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No…Comment. Flu Vaccine linked with Swine Flu Incidence?

April 12th, 2010 No comments

This is… interesting.  I won’t comment, just link and quote… and highlight…

http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000258

Abstract

Background

In late spring 2009, concern was raised in Canada that prior vaccination with the 2008–09 trivalent inactivated influenza vaccine (TIV) was associated with increased risk of pandemic influenza A (H1N1) (pH1N1) illness. Several epidemiologic investigations were conducted through the summer to assess this putative association.

Methods and Findings

Studies included: (1) test-negative case-control design based on Canada’s sentinel vaccine effectiveness monitoring system in British Columbia, Alberta, Ontario, and Quebec; (2) conventional case-control design using population controls in Quebec; (3) test-negative case-control design in Ontario; and (4) prospective household transmission (cohort) study in Quebec. Logistic regression was used to estimate odds ratios for TIV effect on community- or hospital-based laboratory-confirmed seasonal or pH1N1 influenza cases compared to controls with restriction, stratification, and adjustment for covariates including combinations of age, sex, comorbidity, timeliness of medical visit, prior physician visits, and/or health care worker (HCW) status. For the prospective study risk ratios were computed. Based on the sentinel study of 672 cases and 857 controls, 2008–09 TIV was associated with statistically significant protection against seasonal influenza (odds ratio 0.44, 95% CI 0.33–0.59). In contrast, estimates from the sentinel and three other observational studies, involving a total of 1,226 laboratory-confirmed pH1N1 cases and 1,505 controls, indicated that prior receipt of 2008–09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring–summer 2009, with estimated risk or odds ratios ranging from 1.4 to 2.5. Risk of pH1N1 hospitalization was not further increased among vaccinated people when comparing hospitalized to community cases.

Conclusions

Prior receipt of 2008–09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring–summer 2009 in Canada. The occurrence of bias (selection, information) or confounding cannot be ruled out. Further experimental and epidemiological assessment is warranted. Possible biological mechanisms and immunoepidemiologic implications are considered.

 No...Comment.  Flu Vaccine linked with Swine Flu Incidence?

You'll never see a headline saying "Vaccination Spreads Disease"

Background

Every winter, millions of people catch influenza—a viral infection of the airways—and hundreds of thousands of people die as a result. These seasonal epidemics occur because small but frequent changes in the influenza virus mean that an immune response produced one year through infection or vaccination provides only partial protection against influenza the next year. Annual vaccination with killed influenza viruses of the major circulating strains can greatly reduce a person’s risk of catching influenza. Consequently, many countries run seasonal influenza vaccination programs. In most of Canada, vaccination with a mixture of three inactivated viruses (a trivalent inactivated vaccine or TIV) is provided free to children aged 6–23 months, to elderly people, to people with long-term conditions that increase their risk of influenza-related complications, and those who provide care for them; in Ontario, free vaccination is offered to everyone older than 6 months.

In addition, influenza viruses occasionally emerge that are very different and to which human populations have virtually no immunity. These viruses can start global epidemics (pandemics) that can kill millions of people. Experts have been warning for some time that an influenza pandemic is long overdue and, in March 2009, the first cases of influenza caused by a new virus called pandemic A/H1N1 2009 (pH1N1; swine flu) occurred in Mexico. The virus spread rapidly and on 11 June 2009, the World Health Organization declared that a global pandemic of pH1N1 influenza was underway. By the end of February 2010, more than 16,000 people around the world had died from pH1N1.

Why Was This Study Done?

During an investigation of a school outbreak of pH1N1 in the late spring 2009 in Canada, investigators noted that people with illness characterized by fever and coughing had been vaccinated against seasonal influenza more often than individuals without such illness. To assess whether this association between prior vaccination with seasonal 2008–09 TIV and subsequent pH1N1 illness was evident in other settings, researchers in Canada therefore conducted additional studies using different methods. In this paper, the researchers report the results of four additional studies conducted in Canada during the summer of 2009 to assess this possible association.

What Did the Researchers Do and Find?

The researchers conducted four epidemiologic studies. Epidemiology is the study of the causes, distribution, and control of diseases in populations.

