Avoid folk remedies for the flu

Author: Brian Warren, food and drug/milk and dairy program administrator

Concerned about the lengthy and difficult 2017-2018 flu season? You should be—according to the latest information from the CDC¹, there have been 97 children killed by influenza viruses during the 2017-18 season, and that number is expected to continue to rise.

In addition to getting the flu shot, over-the-counter cold medicines or seeking medical care are appropriate measures to take should you get sick.. Good nutrition and bed rest will often reduce the length and severity of your illness as well. However, there are two popular “alternative” medicines on store shelves in Louisiana that you should avoid because they are unproven and ineffective.

Elderberry is a flowering plant in the genus Sambucus. It is known as “fercido” in the River Parishes and the leaves are used in poultices as a folk remedy to treat conditions ranging from rashes to burns externally. A more widespread use of the plant is to distill the berries and create an extract or syrup, typically mixed with honey, maple syrup, and/or spices. Proponents claim that the product is effective as a prophylaxis and also to treat patients who are currently suffering from influenza. Note that there is insufficient evidence that any of these products are effective treatments for influenza or that they provide any relief from symptoms beyond what might be expected from a placebo. These items are considered dietary supplements by the Louisiana Department of Health, and the department does not regulate such items. At the federal level, FDA has labelling and good manufacturing practices regulations² that manufacturers are supposed to adhere to, but, unlike actual pharmaceuticals, these products are not required to undergo testing for safety and efficacy as part of a pre-market approval process.

Please be aware that the leaves, berries and other parts of these plants typically contain secondary chemicals related to cyanide that can cause illness (though probably not death) if consumed raw, so avoid ingesting unprocessed elderberries or elderberry products.

Another popular remedy that is widely available at drug stores is Oscillococcinum®. This is a so-called homeopathic medicine. Homeopathy is a practice that dates back to the close of the 18^th century and it has several key concepts but the most important one for the purposes of this discussion is that the “active” ingredients in homeopathic treatments are prepared using a large number of serial dilutions that serve to ensure that no molecule of that ingredient remains in the finished product. Homeopaths will readily concede this point but also state that the water of these dilutions “remembers” the ingredient. In the case of Oscillococcinum® in particular, the duck liver and brain that are supposed to contain the elusive bacteria that are the source of the product’s alleged curative properties are not to be found in the lactose-sucrose pill that is the end result of those many dilutions³. Thus, this homeopathic remedy is like all homeopathic remedies in that it is not going to provide the user with any relief beyond what might be expected from a placebo.

So what should you do about the flu?

·       Get your flu shot. Even if the shot you receive is not completely effective for the strains of the virus that are circulating in your area, it will nonetheless give your immune system a “leg up” on preparing for an infection and the partial immunity it provides will reduce the length and severity of your potential illness. Moreover, your immunization will contribute to “herd immunity.”⁴ Herd immunity refers to the immunity conferred upon individuals in a group once a certain threshold number of those group members have been immunized against a particular disease. In effect, it is a way for people who are able to be vaccinated (most healthy individuals) to protect those people who are unable to be vaccinated due to pre-existing medical conditions or severely-weakened immune systems. The benefits to those unimmunized individuals also have a secondary effect of reducing the overall severity of an outbreak by reducing the number of people who are susceptible to a disease at any given point in time.

The department is currently working through parish health units to provide no-cost vaccinations. Contact your local parish health unit for information on getting vaccinated.

 

·       Practice basic good hygiene. If you aren’t sick presently, wash your hands regularly with soap and water. Avoid close contact with those who are sick. If you are sick, do not go to work or school or church or any other gatherings where you may be exposing groups of people to your infection. Cover your mouth and nose when you sneeze or cough.

·       See your primary care doctor about any serious illness. If you experience severe symptoms such as a persistent high fever, shortness of breath, rapid heartbeat, and exhaustion or confusion, see your physician immediately. He or she may prescribe an antiviral agent such as Tamiflu. Any medicine that you are prescribed by a board-certified physician has undergone clinical trials to ensure its safety and efficacy, unlike the two treatments described in this article.

References

¹ https://www.cdc.gov/media/releases/2018/t0209-flu-update-activity.html (accessed 2/19/2018)

² https://www.fda.gov/food/guidanceregulation/guidancedocumentsregulatoryinformation/dietarysupplements/default.htm (accessed 2/19/2018)

³ https://www.homeowatch.org/history/oscillo.html (accessed 2/19/2018)

⁴ https://academic.oup.com/cid/article/52/7/911/299077# (accessed 2/19/2018)

Oscillococcinum® is a registered trademark of Boiron USA, Inc.