Swine Flu – The Real Facts and Homoeopathy Perspective

Dr.Suja Pillai 
Dr. Aji Punnen 
MD Repertory Scholars,  Govt. Homeopathic Medical College. Calicut. Kerala
Moderator : Dr.K.R.Mansoor Ali

A humor through internet : For escaping from swine flu “ Wash your Hands thoroughly and switch off your TV”

The media and multinational pharmaceuticals creating un necessary fear and terror on this influenza – even though it is a self limiting disease.

The disease is indeed self-limiting. It’s like any viral disease overpower those through risk phases like old age, pregnancy., immuno compromised states etc. The havoc created will end up in the west taking few courses of antiviral and antibiotics like it happened during the time of the anthrax dust soon after the 9-11 at US.

Its an organized havoc and chaos! There will be fake alarms in the form this disease. These alarm and pandemonium created by the mass media and pharmaceuticals during last season caused much panic among common man than the actual disease followed by injudicious administration of stronger and combination medicines with out any proper protocol resulted in much side effects and deaths – and much damage to industry.

Swine flu (hog flu, pig flu)  is a respiratory disease caused by  influenza Aviruses  that infect the respiratory tract of pigs and result in nasal secretions, a barking-like cough, decreased appetite, and listless behavior. Swine flu produces most of the same symptoms in pigs as human flu produces in people.

Swine influenza is common in pigs in the midwestern United States (and occasionally in other states), Mexico, Canada, South America, Europe (including the United Kingdom, Sweden, and Italy), Kenya, Mainland China, Taiwan, Japan and other parts of eastern Asia since 1918 – not a new one.

Transmission of swine influenza virus from pigs to humans is not common and properly cooked pork poses no risk of infection. When transmitted, the virus does not always cause human influenza and often the only sign of infection is the presence of antibodies in the blood, detectable only by laboratory tests.

When transmission results in influenza in a human, it is called zoonotic swine flu. People who work with pigs, especially people with intense exposures, are at risk of catching swine flu. However, only about fifty such transmissions have been recorded since the mid-20th century when identification of influenza subtypes became possible.

History of swine influenza
The 1918 flu pandemic in humans was associated with H1N1 and influenza appearing in pigs, this may reflect a zoonosis either from swine to humans, or from humans to swine.

Although it is not certain in which direction the virus was transferred, some evidence suggests that, in this case, pigs caught the disease from humans.

For instance, swine influenza was only noted as a new disease of pigs in 1918, after the first large outbreaks of influenza amongst people.

History of Influenza A virus in the human population:
The various types of influenza virus are clearly illustrated in the above figure. Solid squares show the appearance of a new strain causing recurring influenza pandemics. The dotted line indicates the unidentified strains.

The H1N1 form of swine flu is one of the descendants of the Spanish flu that caused a devastating pandemic in humans during 1918 -1919. It would have been persisting in pigs and was then circulated into humans during the 20th century, contributing to the normal seasonal epidemics of influenza.

This virus constantly changes its form, thereby eluding the protective antibodies that people may have developed in response to previous exposures to influenza vaccines. Every two or three years, the virus undergoes minor changes.

But at intervals, a bulk of world’s population has developed some level of resistance to these minor changes and it easily infect populations around the world, often infecting hundreds of millions of people whose antibody defenses are unable to resist it.

The 2009 flu outbreak in humans, known as “swine flu”, is due to a new strain of influenza A virus subtype H1N1 that contained genes most closely related to swine influenza. The origin of this new strain is unknown. However, the World Organization for Animal Health(OIE) reports that this strain has not been isolated in pigs. This strain can be transmitted from human to human, and causes the normal symptoms of influenza.

Pigs can become infected with human influenza and this appears to have happened during the 1918 flu pandemic and the 2009 flu outbreak

Classification
Of the three genera of influenza viruses that cause human flu, two also cause influenza in pigs, with Influenzavirus A being common in pigs and Influenzavirus C being rare. Influenzavirus B has not been reported in pigs. Within Influenzavirus A and Influenzavirus C, the strains found in pigs and humans are largely distinct, although due to reassortment there have been transfers of genes among strains crossing swine, avian, and human species boundaries.