Three of the four studies were case-control studies in which the researchers assessed the frequency of prior vaccination with the 2008–09 TIV in people with pH1N1 influenza compared to the frequency among healthy members of the general population or among individuals who had an influenza-like illness but no sign of infection with an influenza virus. The researchers also did a household transmission study in which they collected information about vaccination with TIV among the additional cases of influenza that were identified in 47 households in which a case of laboratory-confirmed pH1N1 influenza had occurred. The first of the case-control studies, which was based on Canada’s vaccine effectiveness monitoring system, showed that, as expected, the 2008–09 TIV provided protection against seasonal influenza. However, estimates from all four studies (which included about 1,200 laboratory-confirmed pH1N1 cases and 1,500 controls) showed that prior recipients of the 2008–09 TIV had approximately 1.4–2.5 times increased chances of developing pH1N1 illness that needed medical attention during the spring–summer of 2009 compared to people who had not received the TIV. Prior seasonal vaccination was not associated with an increase in the severity of pH1N1 illness, however. That is, it did not increase the risk of being hospitalized among those with pH1N1 illness.

What Do These Findings Mean?

Because all the investigations in this study are “observational,” the people who had been vaccinated might share another unknown characteristic that is actually responsible for increasing their risk of developing pH1N1 illness (“confounding”). Furthermore, the results reported in this study might have arisen by chance, although the consistency of results across the studies makes this unlikely. Thus, the finding of an association between prior receipt of 2008–09 TIV and an increased risk of pH1N1 illness is not conclusive and needs to be investigated further, particularly since some other observational studies conducted in other countries have reported that seasonal vaccination had no influence or may have been associated with reduced chances of pH1N1 illness. If the findings in the current study are real, however, they raise important questions about the biological interactions between seasonal and pandemic influenza strains and vaccines, and about the best way to prevent and control both types of influenza in future.

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H1N1 Chinese Medicine Treatment Video

November 28th, 2009 No comments

I won’t be linking to the video itself, but to the website http://english.cctv.com/program/newshour/20091126/103083.shtml.  Here is the caption from the article:

With growing numbers of A/H1N1 flu cases on the Chinese mainland, many more people are turning to traditional Chinese medicine.

China has released a TCM prescription to prevent A/H1N1. Honeysuckle (shown in picture – Philip) and mulberry leaf are on the list. Both of them are common herbal medicines used to treat influenza. But their price has doubled recently.

Health officials say the sudden surge in demand has triggered the price rise, and heavy snow in the past few weeks has hampered deliveries. They say herbal medicines are just one way to prevent flu. People are advised to go to community hospitals if they suffer flu-like symptoms.

Honeysuckle and Mullberry leaves have been used since the time of Zhang Zhongjing and his Shang Han Lun (treatise on cold induced disorders) but I believe the honeysuckle achieved prominent status in the later Warm Disease School of Wu Jutong and Ye Tianshi et al.

Incidentally, I read in business news that garlic prices have gone up by as much as 40% in some areas.  Garlic is warm and pungent so I believe it is better for external Cold and seasonal flu, while the cooling Honeysuckle may be better in high fever diseases such as epidemic fevers and H1N1.

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Chinese Medicine for H1N1… Again

November 21st, 2009 No comments

I had written several articles about H1N1 and how Chinese Medicine may be used to help deal with it.  Today, however, I came upon a news article announcing using a chinese medicine formula to help H1N1 (again).  This one though, left a bitter taste in my mouth.  Want to know why? Let’s quote!

TCM may be another alternative in fight against H1N1
By Channel NewsAsia’s Hong Kong Correspondent Leslie Tang | Posted: 21 November 2009 0011 hrs

HONG KONG: Hong Kong Chinese medicine practitioners are collaborating with a Macau university to test what they believe is another alternative to combating the H1N1 virus.

Okay, so far so good.  They’re taking herbs… having it tested in university…

If they are successful, the formula will be the first Chinese herbal prescription cure for H1N1.

*double take*… FIRST Chinese herbal prescription cure?

First… since when?

Hmmm, maybe they mean over the counter?  Nah.

