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Boosting your immune system may help survive BF

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    Posted: July 17 2006 at 7:26am
They say boosting your Immune system may help ward off BF or help your survive, here are some wonderful tips from ask DrSears.com
   
FEEDING YOUR IMMUNE SYSTEM
Topics included in this section are:

8 Foods that Boost Immunity
Recipe for an Immune-Boosting Smoothie
Frequently Asked Questions About Echinacea
4 Habits that Weaken the Immune System
How Your Immune System Works
Boost Your Child's Immune System

8 FOODS THAT BOOST IMMUNITY
Adequately feeding your immune system boosts its fighting power. Immune boosters work in many ways. They increase the number of white cells in the immune system army, train them to fight better, and help them form an overall better battle plan. Boosters also help to eliminate the deadwood in the army, substances that drag the body down. Here are the top nine nutrients to add to your family's diet to cut down on days missed from work and school because of illness.

Vitamin C. Vitamin C tops the list of immune boosters for many reasons. There has been more research about the immune-boosting effects of Vitamin C than perhaps any other nutrient. Vitamin C supplements are inexpensive to produce, and it's available naturally in many fruits and vegetables. Also, you can buy a vitamin-C-fortified version of just about anything. Here's what the research shows about how this mighty vitamin protects your body.
Vitamin C increases the production of infection-fighting white blood cells and antibodies and increases levels of interferon, the antibody that coats cell surfaces, preventing the entry of viruses. Vitamin C reduces the risk of cardiovascular disease by raising levels of HDL (good) cholesterol while lowering blood pressure and interfering with the process by which fat is converted to plaque in the arteries. As an added perk, persons whose diets are higher in vitamin C have lower rates of colon, prostate, and breast cancer.

You don't have to take in massive amounts of vitamin C to boost your immune system. Around 200 milligrams a day seems to be a generally agreed-upon amount and one that can be automatically obtained by eating at least six servings of fruits and vegetables a day. See Top Seven Vitamin C-Containing Fruits. If you take vitamin C supplements, it's best to space them throughout the day rather than take one large dose, most of which may end up being excreted in the urine.

Vitamin E. This important antioxidant and immune booster doesn't get as much press as vitamin C, yet it's important to a healthy immune system.
Vitamin E stimulates the production of natural killer cells, those that seek out and destroy germs and cancer cells. Vitamin E enhances the production of B-cells, the immune cells that produce antibodies that destroy bacteria. Vitamin E supplementation may also reverse some of the decline in immune response commonly seen in aging. Vitamin E has been implicated in lowering the risk of cardiovascular disease. In the Harvard School of Public Health study of 87,000 nurses, Vitamin E supplementation was shown to cut the risk of heart attacks by fifty percent.

It's not difficult to get 30 to 60 milligrams every day of Vitamin E from a diet rich in seeds, vegetable oils, and grains, but it's difficult for most people to consume more than 60 milligrams a day consistently through diet alone. Supplements may be necessary to get enough vitamin E to boost your immune system.

You need 100-400 milligrams per day, depending on your general lifestyle. People who don't exercise, who smoke, and who consume high amounts of alcoholic beverages will need the higher dosage. Those with a more moderate lifestyle can get by with lower levels of supplementation.

Carotenoids. Beta carotene increases the number of infection-fighting cells, natural killer cells, and helper T-cells, as well as being a powerful antioxidant that mops up excess free radicals that accelerate aging. Like the other "big three" antioxidants, vitamins C and E, it reduces the risk of cardiovascular disease by interfering with how the fats and cholesterol in the bloodstream oxidize to form arterial plaques. Studies have shown that beta carotene can lower the risk of cardiovascular disease, especially strokes and heart attacks, giving scientific credence to the belief that a carrot a day can keep the heart surgeon away. Beta carotene also protects against cancer by stimulating the immune cells called macrophages to produce tumor necrosis factor, which kills cancer cells. It has also been shown that beta carotene supplements can increase the production of T-cell lymphocytes and natural killer cells and can enhance the ability of the natural killer cells to attack cancer cells.
Beta carotene is the most familiar carotenoid, but it is only one member of a large family. Researchers believe that it is not just beta carotene that produces all these good effects, but all the carotenoids working together. This is why getting carotenoids in food may be more cancer-protective than taking beta carotene supplements.

