Influenza in Australia: Are We Ready to Fight With It?

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  1. Introduction
  2. Australian Public Health Policy on Influenza Pandemic
  3. Current Western Treatment of Flu
  4. Complementary and Alternative Treatment of Flu
  5. References

Introduction

According to the World Health Organization (2008), influenza is a respiratory viral infection. It mainly affects the nose, throat, bronchi and occasionally, lungs. The infection may last for an average of one week and is normally characterized by sudden onset of high fever, aching muscles, headache and severe malaise, non-productive cough, sore throat and rhinitis. The mode of transmission is through droplets and small particles from one person to another. This type of infection normally spreads rapidly in seasonal epidemics.

Pandemic influenza is caused by influenza A which in the past century have gone major genetic changes in their H-component, causing global pandemics and adverse consequences in terms of disease and deaths. The “Spanish flu” is one of the most infamous pandemics that affected large parts of the world population and was thought to have killed at least 40 million people in 1918-1919. Others include the 1957 Asian influenza and the 1968 Hong Kong influenza.

Diagnosis is mainly by laboratory examinations and, to some extent, respiratory symptoms that may also be due to differential diagnosis. Rapid diagnostic tests have been developed and are able to detect influenza viruses within 30 minutes. Vaccination is the major prevention measure, and it is recommended that people who are at high risk should be vaccinated. These are the elderly and persons of any age who are considered at high risk. The main aim of vaccination is to reduce morbidity by 60% in the elderly and by 70-90% in healthy adults.

Antiviral agents such as amantadine, rimantadine and neuraminidase inhibitors (zanamivir and oseltamivir) are effective and efficient.

Australian Public Health Policy on Influenza Pandemic

In order to understand the current public health policy on influenza pandemic in Australia, this paper will review the National Action Plan for Influenza Pandemic (2009). This is a publication on policies and guidelines on how the pandemic should be addressed, right from surveillance to management of active cases. The main objective of the National Action Plan for Human Influenza Pandemic is to protect Australia against the threat of an influenza pandemic and to support the Australian community should one occur. There are four partners to ensure that this objective is achieved; the commonwealth, state, territory and local government (Commonwealth of Australia, 2009).

There is various Australian legislation that was put into place with the purposes of protecting Australia and its citizens from health threats which may be internal or external. To begin with, there is the international health regulation of 2005 which is a legally binding public health treaty which is under the World Health Organization. These regulations basically are put in place to prevent control and provide PH responses to the international spread of disease. They also help in the monitoring and surveillance of diseases. Within Australia, there are the quarantine Act 1908, air navigation Act 1920, Customs Act 1901, Privacy Act 1988 and National Health Security Act 2007 (Commonwealth of Australia, 2009). The quarantine Act of 1908 deals with both external and internal quarantine arrangements within Australia. The main aim is to protect the public from getting infected with quarantinable diseases. The Air Navigation Act of 1920, on the other hand, allows the government to vary, suspend or cancel an approved timetable of an airline on the basis of health concerns. The Customs act of 1901 established the Customs and Border Protection that monitors the movement of people and goods across the Australian border. It supports the influenza pandemic preparedness and planning. The Privacy Act of 1988 allows for free flow of information even in emergency and or disaster situations such as the influenza pandemic. Finally, the National Health Security Act of 2007 allows for a free exchange of information between jurisdictions and with the WHO with the purpose of monitoring and surveillance and responses to international public health emergencies. In 2008, the National Health Security Agreement was put into place with the objective of surveillance and decision-making structure to help in organizing a national response to public health emergencies such as the influenza pandemic. From these Acts, it is evident that they are capable of monitoring and surveillance of influenza pandemic. The commonwealth, state and territory have human infection health responsibilities with regard to control and prevention of influenza pandemic. These include surveillance, monitoring and reporting, which include clinical and laboratory surveillance activities; infection control and clinical care guidelines for health workers and the public to minimize transmission of the influenza virus; quarantine of humans suspected of being infected or contaminated; border measures which include preventing of access of any animal or human infected with virus from or to countries having outbreaks of the influenza virus.; the National Influenza Pandemic communications guidelines that have made smooth, free flow of information about influenza and easy coordination of surveillance and monitoring services across the country; There are measures that have been put into place to ensure that the risk of transmission is reduced. These are done at the community level, and the national level; the use of vaccines and antivirals are currently being advocated for in Australia. With the development of the National Medical Stockpile by the commonwealth government in 2002, there has been stocking of equipment, medications, and other supplies for purposes of health emergencies. Another co-function of primary health care is public awareness and education. This has been well developed in Australia with three major components: public education, public information, and effective media engagement. These have been put into place to primarily inform the public prior to an influenza pandemic. Awareness and health education and is a powerful tool to equip the public with relevant and accurate information. From all the information given above, it is clear that Australia has put enough measures that are concrete and capable of combating the influenza pandemic. It will therefore be right to conclude that Australia is ready to face an influenza pandemic (Commonwealth of Australia, 2009).

Current Western Treatment of Flu

Tamiflu is the drug of choice in the treatment and prophylaxis of influenza. The drug must be taken within 48 hours of appearing symptoms. The normal adult dose is 75mg BD for five days, while the weighted adjusted dose is used in children one year of age or older. The doses, even in children, are twice daily. Prophylaxis doses are as follows; adults and teenagers above 13 years get 75mg BD for ten days, children between 1 year and 12 years get weighted calculated dose. This drug is contraindicated in children under a year.