I hope the reader can see where I may have a problem with this statement.  But anyway let’s continue

Other than Tamiflu and flu jabs, Hong Kong R&D company Rorric Biotechnology believes it may be able to offer a less invasive cure to H1N1, using traditional Chinese medicine.

Dr Chow Ching-fung, chairman of Rorric Biotechnology, said: “This formula is effective in two ways. First, it combats and eliminates the virus. Second, it boosts the immune system, helping the patient to become stronger.”

The formula is made up of 21 common Chinese herbs, such as honeysuckle and Bai Shu.

Honeysuckle, along with chrysanthemum, are among the chief herbs used in the Warm Disease School, as opposed to Zhang Zhongjing’s Cold Disease train of thought.  The Warm Disease theories and practice came about 1500 years after Zhang, during the Qing Dynasty (which ended in the early 20th century).

Unlike Cold Disease theory, which emphasizes environmental excesses, Warm Disease theory recognizes that there are infectious agents out there that can brutally invade and cause febrile disease in patients with strong immune systems.  You see, in Cold Disease Theory, exemplified by the book Shang Han Lun, it’s more of a balance between environment and pathogen.  If you’re healthy, and the environment is temperate, no problem.  If your defenses are weak, then you’d be prone to problems from environments normal people would have no problem with.  If the environmental factor is really excessive, it can overwhelm normal defenses.

But with Warm diseases, they come in and whack away.

And they’re respiratory in nature, marked by high fevers.  The stages range from flu-like symptoms to sepsis.

And they’re contagious.

In other words, sounds like … epidemic flu?

But let’s go on the article.

“Traditional Chinese medicine has a long history of being proven to have fewer side effects as it uses herbal ingredients,” Dr Chow added. “Western medicine contains a mixture of chemicals from the manufacturing process, so the risks are higher.”

Dr Chow said he had prescribed the formula, which is currently in powder form, to 100 patients suspected of contracting H1N1 and they have fully recovered.

Moreover, tests at the Wu Han Institute of Virology have shown that the formula is not only effective against H1N1, but also other mutated forms of Influenza A.

While I agree that TCM can have less side effects when prescribed properly.  But to say that western medicine has more side effects because it is a mixture of chemicals from a manufacturing process… uh… by that logic we shouldn’t decoct herbs, and we shouldn’t process them in a factory and end up with a pill.  That would also be a manufacturing process, yes?

Anyway let me explain my ultimate point here:  I am not against the standardization of chinese medicine, but as I mentioned before, Warm Disease theory in particular classifies epidemic fevers into stages.  Will this medicine be appropriate for all stages?  What are the 21 ingredients?  Is it a modification of an older formula?

Speaking of older formulas, isn’t it interesting that they chose to come up with a “new” formula instead of just taking something from Wenrelun (Treatise on Warm Diseases)?  Older formulas can’t be trademarked and patented… and so can be made into pills by anyone.

Nice to see that Chinese medicine is indeed modernizing… by becoming more like Big Pharma… (sarcasm meter. duh)

Leslie Tang, “TCM may be another alternative in fight against H1N1″ <http://www.channelnewsasia.com/stories/eastasia/view/1019540/1/.html> posted and accessed 11.21.09

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Traditional Chinese Medicine Contributes to Lower Flu Death Rate

November 17th, 2009 No comments

An article in People’s Daily Online claims that the death rate in China from Swine Flu is 1/20th the world rate.  One of the reasons it lists for this is that Traditional Chinese Medicine is very effective for H1N1, among others.

The fatality rate of A/H1N1 carriers is 0.065 percent in China, accounting 1/20 of world’s 1.24 percent average, said Li Lianda, a member of the Chinese Academy of Engineering said on the Cross-Strait Chinese Medicine Development Conference, held in Beijing on Nov. 14-15.

According to the latest data released by the National Health Administration by Nov. 13, 2009, there were 65,927 confirmed A/H1N1 cases in 31 provinces, with 43 deaths. World Health Organization (WHO) said on Nov. 13 that by Nov. 8, 2009, there were over 500,000 A/H1N1 cases worldwide and at least 6,200 people have died.