Influenza A
Swine influenza is known to be caused by influenza A subtypes H1N1, H1N2,H3N1, H3N2 and H2N3 In pigs, three influenza A virus subtypes (H1N1, H3N2, and H1N2) are the most common strains worldwide. In the United States, the H1N1 subtype was exclusively prevalent among swine populations before 1998; however, since late August 1998, H3N2 subtypes have been isolated from pigs.

History
Swine influenza was first proposed to be a disease related to human influenza during the 1918 flu pandemic, when pigs became sick at the same time as humans. The first identification of an influenza virus as a cause of disease in pigs occurred about ten years later, in 1930. For the following 60 years, swine influenza strains were almost exclusively H1N1. Then, between 1997 and 2002, new strains of three different subtypes and five different genotypes emerged as causes of influenza among pigs in North America. In 1997-1998, H3N2 strains emerged. These strains, which include genes derived by reassortment from human, swine and avian viruses, have become a major cause of swine influenza in North America. Reassortment between H1N1 and H3N2 produced H1N2  In 1999 in Canada, a strain of H4N6 crossed the species barrier from birds to pigs, but was contained on a single farm.

The H1N1 form of swine flu is one of the descendants of the strain that caused the 1918 flu pandemic As well as persisting in pigs, the descendants of the 1918 virus have also circulated in humans through the 20th century, contributing to the normal seasonal epidemics of influenza.However, direct transmission from pigs to humans is rare, with only 12 cases in the U.S. since 2005  Nevertheless, the retention of influenza strains in pigs after these strains have disappeared from the human population might make pigs a reservoir where influenza viruses could persist, later emerging to reinfect humans once human immunity to these strains has waned.

Swine flu has been reported numerous times as a zoonosis in humans, usually with limited distribution, rarely with a widespread distribution. Outbreaks in swine are common and cause significant economic losses in industry, primarily by causing stunting and extended time to market. For example, this disease costs the British meat industry about £65 million every year.

Why is swine flu now infecting humans?
Many researchers now consider that two main series of events can lead to swine flu (and also avian or bird flu becoming a major cause for influenza illness in humans.

First, the influenza viruses (types A, B, C) are enveloped RNA viruses with a segmented genome; this means the viral RNA genetic code is not a single strand of RNA but exists as eight different RNA segments in the influenza viruses. A human (or bird) influenza virus can infect a pig respiratory cell at the same time as a swine influenza virus; some of the replicating RNA strands from the human virus can get mistakenly enclosed inside the enveloped swine influenza virus. For example, one cell could contain eight swine flu and eight human flu RNA segments. The total number of RNA types in one cell would be 16; four swine and four human flu RNA segments could be incorporated into one particle, making a viable eight RNA segmented flu virus from the 16 available segment types. Various combinations of RNA segments can result in a new subtype of virus (known as antigenic shift that may have the ability to preferentially infect humans but still show characteristics unique to the swine influenza virus It is even possible to include RNA strands from birds, swine, and human influenza viruses into one virus if a cell becomes infected with all three types of influenza (for example, two bird flu, three swine flu, and three human flu RNA segments to produce a viable eight-segment new type of flu viral genome). Formation of a new viral type is considered to be antigenic shift; small changes in an individual RNA segment in flu viruses are termed antigenic drift and result in minor changes in the virus. However, these can accumulate over time to produce enough minor changes that cumulatively change the virus’ antigenic makeup over time (usually years).

Second, pigs can play a unique role as an intermediary host to new flu types because pig respiratory cells can be infected directly with bird, human, and other mammalian flu viruses. Consequently, pig respiratory cells are able to be infected with many types of flu and can function as a “mixing pot” for flu RNA segments  Bird flu viruses, which usually infect the gastrointestinal cells of many bird species, are shed in bird feces. Pigs can pick these viruses up from the environment and seem to be the major way that bird flu virus RNA segments enter the mammalian flu virus population.

Transmission
Transmission between pigs
Influenza is quite common in pigs, with about half of breeding pigs having been exposed to the virus in the US. Antibodies to the virus are also common in pigs in other countries.