The body converts beta carotene to vitamin A, which itself has anticancer properties and immune-boosting functions. But too much vitamin A can be toxic to the body, so it's better to get extra beta carotene from foods and let the body naturally regulate how much of this precursor is converted to the immune-fighting vitamin A. It's highly unlikely that a person could take in enough beta carotene to produce a toxic amount of vitamin A, because when the body has enough vitamin A, it stops making it.

Bioflavenoids. A group of phytonutrients called bioflavenoids aids the immune system by protecting the cells of the body against environmental pollutants. Bioflavenoids protect the cell membranes against the pollutants trying to attach to them. Along the membrane of each cell there are microscopic parking spaces, called receptor sites. Pollutants, toxins, or germs can park here and gradually eat their way into the membrane of the cell, but when bioflavenoids fill up these parking spots there is no room for toxins to park. Bioflavenoids also reduce the cholesterol's ability to form plaques in arteries and lessen the formation of microscopic clots inside arteries, which can lead to heart attack and stroke. Studies have shown that people who eat the most bioflavenoids have less cardiovascular disease. A diet that contains a wide variety of fruits and vegetables, at least six servings per day, will help you get the bioflavenoids needed to help your immune system work in top form.

Zinc. This valuable mineral increases the production of white blood cells that fight infection and helps them fight more aggressively. It also increases killer cells that fight against cancer and helps white cells release more antibodies. Zinc supplements have been shown to slow the growth of cancer.
Zinc increases the number of infection-fighting T-cells, especially in elderly people who are often deficient in zinc, and whose immune system often weakens with age. The anti-infection hype around zinc is controversial. While some studies claim that zinc supplements in the form of lozenges can lower the incidence and severity of infections, other studies have failed to show this correlation. A word of caution: too much zinc in the form of supplements (more than 75 milligrams a day) can inhibit immune function. It's safest to stick to getting zinc from your diet and aim for 15 to 25 milligrams a day.

For infants and children, there is some evidence that dietary zinc supplements may reduce the incidence of acute respiratory infections, but this is controversial. The best source of zinc for infants and young children is zinc-fortified cereals.

RICH SOURCES OF ZINC
Food Source of Zinc Serving Size Zinc (in milligrams)
Oysters 6 medium 76
Zinc-fortified cereals 1 ounce 0-15
Crab 3 ounces 7
Beef 3 ounces 6
Turkey, dark meat 3 ounces 3.8
Beans 1/2 cup 1.2-1.8


Garlic. This flavorful member of the onion family is a powerful immune booster that stimulates the multiplication of infection-fighting white cells, boosts natural killer cell activity, and increases the efficiency of antibody production. The immune-boosting properties of garlic seem to be due to its sulfur-containing compounds, such as allicin and sulfides. Garlic can also act as an antioxidant that reduces the build-up of free radicals in the bloodstream. Garlic may protect against cancer, though the evidence is controversial. Cultures with a garlic-rich diet have a lower incidence of intestinal cancer. Garlic may also play a part in getting rid of potential carcinogens and other toxic substances. It is also a heart-friendly food since it keeps platelets from sticking together and clogging tiny blood vessels.

Selenium. This mineral increases natural killer cells and mobilizes cancer-fighting cells. Best food sources of selenium are tuna, red snapper, lobster, shrimp, whole grains, vegetables (depending on the selenium content of the soil they're grown in), brown rice, egg yolks, cottage cheese, chicken (white meat), sunflower seeds, garlic, Brazil nuts, and lamb chops.