Another vaccine used against influenza is the Emerflu. It is sold as a suspension for injection and is made of attenuated flu virus strain called ‘A/Vietnam/1194/2004 NIBRG-14’ (H5N1). Emerflu is expected to work as a ‘mock-up’ vaccine. This is a special type of vaccine that is designed to help with the management of a pandemic.

Complementary and Alternative Treatment of Flu

Traditional Chinese Medicine: clinical trials and studies have shown that TCM is effective in the treatment of influenza. In a review of clinical studies, Chen et al. (2006), with the objective of assessing the therapeutic effect of TCM in treating uncomplicated influenza, showed that most of the reviewed studies showed that TCM as a whole seemed to be comparatively or more effective compared to different chemical drugs. In another study titled ‘Antiviral effect of Gingyo-san, a traditional Chinese herbal medicine, on influenza A2 virus infection in mice’ by Kobayashi et al. (1999) revealed that Gingyo-san has an antiviral agent in mice infected with a lethal amount of mouse-adopted strain of influenza A2 virus. The researchers then concluded that the herb might be effective in human beings, and therefore more studies need to be done using human beings. In yet another similar study by Kaneko and Nakanishi (2004) to prove the mysterious efficacy of ginseng showed that ginseng has preventive effects of medial ginseng on common cold symptoms complex and flu. A study was carried out by Lau et al. (n.d) to investigate the efficacy of a herbal formula in the prevention of severe acute respiratory syndrome (SARS) transmission among health care workers. The results showed that health care workers who used the herbal supplements improved from influenza-like symptoms and quality of life measurements. The study concluded that TCM supplements have the ability to prevent the spread of SARS. Wang et al. (2006) carried out another study to evaluate anti-influenza agents from plants and traditional Chinese medicine, which included a variety of polyphenols, flavonoids, saponins, glucosides and alkaloids. This study showed that TCM has potential in the therapy of influenza and its symptoms.

Acupressure and Massage: this has been shown to be having therapeutic effects in people suffering from the influenza virus. In order to demonstrate this, two studies to evaluate the use of acupressure and massage will be discussed. In a study carried out by Nguyen et al. (1995) titled ‘CHROMASSI: a therapy advice system based on chrono-massage and acupressure using the method of ZiWuLiuZhu. In the study, it was noted that CHROMASSI is able to advise on ways to treat over 153 diseases, including common cold and influenza. In another multi-treatment study done by Ketiladze et al. (1987) where the authors reviewed outcomes of immunological examinations of patients with influenza given adapromine and virazole drugs, as well as reflex therapy, increased host resistance. The study showed that patients with influenza who were administered reflex therapy, among other therapeutic measures, had a high level of IgM as compared to the control group. The final results showed that patients treated with both antiviral drugs and reflex therapy demonstrated a rapid disappearance of influenza antigen from the respiratory mucosa smears than in the control subjects.

Vitamins have been known to boost body immunity. Vitamins that are important to the treatment and prevention of influenza are vitamin C, D, niacin and thiamine. A study by Canell et al. (2006) showed that these vitamins have antiviral properties, and there their supplementation during and or before infection with influenza prevents infection or reduces influenza viral load.

According to Wei et al. (2009), some of the most common Traditional Chinese Medicine (TCM) includes Woad root (Ban Lan Gen), which is a popular herb for the treatment of flu and cold; Woad Leaf (Dan Qing Ye), which is an antiviral; Forsythia Fruit (Lian Qiao), clinical trials has shown that it has antiviral and antibacterial properties and effectively treats Upper and Lower respiratory infections; Honeysuckle Flower (Jin Yin Hua) which has been proved to be effective in deactivating influenza virus strain PR8; Baical Skullcap Root (Huang Qin) which is an antiviral and one of the most effective herbs against influenza and other Upper respiratory tract infections. These are just, but some of the TCM herbs that have been scientifically studied and therefore their safety and use have been tested in humans they have been declared safe for human use. More studies need to be done so that more of these herbs can be approved for human use, as studies that have already been done show that TCM is very effective in treating influenza and that they can treat more than one illness. They have no known side effects and can be used safely together with other western medicines without any interactions.

Complementary and alternative medicine still remains the better option in the treatment and management of many diseases, including influenza. Acupuncture, acupressure, TCM, and vitamin supplements have very few side effects, if not none, and treat more than one disease at any given time. Therefore, more studies need to be done on the use of CAM in the treatment and management of influenza.

References

  1. Cannell, J. J., et al. (2006). Epidemic influenza and vitamins. Epidemiology and Infection, 134(6):1129-40.
  2. Chen, X. Y., et al (2006). J Altern Complement Med, 2(2):171-80.
  3. Kaneko, H., & Nakanishi, K. (2004). . J Pharmacol Sci, 95(2):158-62. Web.
  4. Ketiladze, E. S., (1987). Vopr Virusol, 32(1):35-9. Web.
  5. Kobayashi, M., et al (1999). . Am J Chin Med, 27(1):53-62. Web.
  6. Lau, J. T., et al (2005). . J Altern Complement Med, 11(1):49-55. Web.
  7. Commonwealth of Australia (2009). National Action Plan for Human influenza Pandemic. Australia: department of the Prime Minister and Cabinet.
  8. Nguyen, H. P., et al (1995). . Medinfo, 8 Pt 2:998. Web.
  9. Wang, X., Jia, W., Zhao, A., & Wang, X. (2006). . Phytother Res, 20(5):335-41. Web.
  10. Wei, L., et al (2009).. Web.
  11. WHO, (2008). . Web.
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