The main route of transmission is through direct contact between infected and uninfected animals. These close contacts are particularly common during animal transport. Intensive farming may also increase the risk of transmission, as the pigs are raised in very close proximity to each other. The direct transfer of the virus probably occurs either by pigs touching noses, or through dried mucus. Airborne transmission through the aerosols produced by pigs coughing or sneezing are also an important means of infection.The virus usually spreads quickly through a herd, infecting all the pigs within just a few days. Transmission may also occur through wild animals, such as wild boar, which can spread the disease between farms.

Transmission to humans
People who work with poultry and swine, especially people with intense exposures, are at increased risk of zoonotic infection with influenza virus endemic in these animals, and Other professions at particular risk of infection are veterinarians and meat processing workers, although the risk of infection for both of these groups is lower than that of farm workers.

Transmission of Swine Flu 
Coughing
Sneezing
Kissing
Touching infected objects
Touching nose, mouth and/or eyes with infected hands
Swine flu does not spread by eating pork.

Signs and symptoms

In swine
In pigs influenza infection produces fever, lethargy, sneezing, coughing, difficulty breathing and decreased appetite. In some cases the infection can cause abortion. Although mortality is usually low (around 1-4%), the virus can produce weight loss and poor growth, causing economic loss to farmers. Infected pigs can lose up to 12 pounds of body weight over a 3 to 4 week period.

In Humans

Symptoms of Swine flu
According to Centre for Disease Control and Prevention (CDC), the symptoms of swine flu were similar to those of influenza and of influenza like illness. It includes fever, sore throat, body aches, headaches, chills and fatigue.

The 2009 outbreak has shown an increased percentage of patients reporting diarrhea and vomiting. In United States, CDC advised physicians to consider swine influenza infection in the differential diagnosis of patients with acute febrile respiratory illness.

The presumed pathophysiology indicates that influenza viruses bind through hemagglutin on to sialic acid sugars on the surfaces of epithelial cells, which typically affect the nose, throat and lungs of humans. The viruses are 80-120 nm in diameter

When to Seek Emergency Medical Care?

•  has difficulty breathing or chest pain
•  has purple or blue discoloration of the lips
•  is vomiting and unable to keep liquids down
•  has signs of dehydration such as dizziness when standing, absence of urination, or in infants, a lack of tears when they cry
•  has seizures (for example, uncontrolled convulsions)
•  is less responsive than normal or becomes confused

COMPLICATIONS

• Pneumonia
• Respiratory failure
• Convulsions

Infectious Period
Persons with swine influenza A (H1N1) virus infection should be considered potentially contagious for up to 7 days following illness onset.

 Persons who continue to be ill longer than 7 days after illness onset should be considered potentially contagious until symptoms have resolved.

Children, especially younger children, might potentially be contagious for longer periods. The duration of infectiousness might vary by swine influenza A (H1N1) virus strain. Non-hospitalized ill persons who are a confirmed or suspected case of swine influenza A (H1N1) virus infection are recommended to stay at home (voluntary isolation) for at least the first 7 days after illness onset except to seek medical care.

DIAGNOSIS
Swine flu is presumptively diagnosed clinically by the patient’s history of association with people known to have the disease and their symptoms listed above.

Usually, a quick test (for example, nasopharyngeal swab sample) is done to see if the patient is infected with influenza A or B virus. Most of the tests can distinguish between A and B types. The test can be negative (no flu infection) or positive for type A and B.

If the test is positive for type B, the flu is not likely to be swine flu (H1N1).

If it is positive for type A, the person could have a conventional flu strain or swine flu (H1N1). Swine flu (H1N1) is definitively diagnosed by identifying the particular antigens associated with the virus type. In general, this test is done in a specialized laboratory and is not done by many doctors’ offices or hospital laboratories. However, doctors’ offices are able to send specimens to specialized laboratories if necessary

A confirmed case of swine influenza A (H1N1) virus infection is defined as a person with an acute respiratory illness with laboratory confirmed swine influenza A (H1N1) virus infection at CDC by one or more of the following tests:

• real-time RT-PCR
• viral culture
• four-fold rise in swine influenza A (H1N1) virus-specific neutralizing antibodies

RISK GROUPS
Household close contacts who are at high-risk for complications of influenza (persons with certain chronic medical condition

1. School children who are at high-risk for complications of influenza (persons with certain chronic medical conditions) who had close contact (face-to-face) with a confirmed or suspected case.
2. Travelers to Mexico who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly).
3. Border workers
4. Health care workers or public health workers

Prevention
Prevention of swine influenza has three components: prevention in swine, prevention of transmission to humans, and prevention of its spread among humans.