Omega-3 fatty acids. A study found that children taking a half teaspoon of flax oil a day experienced fewer and less severe respiratory infections and fewer days of being absent from school. The omega 3 fatty acids in flax oil and fatty fish (such as salmon, tuna, and mackerel) act as immune boosters by increasing the activity of phagocytes, the white blood cells that eat up bacteria. (Perhaps this is why grandmothers used to insist on a daily dose of unpalatable cod liver oil.) Essential fatty acids also protect the body against damage from over-reactions to infection. When taking essential fatty acid supplements, such as flax or fish oils, take additional vitamin E, which acts together with essential fatty acids to boost the immune system. One way to get more omega-3 fatty acids in your diet is to add one to three teaspoons of flax oil to a fruit and yogurt smoothie.

NUTRITIP


Hot Foods for Colds

Hot foods such as chili peppers, hot mustard, radishes, pepper, onions, and garlic contain substances called "mucolytics" (similar to over-the-counter expectorant cough syrups) that liquefy thick mucus that accumulates in the sinuses and breathing passages.

RECIPE FOR IMMUNE-BOOSTING SMOOTHIE
Children often don't feel like eating following a cold or illness. Their nutrition suffers and their immune system suffers. This accounts for the common occurrence of getting one infection after another. It's best to keep so well nourished that the nutritional reserves can withstand several days of poor eating. Drink this smoothie daily upon school entry in September, upon beginning daycare, upon exposure to a contagious illness, or when you or your child feels a cold coming on.

2 cups milk or soy or rice beverage
1 cup plain nonfat yogurt
1 serving of a multinutrient supplement
one frozen banana, cut up
1/2 cup frozen blueberries
1/2 cup each of your favorite fruit, frozen (e.g., organic strawberries, papaya, mango)
1 tbsp. flax oil or 2 tbsp. flaxseed meal (Because fiber steadies the absorption of carbohydrates and therefore contributes to a steadier blood sugar we suggest using rich sources of fiber, such as flaxseed meal (i.e., ground flax seeds, containing both the oil and fiber), although flax oil has a more palatable consistency than flaxseed meal. For additional fiber, if you don't mind an even grainier texture, add 1 tbsp. or more of oat bran.)
3 ounces tofu
10 mg. zinc
100 mcg. selenium
50-100 IU vitamin E
1 serving soy isolate powder (optional)
2 tbsp. peanut butter (optional)
Combine all the ingredients and blend until smooth. Serve immediately after blending while the mixture still has a bubbly milkshake-like consistency.

FREQUENTLY ASKED QUESTIONS ABOUT ECHINACEA
What is it and how does it work?
Echinacea is one of the top-selling herbal remedies throughout the world. It is also one of the oldest. Not only has this healing herb enjoyed long popularity, it also has been the subject of much scientific research. Echinacea is a native American plant that was recognized over a century ago as a natural infection fighter. It is an immunostimulant, a substance that boosts the body's immune system. Unlike traditional antibiotics that kill bacteria directly, echinacea works indirectly, killing the germ by strengthening your immune system. While the entire echinacea story is still being researched, there is some evidence that it stimulates the body to produce more infection-fighting white blood cells, such as T-lymphocytes and killer white blood cells. It may also stimulate the release of interferons, one of the body's most potent infection-fighting weapons. Interferon kills germs and also infiltrates their genetic control center, preventing them from reproducing. Besides helping the body produce more infection- fighting cells, echinacea helps these cells to produce more germ-eating cells, called macrophages, and it helps these cells eat the germs more voraciously, a process called phagocytosis. Echinacea also prevents bacteria from secreting an enzyme called hyaluronidase, which enables them to break through protective membranes, such as the lining of the intestines and respiratory tract, and invade tissues. Echinacea also seems to search out and destroy some viruses, such as the common cold and flu viruses. Here are some questions you may have about this valuable addition to your home pharmacy.

