless of how they work, homeopathic medicines have been proven to be significantly better than placebo in randomized double blind control clinical trials, which indicates that there must be something to them, even though they are extremely dilute.  At times they have been called “vibrational” medicines.

Homeopaths claim a long history of successfully treating the flu, including the 1918 flu.  According to Randall Neustaedter in his book “Flu: Alternative Treatments and Prevention”, many patients in the U.S. had access to homeopathic care during the 1918 pandemic.  In a report to the American Institute of Homeopathy in 1921, the dramatic success of homeopathic flu treatment was documented.  According to this report, the death rate for 24,000 flu cases under conventional medical care was 28.2 percent, while the death rate for 26,000 cases treated with homeopathy was 1.05 percent.  According to this report, many homeopathic physicians each reported treating thousands of patients with very few deaths.  No information is available on exactly how these cure rates were derived, and if they would meet modern statistical standards.

There are however, modern clinical trials that have tested the effectiveness of homeopathic remedies for flu against placebo. Researchers at the Cochrane Collaboration conducted a meta-analysis of the data from seven controlled trials in order to see if Oscillococcinum and other homeopathic remedies were effective in preventing or treating human influenza illness.²⁹ Oscillococcinum is made from wild duck heart and liver, which are said to be reservoirs for influenza virus.  The authors concluded that the when used in treatment, Oscillococcinum and similar homeopathic remedies reduced the duration of illness by .28 days. The medicine also increased the chance that the patient considered the treatment effective, compared to the patients treated with a placebo. The authors found no evidence, however, that homeopathic remedies are effective in preventing influenza illness. They conclude by stating that they can’t recommend homeopathic medicines as a first line defense against influenza based on the data at hand; however, they feel the results are promising and more research is warranted.  A reduction in illness duration of just .28 days may not seem like much, however it should be remembered that the best prescription antivirals only reduce illness duration by about 1 day.  Other controlled trials not included in the Cochrane review have also shown that homeopathic medicines are effective against the flu.

In his book Neustaedter says that homeopaths treat patients with a variety of homeopathic medicines; however he says:

“most flu seasons and epidemics fit a common homeopathic picture, so that the majority of people with the flu will benefit from the epidemic medicine.  Homeopaths in practice will easily discover the medicine in their community after seeing a few cases of the flu.”

 He also tells us that the epidemic medicine for the 1918 flu was Gelsemium, with Bryonia and Eupatorium as secondary prescriptions. He also mentions that a homeopathic medication named Influenzinum is prepared each year from the flu virus strains recommended by the WHO for the year’s vaccine production.  

What does all this mean for the average reader with no knowledge of homeopathy?  And will homeopathic practitioners rely solely on homeopathic remedies during an H5N1 pandemic?  After all, there were no modern antiviral medicines available in 1918, so no comparison could be made at that time between antiviral drug therapy and homeopathic flu therapy.  If one is interested in investigating homeopathic flu treatment, then one should educate oneself a little on the methods and principles ahead of time, and if possible find and get to know a good homeopathic practitioner. There are many books and free online materials available on the subject.  Unlike most other medications, in homeopathic medicines the more dilute the substance the higher the potency. Also, the medicines are given in a certain way, they are not administered on a regular, timed schedule for a set number of days, as for instance antibiotic therapy is administered.

At the very least, anyone interested in homeopathic therapy for H5N1 should have the medicines stored at home ahead of time, along with some downloaded information from the internet on their usage for flu treatment.  Since Neustaedter in his book says that Gelsemium and Bryonia have been the two most frequently indicated flu remedies over the past 100 years, it would make sense to stock those two, as well as Eupatorium, which he also mentions as being used during the 1918 flu.  It would also seem logical to stock some Oscillococcinum, as that has been clinically tested and found to be effective in decreasing flu illness duration.  All of these medicines are extremely cheap and can be found at health food stores and online.  Gelsemium, Bryonia, and Eupatorium from the Boiron company are under $8 for 100 pellets in the 200c strength.  Oscillococcinum is slightly more expensive, but can readily be found in health food stores and even some drug stores.  As a start, the reader could visit the online article, Homeopathy and the Flu, which contains an excerpt from Neustaedter’s book describing the homeopathic treatment of flu and the contrasting indications for Gelsemium and Bryonia.

 Remember, consulting a homeopathic practitioner is always best, however in a flu pandemic situation self treatment may become a necessity.  If it becomes impossible to actually visit a homeopath for treatment during a pandemic, then it may be possible to consult one over the phone or self treat from books and online literature, if the remedies are stored at home ahead of time.

And it may not be wise to rely on homeopathic treatment alone, especially if it looks like cytokine storm is a danger.  If it is not possible to obtain any conventional medical treatment, then in addition to homeopathic medicine the reader should consider the non-prescription antivirals discussed in the previous section, as well as intensive vitamin C therapy, discussed in the next section.