Prevention in swine
Methods of preventing the spread of influenza among swine include facility management, herd management, and vaccination.

Vaccine
Control of swine influenza by vaccination has become more difficult in recent decades, as the evolution of the virus has resulted in inconsistent responses to traditional vaccines. Standard commercial swine flu vaccines are effective in controlling the infection. Present vaccination strategies for SIV control and prevention in swine farms typically include the use of one of several bivalent SIV vaccines commercially available in the United States.

Since the protective ability of influenza vaccines depends primarily on the closeness of the match between the vaccine virus and the epidemic virus, the presence of nonreactive H3N2 SIV variants suggests that current commercial vaccines might not effectively protect pigs from infection with a majority of H3N2 viruses.

The United States Department of Agriculture researchers say that while pig vaccination keeps pigs from getting sick, it does not block infection or shedding of the virus.

Facility management; includes using disinfectants and ambient temperature to control virus in the environment. The virus is unlikely to survive outside living cells for more than two weeks, except in cold (but above freezing) conditions, and it is readily inactivated by disinfectants.

Herd management; includes not adding pigs carrying influenza to herds that have not been exposed to the virus. The virus survives in healthy carrier pigs for up to 3 months and can be recovered. carrier pigs for up to 3 months and can be recovered from them between outbreaks. Carrier pigs are usually responsible for the introduction of SIV into previously uninfected herds and countries, so new animals should be quarantined

Prevention in humans
The transmission from swine to human is believed to occur mainly in swine farms where farmers are in close contact with live pigs. so farmers and veterinarians are encouraged to use a face mask when dealing with infected animals.

The use of vaccines on swine to prevent their infection is a major method of limiting swine to human transmission. Risk factors that may contribute to swine-to-human transmission include smoking and not wearing gloves when working with sick animals

Prevention of human to human transmission
Influenza spreads between humans through coughing or sneezing and people touching something with the virus on it and then touching their own nose or mouth. Swine flu cannot be spread by pork products, since the virus is not transmitted through food.

Recommendations to prevent spread of the virus among humans include
Using standard infection control against influenza This includes frequent washing of hands with soap and water or with alcohol-based hand sanitizers, especially after being out in public.

• Use of handkerchief while sneezing.
• Use of face mask while dealing with infected people
• Although the current trivalent influenza vaccine is unlikely to provide protection against the new 2009 H1N1 strain, vaccines against the new strain are being developed and could be ready as early as June 2009.
• Social distancing is another tactic. It means staying away from other people who might be infected and can include avoiding large gatherings, spreading out a little at work, or perhaps staying home and lying low if an infection is spreading in a community.
• Public health and other responsible authorities have action plans which may request or require social distancing actions depending on the severity of the outbreak.

Treatment
In swine
As swine influenza is rarely fatal to pigs, little treatment beyond rest and supportive care is required. Instead veterinary efforts are focused on preventing the spread of the virus throughout the farm, or to other farms.

Vaccination and animal management techniques are most important in these efforts. Antibiotics are also used to treat this disease, which although they have no effect against the influenza virus, do help prevent bacterial pneumonia and other secondary infections in influenza-weakened herds.

In humans
If a person becomes sick with swine flu, antiviral drugs can make the illness milder and make the patient feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).

Beside antivirals, palliative care, at home or in hospital, focuses on controlling fevers and maintaining fluid balance.

The U.S. Centers for Disease Controland Prevention recommends the use of Tamiflu (oseltamivir or Relenza (zanamivir) for the treatment and/or prevention of infection with swine influenza viruses, however, the majority of people infected with the virus make a full recovery without requiring medical attention or antiviral drugs.