Everyone already knows my opinions about H1N1 misdiagnoses – anyone found to have H1N1 and dies of whatever reason will be classified as an H1N1 death – but this is still worth examining because it means one of two things: less people who die have H1N1 antibodies and/or less people with H1N1 antibodies die.

Li claimed there are three main reasons contributing to the low fatality rate. First, efficient prevention and control methods help maintain low infection rate in the Chinese mainland. Second, key areas and focused groups were given priority to use the flu vaccine at an early stage, which slowed down its spread. Third, Chinese traditional medicine was very effective in flu control.

traditional chinese herbal medicine 1 300x198 Traditional Chinese Medicine Contributes to Lower Flu Death Rate

Traditional Chinese Medicine: Effective in Flu Control?

Li added that tamilflu was not the best choice for A/H1N1 carriers considering its limitations, including drug resistance, side effects and its high price. On the contrary, Chinese traditional medicine has a noticeable effect; no matter whether patients have light or severe conditions. Chinese traditional therapy has greater effect such as antibacterial, antiviral, pain-relieving, fever-easing and immune system adjusting.

However, Li suggested that China should do more research to bring effective traditional therapy.

I will be very very pleasantly surprised if this article reaches the western press.  But I’m not holding my breath.

Note that the article does not mention any specific formula.  This fits in with the idea that the herbal formula is to be customized for each patient.  Warm Disease Theory (under which H1N1 would fall) classifies disease into four stages.  From early to late, mild to worst, the stages are wei (defensive), qi, ying (nutritive) and blood.  As one can surmise, these stages may be compared to development from acute infection until sepsis.

Each stage even has subcategories, and each has their own recommended formulas.

The great part is that instead of having to go for ludicrously expensive pharmaceuticals, most warm disease theory formulas are made from common ingredients.  These include honeysuckle flower and chrysanthemum.

This is what I love about Chinese herbal medicine, the utter simplicity and beauty of it!

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Astragalus Root for Swine Flu?

October 20th, 2009 3 comments

It has been reported in the media that Dr. Andrew Weil, MD has been critiqued by the US Food and Drug Administration for promoting astragalus root (huang qi) in general and his “Immune Booster” formula against Swine Flu.  My opinions on Whine, er Swine Flu aside, I would like to take this opportunity to discuss Huang Qi in general and it’s use against flus in particular.

But first I have to correct the online article as it showed the astragalus stem and leaves on the page.

 Astragalus Root for Swine Flu?

Leaves of the astragalus plant

Actually the Huang Qi often used is the astragalus ROOT

10024614 300x166 Astragalus Root for Swine Flu?

Astragalus root sliced and ready for use

Some excerpts from the article:

In a stern warning letter, the Food and Drug Administration and Federal Trade Commission told Weil Lifestyle LLC to stop marketing a dietary supplement called “Immune Support Formula” as a product that could “diagnose, mitigate, prevent, treat or cure the H1N1 Flu Virus in people.”

…The regulators go on to call out several other statements on the Web site about studies and scientific evidence to back the antiviral and immune-boosting power of the herb astragalus, an ingredient in Immune Support Formula.

…The NIH’s National Center for Complementary and Alternative Medicine says, “The evidence for using astragalus for any health condition is limited.” Data from small and preliminary studies suggest the herb may help the immune system fight infections, the NCCAM says, and researchers funded by the center are studying astragalus’s effects on the immune system.

…On “Larry King Live” last month, Weil recommended some “interesting strategies” to combat swine flu, including taking capsules of astragalus, which he called “perfectly safe.”

Offhand, I must say that while I admire Dr. Weil for having the courage to stand up for traditional medicine, I believe it is irresponsible to call astragalus, or any other medicinal plant “perfectly safe” and on Larry King Live yet!

I know that what he probably meant was that the amount of astragalus in his formulations were within accepted safety levels, but I believe that ordinary laymen who hear such statements as “perfectly safe” would interpret that to mean “I can take it like candy.”  Not the case.  Sure, it has a high theapeutic index, with a dosage range from 9-30 grams (relatively high) but still there is an UPPER LIMIT.