Vitamin C

Much has been written about the usefulness of vitamin C for both antibacterial and antiviral purposes, and very large doses of vitamin C may have a role in fighting an H5N1flu infection. However, the amount of vitamin C needed by the body to overcome infection may be extremely large, even as much as 100,000 grams or more in an eight hour period. It has been suggested by experts in the usage of vitamin C that at the first sign of influenza infection the patient should begin taking oral vitamin C to “bowel tolerance”.  This would mean taking 1000 - 4000 mg of vitamin C per hour until bowels become loose.  At that point the vitamin C dose should be maintained or decreased slightly until the bowels normalize. Vitamin C experts say that often, until a certain dosage threshold is reached, no improvement at all is noted, and then all of a sudden the patient will improve very rapidly.  Once the virus is overwhelmed, then a far lower dose will cause loose stools. It is also possible to administer intravenous vitamin C; however, in a self treatment situation this option would not exist.

It would probably be wise to have a large quantity of vitamin C on hand to function as an adjunct to other antiviral medication and/or homeopathic therapy.  At the first sign of infection vitamin C could be started along with one or more antiviral medications.  One source of inexpensive high quality bulk Vitamin C powder (ascorbic acid crystals) is from a company called VitaPurity.  Their Buffered Vitamin C powder can be mixed with water, juice, or mixed in applesauce.

Hydrogen Peroxide

And finally in the arena of somewhat controversial flu fighters there is hydrogen peroxide. There is considerable anecdotal evidence from people who have tried it that hydrogen peroxide drops in the ears works successfully to fight cold and flu if taken at the onset of symptoms. One can find unsubstantiated information on the internet that in 1928 a doctor named Richard Simmons hypothesized that cold and flu viruses actually entered the body through the ear canal, not just the nose and mouth. Hence the rationale for putting hydrogen peroxide drops in the ear canal. There is more unsubstantiated information on the internet that in the 1930’s German doctors had success with treating cold and flu patients with hydrogen peroxide.

In the case of H5N1 infection it would probably not be a good idea to forego antiviral therapy for hydrogen peroxide therapy, if antivirals were available. If no antivirals are available, however, then hydrogen peroxide drops may be worth trying. It is also possible that hydrogen peroxide drops could be used as a preventative or in conjunction with antiviral therapy.

A bottle of 3% hydrogen peroxide can be found in the drug store for around $3.00. This type of peroxide should not be taken orally, and should be stored out of sunlight to avoid degradation. There is also a type of food grade hydrogen peroxide that is available on the internet that is meant to be taken orally for various health reasons. There is some controversy over the safety of consuming hydrogen peroxide orally though, so anyone attempting this should be careful and research it well. There are some very thorough books on the subject, such as “Hydrogen Peroxide, Medical Miracle,” by William Douglass, MD.

Maintaining Optimal Body Health – Acid/Alkaline Balance

In some ways the idea of preparing for a flu pandemic by maintaining optimal health ahead of time seems like a contradiction to the previous section where the problem of cytokine storm killing some of the healthiest people was discussed. It would seem logical that if this type of flu were especially dangerous to people with the healthiest immune systems, then trying to improve health ahead of time may not be the best idea.

Again, this is a very uncertain area, and no one knows the answers. But it should also be remembered that in any disease pandemic there are always those who never get sick or who only have a mild infection and recover quickly. In southeast Asia right now it is thought that there are many asymptomatic H5N1 carriers, and many others who have probably had a mild case and recovered on their own.

What is the difference between those that get very sick and those that don’t, when to begin with no one on Earth actually had an acquired immunity? There are many factors that could come into play, such as some form of natural immunity and genetic differences, however one very possible answer to the age old question of why some people get sick and others don’t is the pH balance of the body – the alkaline/acid balance.

The Edgar Cayce readings shed much light on this subject. In the Cayce readings the importance of maintaining the correct acid/alkaline balance in the body was discussed time and time again. The Cayce readings said that when the correct balance is maintained, which is about 80% alkaline, then the body would not be susceptible to any communicable disease. In short, a properly pH balanced body does not provide a hospitable environment for cold and flu germs. Note that the Edgar Cayce readings indicate that it is just as bad to be too basic as it is to be too acid.

When during a reading Cayce was asked “What causes colds? Can you give me a formula or method of preventing them, or curing them?” Cayce responded: “Keep the body alkaline! Cold germs do not live in an alkaline system! They do breed in any acid or excess of acids of any character left in the system.” [1947-4]

Is there any scientific evidence that would back up the Cayce readings on this subject?  David McMillin in his paper “Diet and Urinary PH: A Preliminary Study and Brief Discussion of Relevance to Infectious Disease”, notes studies that show that many viruses infect host cells by fusing with the cell membrane at low pH.  Thus, a mildly acidic environment is required for optimal infectivity of such pH-dependent viruses. He notes also that drugs that increase intracellular pH (alkalinity) have been shown to decrease infectivity of rhinovirus. He also notes that the antimicrobial effects of many substances are pH-dependent. 