The virus isolates in the 2009 outbreak have been found resistant to amantadine and rimantadine

PROGNOSIS
In general, the majority (about 90%-95%) of people that get the disease feel terrible  but recover with no problems, as seen in patients in both Mexico and the U.S.

Caution must be taken as the swine flu (H1N1) is still spreading and may become a pandemic.

Young adults have not done well, and in Mexico, this group currently has the highest mortality rate, but this data could quickly change.

People with depressed immune systems historically have worse outcomes.

Another confounding problem with the prognosis of swine flu (H1N1) is that the disease is occurring and spreading in high numbers at the usual end of the flu season.

Most flu outbreaks happen between November to the following April, with peak activity between late December to March

This outbreak is not following the usual flu pattern.

Because swine flu (H1N1)  does not seem to be following the usual flu disease pattern, any prognosis is speculative.

The first traceable case in Mexico, termed “patient zero,” was a 5-year-old child in Veracruz who has completely recovered. Investigators noted that large pigfarms were located close to the boy’s home.

The first death in the U.S. occurred in a 23-month-old child who was visiting Texas from Mexico but apparently caught the disease in Mexico. 

The World Health Organization has not, as of Apr. 29, declared a pandemic, but it has declared a phase 5 alert (a phase 5 WHO alert warns that a disease outbreak has occurred that is transmitted from person to person, is sustained in communities, and has spread to several nations). The WHO said it may consider declaring a pandemic (WHO stage 6) if the number of cases and nations affected increase; some scientists suggest that phase 6 is imminent.

Differential Diagnosis
1. Dengue Fever
Of all the arthropod- borne viral diseases, Dengue fever is the most common. This infection may be asymptomatic or may lead to
1. Classical Dengue Fever
2 .Dengue Haemorrhagic fever without shock
3. Dengue Haemorrhagic fever with shock

The main vector is Aedes aegypti mosquito. The illness is characterised by a incubation period of 3 to 10 days. The onset is sudden with chills and high fever, intense headache, muscle and joint pains which prevent all movement. Within 24 hrs retro-orbital pain and photophobia develops. Other symptoms include extreme weakness, anorexia, constipation, colicky pain and abdominal tenderness. Fever is typically but not inevitably followed by a remission of a few hrs to2 days. The rash may be diffuse flushing, mottling, or fleeting pin point eruptions on face, neck and chest during the first half of the febrile period and a conspicuous rash that may be maculopapular or scarlatiform on 3rd or 4th day. Fever lasts for about 5 days.

Dengue haemorrhagic fever is confined exclusively to children less than 15 yrs of age. There may be plasma leakage and abnormal haemostasis, as manifested by a rising haematocrit value and moderate to marked thrombocytopenia.The fever may rise again producing a saddle-back fever curve. There may be generalised lymphadenopathy.

In dengue shock syndrome shock is present along with all the above criteria.

2. Yellow fever
It is a zoonotic disease affecting principally monkeys and other vertebrates. It shares clinical features of dengue fever but is characterised by more severe hepatic and renal involvement.. So death is more common in yellow fever than chikungunya.

3. Other viral fevers
Many of the viruses produce encephalitis, haemorrhagic fever or arthritis in various combinations. There may be high fever with backache and joint pain. Clinical features depend upon the type of virus causing infection.

a. SINDBIS virus infection: Transmitted among birds by mosquitoes. The disease begins with rash and arthralgia. Constitutional symptoms are not marked and fever is modest or lacking altogether.

b. MAYARO fever: Transmitted by Haemagogus mosquitoes. It causes a frequently endemic or epidemic infection of humans and appears to produce a syndrome resembling Chikungunya.

c. Epidemic Polyarthritis (ROSS RIVER virus infection): Constitutional symptoms are absent in many cases. Many patients are incapacitated by joint involvement.

d. Influenza: It is an acute respiratory illness caused by infection with influenza virus. Respiratory tract infection is accompanied by systemic signs and symptoms such as fever, headache and myalgia

4. Eruptive fevers like measles and German measles

5.West Nile Fever: West Nile Virus was recovered from the blood of a fever patient in Uganda in 1937. This virus is transmitted by Culex mosquitoes among wild birds. Humans are incidental hosts. Human infections are usually asymptomatic. Disease may present as a dengue like febrile illness with or without rash. Headache, myalgia, anorexia, nausea, epigastric pain, diarrhoea, lymphadenopathy may accompany the fever which lasts up to a week. The rash is maculopapular and non pruritic; unlike dengue. In its severe form it may cause aseptic meningitis or encephalitis especially in elder people and children. Rare complications include myocarditis, hepatits and pancreatitis.

