I hope you are out enjoying the wonderful fall weather. We are settling into the new office and like it very much. It is a fantastic improvement over the last industrial setting.

The popular media has caught onto the wave of articles on avian flu in the medical literature, and so I must comment on that topic this time. Counter balancing this potentially troubling information are some pieces about positive effects of diet.

Best, Michael Carlston, M.D.
www.carlstonmd.com 
707-545-1554

Many of you have been asking me questions about avian flu, and I suspect more of you have questions. This is understandable, given the semi-rational fear-mongering in the media. As that last line indicates, there MAY be reason to be fearful, and then again, maybe not. Lets begin with a few facts.

Influenza is a viral infection. These viruses are known for their ability to mutate. The mutations are the reason why the experts have such a difficult time figuring out how to make a vaccine that works for the current year’s strain. (You may know that THIS year’s flu vaccine includes the Santa Clara virus, so named because those of us in the Bay Area were the first to have it LAST year, and, of course, this part of the vaccine will do nothing for us as a result.) If the wrong strain is chosen, the vaccine has little, if any effect, in preventing the disease. Conventional medicine has little to offer in the way of effective anti-influenza medication.

Avian flu is not regular flu. Regular flu passes from one human to another. Most human flu viruses change from year to year as the virus picks up mutations from birds, pigs or another animals before re-infecting humans. As of now, the only way to catch avian flu is from a bird. It has not fully jumped the species barrier and so cannot pass from one human to another. The annual flu vaccines will not prevent avian flu. Birds are very vulnerable to influenza viruses.

When a virus jumps from one species to another it usually has to change. The passage through a series of species is like a filtering process. It changes the virus markedly, and generally speaking, lessens its severity.

Rare but terrifying diseases like Ebola virus or Marburg virus, have jumped directly from one animal to another (us). The first animal, the reservoir of the infection, generally copes relatively well with the infection. When a virus does jump directly and fully into a new species, that species is not accustomed to the virus, and so, uniquely vulnerable. I think of it in this way. The virus uses the organism it infects (you) as a food supply. It is not in the best interest of any living organism to kill off its food supply. When we find some horrible new disease, it has usually jumped a species barrier somewhere (trying out a new restaurant?). Interestingly, after a while, the virus tends to mutate and become less nasty. That is both good and bad. More on that later.

The people who have died of avian flu have gotten the disease directly from their birds. Avian flu has not fully jumped the species barrier because it cannot be transmitted from one human to another. The only time we know of an avian flu fully jumping the species barrier to humans was 87 years ago. That was very, very bad. Somewhere between 20 and 100 million people died. Again, I must repeat, this avian flu has NOT fully jumped the species barrier. It needs to mutate (maybe in 5 places) to make human-to-human transmission possible. It may never do that. It has been around for decades and has not accomplished that so far. However, it could and if it did, given the sheer volume of international air travel, we would face a situation potentially worse than 1918-19.

As I mentioned, there is a tendency for viruses to become less deadly as they accommodate to their victims/hosts. In the 1918 pandemic the death rate among those infected dropped from around 8% to under 1% in only a few months time. That is good.

There is a bad side to this trend. The avian flu getting all of the attention may be changing so that it is less deadly to birds. The problem with that is that if the birds can live with the disease, they can spread it all over the world. IF that mutation does not make it less virulent for humans, this change could increase the likelihood of problems for us.

Some patients have asked about stockpiling prescription antiviral medication. Although there were positive reports about the effectiveness of one of them for human bird handlers infected with this avian flu, recent reports indicate that the virus is mutating and becoming resistant to that medication (Tamiflu).

Our familiar annual influenzas do kill some people. Victims tend to be already weakened in some way. This would be different. As it would be a new, unfamiliar virus, even healthy young adults would be vulnerable. For unknown reasons, the 1918-19 pandemic claimed more lives among previously healthy young adults than any other group.

So what should you do?
1) Don’t over react in fear. Avian flu may not jump the species barrier. If it does, the mutations it undergoes to do so might make it not such a nasty bug. If it does, it might not be for a very very long time
2) Taking good care of yourself (see Good Health Habits page on my website) is always a good idea
3) There are a number of homeopathic remedies used to treat influenzas (including one derived from the 1918 organism)
4) Fortunately we are learning more and more about other traditional therapies which seem to have general immune stimulating or specific anti-viral effects

A report from the FDA is an unfortunate reminder of the potential risks of vaccines. Currently, it is almost universally recommended that college freshman living in dorms receive vaccination to prevent a very serious and often lethal form of meningitis. Five young people who received this vaccine developed Guillain-Barré Syndrome (GBS) within 2-4 weeks afterwards. GBS is an immune mediated paralytic disease which has been linked with influenza vaccines. Most people who get GBS recover fully. Some die of respiratory failure. The swine flu vaccination program of the late 1970s led to nearly 700 deaths from vaccine-induced GBS.