So, it would appear indeed that there is some scientific evidence backing up the theory that a properly balanced body pH does not provide a hospitable environment for cold and flu germs.

Even more remarkable is the Cayce reading in which a 23 year old woman in 1935 who was traveling out of the country asked Cayce whether she should submit to travel vaccinations for infectious diseases. Cayce said

“So far as the body-physical condition is concerned, the adherence to the use of carrots, lettuce, and celery every day at a meal or as a portion of the meal will insure against any contagious forces with which the body may be in contact.” “As indicated, if an alkalinity is maintained in the system – especially with lettuce, carrots, and celery, these in the blood supply will maintain such a condition as to immunize a person”

[480-19]

One of the reasons that lettuce, carrots, and celery are very beneficial to the body is because they are very alkalizing.

Many nutritionally conscious people have heard of the importance of maintaining the correct acid/alkaline balance, but have avoided learning more and attempting to do it because they fear it will be too difficult and complicated and involve knowing about chemistry. But maintaining a reasonably good pH balance is not that difficult. One good book that covers the subject, as well as much more of Edgar Cayce’s advice on food and nutrition is Simone Gabby’s “Nourishing the Body Temple”. Lists of foods that are acid and alkaline can also easily be found on the internet, along with discussions of how to balance the diet in regard to pH.

Basically, most, but not all, fruits and vegetables are alkalizing, while most meats, poultry, fish, dairy, alcohol, grains, and sugars are acidifying. The trick is to try to eat more fruits and vegetables and less grain products, meats, dairy, sugars, alcohol and refined carbohydrates. The Cayce readings say to try to keep an 80/20 alkaline/acid balance. Even taking the time to grab some raw carrots and celery for a snack once a day can make a big difference in body pH, especially if the intake of acidic foods is limited. There are a few surprises in the reading's list of foods, such as the information that black tea is acidic in the body, however coffee is considered to actually have nutritional value, and when taken black after a meal it is alkalizing. Taking the time to learn more about balancing the body chemistry would not only help prepare the individual for a flu pandemic but would also be very beneficial in general.

William Hutton and his wife decided to make a reserve "potion" of lettuce, celery, and carrots to have on hand in the event of the sudden appearance of bird flu in their neighborhood, and/or at a time when fresh vegetables were not easily available. This was done by juicing the three vegetables and then freezing the liquid in plastic ice-cube trays. This reserve is used by removing a number of the ice cubes and eating them at suitable times each day. Such could be very helpful to battle the first wave of a bird-flu, or any other flu virus that comes along.

The Cayce readings also mention a substance called Glyco Thymoline, which is said to act as an aid in restoring the body to its correct, slightly alkaline pH balance. Cecil Nichols, in a paper prepared for the Medical Research Division of the Edgar Cayce Foundation, titled "Glyco Thymoline In The Edgar Cayce Readings", studied and reported on the 193 Cayce readings in which Glyco Thymoline was mentioned. The readings recommended Glyco’s use as an internal antiseptic, to be used for gargling, as a pack, and as an eye wash.  The readings vary in the amount of Glyco prescribed, but generally small quantities, 3-10 drops in water, acts as “an alkalizer for the alimentary canal”.  Many people today gargle with Glyco when they feel a cold or flu coming on, and note that it often stops the infection from progressing. The readings also caution against taking too much Glyco internally, for care must be taken not to over alkalize the body.    

It may be very worthwhile to have a bottle of Glyco Thymoline on hand as one more weapon in the home preparedness arsenal against H5N1.  At the first sign of infection, the patient can begin gargling with Glyco, and it may also function well as a flu preventative.  Glyco Thymoline can be ordered from the Heritage Store at the A.R.E. as well as many places online.

Finally, it is also known that too much stress will cause the body to become unbalanced with regard to pH. This helps to explain why some people are more susceptible to colds and flu when under duress.  

Storing Food and Other Supplies Ahead of Time

There is a strong possibility that if the world experienced another flu pandemic like the 1918 pandemic, life would change dramatically for months or even years. It is likely that many of the goods and services that we take for granted now would not be so readily available. In the U.S. many stores are stocked with goods on a daily or weekly basis, and if the supply line were disrupted then stores would empty very quickly.

This phenomenon can already be seen in areas of the country when the threat of severe weather approaches and stores are quickly emptied by shoppers frantically trying to prepare. In those cases though after the severe weather is over life quickly returns to normal and trucks restock the stores immediately.