6.Japanese Encephalitis: First occurred in Japan as asevere epidemic in 1924. Japanese Encephalitis virus has been isolated from the culex mosquitoes and mansonia. Onset is rapid. Encephalomyelitis developes within 2-4 days. There may be fever, headache, altered sensorium, coma, convulsions, neck rigidity, C S F pleocytosis etc 

Swine Flu- Homeopathic approach
Aphorism 100-102 is dealing with the treatment of epidemic diseases. According to Dr.Hahnemann, a carefully observing physician can arrive so nearly at knowledge of the true state of the epidemic from the examination of even the first and second patients and can even find a suitable homoeopathic remedy for it. Dr. Hahnemann recommends investigating each epidemic disease as a new and unknown case and selecting medicine according to its symptom similarity. 

Swine flu can be considered  as an acute epidemic disease

Aphorism 73 — Organon of Medicine by Dr.samuel Hahnemann

they are of such a kind as attack several persons at the same time, here and there (sporadically), by means of meteoric or telluric influences and injurious agents, the susceptibility for being morbidly affected by which is possessed by only a few persons at one time.

Allied to these are those diseases in which many persons are attacked with very similar sufferings from the same cause (epidemically); these diseases generally become infectious (contagious) when they prevail among thickly congregated masses of human beings.

Case taking in epidemic diseases
Aphorism 100 — In investigating the totality of the symptoms of epidemic and sporadic diseases it is quite immaterial whether or not something similar has ever appeared in the world before under the same name or any other name.

The novelty or peculiarity of a disease of that kind makes no difference either in the mode of examining or of treating it, as the physician must anyway regard the pure picture of every prevailing disease as if  it were something new and unknown, and investigate it thoroughly for itself, if he desire to practise medicine in a real and radical manner, never substituting conjecture for actual observation, never taking for granted that the case of disease before him is already or partially known, but always carefully examining it in all its phases; and this mode of procedure is all the more requisite in such cases, as a careful examination will show that every prevailing disease is in many respects a phenomenon of a unique character, differing vastly from all previous epidemics, to which certain names have been falsely applied – with the exception of those epidemics resulting from a contagious principle that always remains the same, such as smallpox, measles, &c.

APHORISM  101
It may easily happen that in the first case of an epidemic disease that presents itself to the physician’s notice he does not at once obtain a knowledge off its complete picture, as it is only by a close observation of several cases of every such collective disease that he can become conversant with the totality of its signs and symptoms.

Aphorism 102
In the course of writing down the symptoms of several cases of this kind the sketch of the disease picture becomes ever more and more complete, not more spun out and verbose, but more significant (more characteristic), and including more of the peculiarities of this collective disease; on the one hand, the general symptoms (e.g., loss of appetite, sleeplessness, &c.)becomes precisely defined as to their peculiarities; and on the other, the more marked and special symptoms which are peculiar to but few diseases and of rarer occurrence, at least in the same combination, become prominent and constitute what is characteristic of this malady.

All those affected with the disease prevailing at a given time have certainly contracted it from one and the same source and hence are suffering from the same disease; but the whole extent of such an epidemic disease and the totality of its symptoms (the knowledge whereof, which is essential for enabling us to choose the most suitable homoeopathic remedy for this array of symptoms, is obtained by a complete survey of the morbid picture) cannot be learned from one single patient, but is only to be perfectly deduced(abstracted) and ascertained from the sufferings of several patients of different constitutions.

Footnote
The physician who has already, in the first cases, been able to choose a remedy approximating to the homoeopathic specific, will, from the subsequent cases, be enabled either to verify the suitableness of the medicine chosen, or to discover a more appropriate, the most appropriate homoeopathic remedy.