But what is Astragalus Root all about?  It’s common english name is milkvetch and it’s scientific name is Astragalus propinquus or Astragalus membranaceus according to some.  The component used in Chinese Medicine is the root and thus the herbal component is called Radix Astralagi.

It is considered one of the 50 fundamental herbs in Chinese medicine.  According to tcm-healthinfo.org it can be used:

Orally, Huang Qi/Astragalus is used for treating the common cold and upper respiratory infections; to strengthen and regulate the immune system; and to increase the production of blood cells particularly in individuals with chronic degenerative disease or in individuals with cancer undergoing chemotherapy or radiation therapy. It is also used orally for chronic nephritis and diabetes. Astragalus is also used orally as an antibacterial and antiviral; a tonic; liver protectant; anti-inflammatory; antioxidant; and as a diuretic, vasodilator, or hypotensive agent.
Topically, Huang Qi/Astragalus is used as a vasodilator and to speed healing.
In combination with Ligustrum lucidum (glossy privet), astragalus is used orally for treating breast, cervical, and lung cancers.

Let’s take a sampling of research articles about the effects of Astragalus

Shen et al.  “Differential Effects of Isoflavones, from Astragalus Membranaceus and Pueraria Thomsonii, on the Activation of PPAR-alpha, PPAR-gamma, and Adipocyte Differentiation In Vitro“  American Society for Nutrition J. Nutr. 136:899-905, April 2006

Our data suggest the potential value of isoflavones, especially biochanin A and their parent botanicals, as antidiabetic agents and for use in regulating lipid metabolism. – from abstract.

Here’s an article so good I have to quote the whole thing with some points highlighted…

Could an herbal therapy that’s been used for centuries in Chinese medicine to strengthen the immune system hold the key to an effective treatment for Acquired Immune Deficiency Syndrome, better known as AIDS? A new study by scientists at the UCLA AIDS Institute says that’s possible.

The research, set to be published in the Journal of Immunology November 15th (available on-line now at http://www.jimmunol.org/cgi/content…), concludes astragalus root contains a substance that could make it a powerful weapon in the fight against the HIV virus that causes AIDS. “This has the potential to be either added to or possibly even replace the HAART (highly active antiretroviral therapy), which is not tolerated well by some patients and is also costly,” co-author Rita Effros, a professor of pathology and laboratory medicine at the David Geffen School of Medicine at UCLA and member of the UCLA AIDS Institute, said in a press statement.

So what specifically appears to make astragalus effective in treating HIV infection? The key finding in the UCLA study shows a substance in the herbal therapy prevents or slows down the progressive shortening of a part of immune system cells called telomeres.

A telomere is a region found at the end of each cell chromosome. It does not contain genes but does contain repeated DNA sequences. As immune cells age, telomeres gets shorter and shorter when the cells divide. Eventually, the cells change, can no longer divide and their ability to fight infections is compromised. This phenomenon is dubbed replicative senescence.

For a strong immune system to function correction, a great deal of cell division has to take place. For example, when a virus invades the body, killer T-cells (known as CD8 T-lymphocytes) have receptors that recognize the invader and begin to create versions of themselves to fight the virus — through division, they create more and more of an immune system “army” to knock out the virus. In most healthy people, the telomeres in cells are long enough to allow cells to divide many times without a glitch. What’s more, T-cells can switch on an enzyme called telomerase to prevent the telomeres from shortening and to boost the ability of the cells to divide.

“The problem is that when we’re dealing with a virus that can’t be totally eliminated from the body, such as HIV, the T-cells fighting that virus can’t keep their telomerase turned on forever. They turn off, and telomeres get shorter and they enter this stage of replicative senescence,” Dr. Effros explained in a statement to the press.

Previous studies have shown that injecting the telomerase gene into T-cells can keep the telomeres from shortening so they fight HIV longer than they normally would be able to. However, this complicated and expensive gene therapy isn’t a practical way to treat the millions of people infected with the HIV virus. Good news: the current study shows that treatment with a natural substance called TAT2 found in astragalus could be a far better approach.

The reason? Not only did the researchers find that the astragalus-derived TAT2 slowed the shortening of telomeres, but it also boosted the CD8 T-lymphocytes production of soluble factors called chemokines and cytokines. And these substances have been shown in other research to shown to block the replication of the HIV virus.