In a flu pandemic, however, the entire supply line may be disrupted if many people fall ill and many other people refuse to go to work for fear of falling ill. It makes sense then for individuals to store some food and other supplies at home as part of their overall preparations. This also makes great sense in general, regardless of whether or not a flu pandemic ever materializes, for there is always the possibility of other natural disasters or earth changes for which one should be prepared. The Cayce readings discuss this quite frequently, and The Hutton Commentaries keeps readers well informed of the status of Earth changes through his website and bulletins.

Since this article was originally published in July 2005, many of the recommendations found here for storing food have been echoed by one of the leading flu and infectious disease experts in the world, Dr. Michael Osterholm of the University of Minnesota.  As stated earlier in the article, Dr. Osterholm has gone on record advising the U.S. government that it is actually too late now to worry about stockpiling antivirals and vaccines – what is needed now is for communities and individuals to actually begin to stockpile food and other life necessities.

It should be a real wake up call to the world for a dire warning like this to come from a mainstream scientist like Dr. Osterholm.  And while it does not appear that governments are beginning to stockpile food, there is still time for individuals to stockpile food and other supplies at home.

Also alarming is the decrease in government stored food in the U.S. over time.  At one time the country had enough food in storage to feel every man, woman, and child for a three year period.  Gradually our stores of grain and other food have been sold off or given to other countries, until the point today when we are left with about a 15 pound supply of food in storage for every person in the country.  And most of that 15 pounds is not very palatable – unprocessed wheat, peanut butter, cheese products, etc.

What kinds of food and supplies should one stock and how much should be stocked? That is not an easy question to answer, however there are many books and websites on the subject to guide you. The Mormon religion has always instructed its followers to store a year’s worth of food and supplies at home for use during emergency. They have learned to do this very economically, by placing large group orders with suppliers like Walton Feed and Mountain House Foods.

Another approach to food storage is to simply buy and store a lot more of the food you normally eat anyway, rotating the stored food into usage on a regular basis. For instance if you like canned soups or jars of pasta sauce, simply buy and keep on hand enough to last for weeks or months, and then rotate the stored food into use. Large bags of rice can be bought at discount grocery stores extremely cheaply, and if you never end up eating them it would not be a huge financial loss.

Don’t forget to think about the acid/alkaline balance of foods for storage also. As discussed in a previous section, one might consider making reserve potions of lettuce, celery, and carrot juice to store in the freezer to have on hand for supplying alkalinity, enzymes, and other nutrients that vegetables supply.  Another idea for getting fresh food into the diet is making one's own sprouts.  This is relatively easy and cheap to do, but you should lay in the seeds and sprouting supplies ahead of time.

It is important to have access to a supply of potable water. Stored water should be contained in glass or food-safe plastic containers, and should have purifiers such as stabilized oxygen, hydrogen peroxide, and chlorine drops added to keep it uncontaminated. And of course any necessities that you couldn’t live without such as prescription drugs should be thought about in advance. It would probably be a good idea to have some cash on hand also.

Review and Conclusion

Supplies to Get Ahead of Time:

• Antiviral medications
• Homeopathic medications
• Vitamin C
• Glyco Thymoline
• Food and Water
• Matches, batteries, cooking fuel, other life necessities

Steps to take for Suspected H5N1 Infection

• Try to get immediate medical help from doctor or hospital – get antiviral prescription
• Consider non-prescription drug therapy also  – Sambucol and resveratrol
• Consider starting homeopathic medications
• Start taking massive doses of vitamin C – 1000-4000 mg per hour or more
• Gargle with Glyco Thymoline, take a few drops internally
• Consider drops of hydrogen peroxide for ear canal
• Make sure diet is properly pH balanced – 80% alkaline, 20% acidic
• All family members should begin preventative therapy – much the same as the patient

That about covers that main physical preparations that one can make at present for a possible global flu pandemic. Readers should weigh the information in this article carefully and make decisions and preparations as he or she feels guided. This article will be updated as new information becomes available.

Disclaimer

The information provided herein should not be construed as a health-care diagnosis, treatment regimen or any other prescribed health-care advice or instruction. The information is provided with the understanding that the author or web-publisher are not engaged in the practice of medicine or any other health-care profession and do not enter into a health-care practitioner/patient relationship with its readers. The author/publisher does not advise or recommend to its readers treatment or action with regard to matters relating to their health or well-being other than to suggest that readers consult appropriate health-care professionals in such matters. No action should be taken based solely on the content of this article. The information and opinions provided herein are believed to be accurate and sound at the time of publication, based on the best judgment available to the author. However, readers who rely on information in this publication to replace the advice of health-care professionals, or who fail to consult with health-care professionals, assume all risks of such conduct. The author/publisher is not responsible for errors or omissions.

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