Kent’s Approach

• Epidemic cases are dealt in the III lecture ‘what the physician must perceive’
• After visiting many patients symptoms are written in an schematic form arranging in different headings
• Essential features of case is obtained.ie symptoms found in majority cases
• Symptoms are classified in to pathognomonic & peculiar symptoms

Totality of symptoms

• Chill with  fever
• Sore throat
• Muscular pains
• Nausea & vomiting
• Diarrhea
• Running nose
• Cough
• Lethargy
• Headache 

Related Rubrics

• NOSE – CORYZA – fever, with
• THROAT – PAIN – sore
• STOMACH – NA– USEA – fever – during
• STOMACH – VOMITING
• COUGH – FEVER – during
• HEAD – PAIN – chill – during
• RECTUM – DIARRHEA
• GENERALS – WEAKNESS – fever – during
• EXTREMITIES – PAIN – fever, during
• BACK – PAIN – fever, during
• FEVER – CHILL, with

 Repertorial Result

• Arsenicum album – 25/11
• Nux –24/9
• Bryonia – 22/9
• Belladona – 20/9
• Natrum muriaticum – 21/10
• Rhustox – 15/9
• Calcarea carb – 20/9
• Phosphorus – 17/9
• Eupatorium – 16/9
• Sulphur –17/9

 Probable Homeopathic Medicines and Their Indications

Ars — High temperature. Paroxysms incomplete, with marked exhaustion. Thin, watery, excoriating discharge. Nose feels stopped up. Sneezing without relief. Unable to lie down; fears suffocation. Air-passages constricted. Asthma worse midnight. Burning in chest. Suffocative catarrh. Cough worse after midnight; worse lying on back. Expectoration scanty, frothy. Darting pain through upper third of right lung. Wheezing respiration. Haemoptysis with pain between shoulders; burning heat all  over. Cough dry, as from sulphur fumes; after drinking. Fear of death, prostration, thirst for sips of cold water

Gelsemium:
Extensive experience with this remedy in the great Epidemic of 1918 proved its usefulness in European Countries.
This remedy found to be most useful both as curative and preventive in swine flu all over the world. Heat and chill stage, long and exhausting. With muscular soreness, great prostration, violent head ache. Difficult swallowing, swollen tonsils, pain in sterno cledo mastoid. Throat feels rough and burning, shooting pain to ears, difficult swallowing. spam of glottis, dry cough with sore chest and fluent coryza. Oppression chest, respiration quickened, spasmodic affections of lung and diaphragm.

Nux vomica — Cold stage predominates. Paroxysms anticipate in morning. Excessive rigor, with blueness of finger-nails. Aching

in limbs and back, and gastric symptoms. Chilly; must be covered in every stage of fever. Perspiration sour; only one side of body.Chilliness on being uncovered, yet he does not allow being covered. Dry heat of the body.After drinking shivering & chilliness immediately.Chillines on slightest movement.

Bryonia — Coryza with shooting and aching in the forehead. Pulse full, hard, tense, and quick. Chill with external coldness, dry cough, stitches. Internal heat. Sour sweat after slight exertion. Easy, profuse perspiration.Complaints with gastro-hepatic complications.White tongue.Thirst for much cold fluid.Dry heat with every movement & noise.Wants to lie quite still &let be alone.Headache & pressure better pressure,worse movement.pain in head while coughing.

Belladona — Throat feels constricted; Difficult deglutition; worse, liquids. Oesophagus dry; feels contracted. Continual inclination to swallow. Scraping sensation. A high feverish state with comparative absence of toxaemia. Burning, pungent, steaming, heat. Feet icy cold.Superficial blood-vessels, distended. Perspiration dry only on head. No thirst with fever

Rhustox — Restless, trembling. Tongue dry and brown with triangular red tip. bowels loose; great restlessness. chill, with dry cough and restlessness. Chilly, as if cold water were poured over him, followed by heat and inclination to stretch the limbs.Stiff ,lame & bruised on first moving.Passes of with motion till he becomes weak & must rest.Severe aching in bones.Fever with restlessness & thirst.