“The ability to enhance telomerase activity and antiviral functions of CD8 T-lymphocytes suggests that this strategy (using TAT2 from astragalus) could be useful in treating HIV disease, as well as immunodeficiency and increased susceptibility to other viral infections associated with chronic diseases or aging,” the researchers wrote in their research paper.

According to the Memorial Sloan-Kettering Cancer Center web site (http://www.mskcc.org/mskcc/html/691…), astragalus has no reported adverse effects. It has been used in traditional Chinese medicine to support and enhance the immune system and for heart disease. Currently, the herb is widely used in China for chronic hepatitis, colds and upper respiratory infections and as an adjunctive therapy in cancer. The remarkable herbal therapy has also shown promise in animal experiments as a way to prevent dementia.

WOW.  “Possibly replace HAART”.  THIS is the Huang Qi that is they doubt has an effect against a FLU?

Some other research cited by this article from the University of Maryland Medical Center website

Chen KT, Su CH, Hsin LH, et al. Reducing fatigue of athletes following oral administration of huangqi jianzhong tang. Acta Pharmacol Sin. 2002;23(8):757-761.

Duan P, Wang ZM. [Clinical study on effect of Astragalus in efficacy enhancing and toxicity reducing of chemotherapy in patients of malignant tumor]. Zhongguo Zhong Xi Yi Jie He Za Zhi.2002;22(7):515-517.

Hao Y, Qiu QY, Wu J. [Effect of Astragalus polysaccharides in promoting neutrophil-vascular endothelial cell adhesion and expression of related adhesive molecules]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2004;24(5):427-430.

Hei ZQ, Zhang JJ, Lin SQ, et al. [Effects of Astragalus membranaceus injection on nitric oxide and endothelin concentration of intestinal mucosa after hemorrhage shock-reperfusion in rats]. Zhongguo Zhong Yao Za Zhi. 2004;29(5):444-447.

Kim SH, Lee SE, Oh H, et al. The radioprotective effects of bu-zhong-yi-qi-tang: a prescription of traditional Chinesemedicine astragalus. J Chin Med. 2002;30(1):127-137.

Mao SP, Cheng KL, Zhou YF. [Modulatory effect of Astragalus membranaceus on Th1/Th2 cytokine in patients with herpes simplex keratitis]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2004;24(2):121-123.

Shao BM, Xu W, Dai H, et al. A study on the immune receptors for polysaccharides from the roots of Astragalus membranaceus, a Chinese medicinal herb. Biochem Biophys Res Commun. 2004;320(4):1103-1111.

Shi FS, Yang ZG, Di GP. [Effect of Astragalus saponin on vascular endothelial cell and its function in burn patients]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2001;21(10):750-751.

So the evidence IS there.  But why the need to bash it?  Like I said, if properly used, the commonly found and inexpensive Astragalus root (btw, it’s also used in contemporary asian cooking) can REPLACE expensive drugs that are money-makers for Big Pharma… maybe.

Sources:

Hensley, Scott.  “FDA and FTC Slam Swine Flu Claims For Dr. Weil Supplement” http://www.npr.org 16 October 2009.  20 October 2009 <http://www.npr.org/blogs/health/2009/10/fda_and_ftc_slam_swine_flu_cla.html>

tcm.health-info.org “Huang Qi – Astragalus Root”. 20 October 2009 <http://tcm.health-info.org/Herbology.Materia.Medica/huangqi-properties.htm>

Shen et al.  “Differential Effects of Isoflavones, from Astragalus Membranaceus and Pueraria Thomsonii, on the Activation of PPAR-alpha, PPAR-gamma, and Adipocyte Differentiation In Vitro“  American Society for Nutrition J. Nutr. 136:899-905, April 2006

University of Maryland Medical Center. 20, October 2009 <http://www.umm.edu/altmed/articles/astragalus-000223.htm>

Baker, Sherry. NaturalNews.com 13 November 2008. 20 October 2009 <http://www.naturalnews.com/024799_HIV_astragalus_AIDS.html>

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