Eupatorium — Chilly. < Uncovering, draft. PAIN IN THE BONES, ‘AS IF BROKEN’. < Motion, but pain is so severe that he can’t keep still.CHILL BETWEEN 7-9 A.M., PRECEDED BY GREAT THIRST WITH GREAT SORENESS AND ACHING OF BONES. BONE PAINS WITH SORE MUSCLES.Bursting headache. Vomiting of bile.Eyeballs sore.bones as if dislocated & would break.

Calcarea carb — Chill at 2 p.m. begins internally in stomach region. Fever with sweat. Pulse full and frequent. Chilliness and heat. Partial sweats. Night sweats, especially on head, neck and chest. Sweat over head. Sharp sticking, as if parts were wrenched or sprained. Weakness of extremities.

Phosphorus — Chilly every evening. Cold knees at night.lack of thirst,  but unnatural hunger.viscid night-sweats. Stupid delirium. Profuse perspiration.

Sulphur — Frequent flashes of heat. Dry skin and great thirst. Night sweat, on nape and occiput. Perspiration of single parts. Disgusting sweats.Heat in crown of head with cold feet.Drowsy by day. Restless nights .Soles burn at night,must be put out of bed.

Rare remedies
Influenzinum, Eryngium, Lobelia cerulia, Antimonium iodatum, Asclepias tuberosa, canchalagua, glycerinum, gymnocladus, lobelia purpurescens, natrum salicylicum, sanguinaria nitrica.

Homeopathic Prophylaxis
RAECH ( Rapid Action Epidemic Cell Homeopathy) by the Govt. of Kerala, after extensive study and discussion, suggested that Ars. alb 30 is the best preventive medicine for swine flu for India.

This remedy should be administered at least for 5 days. Two tablets (medicated in 1 grain BT) of Ars. alb 30 per day (morning and evening).

High temperature. Paroxysms incomplete, with marked exhaustion. Thin, watery, excoriating discharge. Nose feels stopped up. Sneezing without relief. Unable to lie down; fears suffocation. Air-passages constricted. Asthma worse midnight. Burning in chest. Suffocative catarrh. Cough worse after midnight; worse lying on back. Expectoration scanty, frothy. Darting pain through upper third of right lung. Wheezing respiration. Haemoptysis with pain between shoulders; burning heat all  over. Cough dry, as from sulphur fumes; after drinking. Fear of death, prostration, thirst for sips of cold water.

Gelsemium : This remedy found to be most useful both as curative and preventive in swine flu over European Continent.

Heat and chill stage, long and exhausting. With muscular soreness, great prostration, violent head ache. Difficult swallowing, swollen tonsils, pain in sterno cledo mastoid. Throat feels rough and burning, shooting pain to ears, difficult swallowing. spam of glottis, dry cough with sore chest and fluent coryza. Oppression chest, respiration quickened, spasmodic affections of lung and diaphragm.

In certain areas Bryonia 200 may also required

It is better to avoid taking Influenzinum 30 as preventive, because that is indicated only during fever stage.

Homeopathy successfully treated flu epidemic in the past
While the mortality rate of people treated with allopathic medicine and drugs was 30 percent, those treated by homeopathic physicians had mortality rate of 1.05 percent.

Of the fifteen hundred cases reported at the Homeopathic Medical Society of the District of Columbia there were only fifteen deaths. Recoveries in the National Homeopathic Hospital were 100%. In Ohio, of 1,000 cases of influenza, Dr. T. A. McCann, MD, Dayton, Ohio reported NO DEATHS.

Reference

• Organon of medicine – 6^th edition
• Lectures on philosophy – J.T kent
• Pointers to common remedies – M L Tyler
• Boericke’s pocket manual of materia medica
• www.wikipedia.com
• www.naturalnews.com
• Centre for disease control and research.
• Social and preventive medicine-Park and Park. 

Study more about Swine Flu
Details about H1N1 Flu (Swine Flu) from CDC : http://cdc.gov/h1n1flu/swineflu_you.htm

The New England Journal of Medicine gives a H1N1 Influenza Center and offers a wealth of free articles: http://h1n1.nejm.org/