Is there proof that echinacea works?
Absolutely, but the research is not well known in America. The best research on echinacea comes from Germany, a country that is far ahead of the United States in the scientific study of over-the-counter herbal medicines. Echinacea has been studied in Germany using double-blind, placebo-controlled studies, the gold standard for scientific research on drugs. In this type of study, one group gets the real pill and the other group, the control group, gets a look-alike dummy pill. Neither the researcher nor the research subjects know who has gotten which pill until data collection is completed and the data are analyzed. This kind of research is especially necessary in studying herbal medicines to correct for the well-known placebo effect in which even a dummy pill can produce healing effects because of the power of suggestion. A double- blind, placebo-controlled study has shown that echinacea users experienced less frequent and less severe virus infections (colds and flus) by one-third to one-half compared to the group that took dummy pills (which interestingly also reported a decrease in severity of flu symptoms).

Is echinacea safe?
Studies have not shown any toxic effects of echinacea. The occasional person may experience some G.I. disturbances, such as diarrhea.

How should echinacea be taken and what is the proper dosage?
When and how much echinacea to take depends on your individual immune system and the medical reason why you want to take it. Best to seek dosage and timing advice from a naturopath or medical doctor knowledgeable about herbal medicines. For example, there are conditions in which you wouldn't want to hype up your immune system, such as illnesses presumably caused by an overactive immune system called "autoimmune diseases."

Studies on the safety and efficacy of echinacea in adults suggest the following dosage:

300 milligrams three time a day for a total of 900 milligrams a day.
The dosage in children has not been studied as much, but a sensible amount would be one- half the adult dose for children ages six to thirteen, and one-quarter the adult dose for children under six.
Some people take echinacea all the time to prevent colds and flu, and others take it just for a couple of weeks when they feel the first signs of a cold coming on or if they have been exposed to a contagious viral infection. While there is no scientific evidence that taking echinacea daily for months is harmful, theoretically, taking any immune booster for too long could cause it to lose its punch or could stress the immune system. Another theoretical concern is that any drug that tampers with the genetic material of a virus cell (as echinacea does) could also affect the genetic material of cells in the body or could cause viruses to change genetically and become more resistant and more virulent.

Because of these concerns, taking echinacea as a preventive medicine during the cold and flu season (two weeks on / two weeks off) may be unwise, as there is no scientific basis for this popular regimen. Instead consider the following:

When you feel a cold coming on or have been exposed to a contagious virus, take echinacea for two weeks, then stop.

When you are under stress because of life changes (positive as well as negative)--pressures at work or at home, travel, or any other situation that affects your emotional or physical health-- take echinacea for a couple of weeks.

When entering a situation that challenges the immune system, such as the beginning of school in September, entering a new daycare situation, or exposure to any other new group of people that increases your contact with germs, take echinacea for two weeks.
Feeding your immune system each day is one way to help your medical bills go away.

4 HABITS THAT WEAKEN THE IMMUNE SYSTEM
Certain foods and environmental influences can keep the immune system army from doing a good job. Watch out for these threats to your body's defenses.
Overdosing on sugar. Eating or drinking 100 grams (8 tbsp.) of sugar, the equivalent of one 12-ounce can of soda, can reduce the ability of white blood cells to kill germs by forty percent. The immune-suppressing effect of sugar starts less than thirty minutes after ingestion and may last for five hours. In contrast, the ingestion of complex carbohydrates, or starches, has no effect on the immune system.

Excess alcohol. Excessive alcohol intake can harm the body's immune system in two ways. First, it produces an overall nutritional deficiency, depriving the body of valuable immune- boosting nutrients. Second, alcohol, like sugar, consumed in excess can reduce the ability of white cells to kill germs. High doses of alcohol suppress the ability of the white blood cells to multiply, inhibit the action of killer white cells on cancer cells, and lessen the ability of macrophages to produce tumor necrosis factors. One drink (the equivalent of 12 ounces of beer, 5 ounces of wine, or 1 ounces of hard liquor) does not appear to bother the immune system, but three or more drinks do. Damage to the immune system increases in proportion to the quantity of alcohol consumed. Amounts of alcohol that are enough to cause intoxication are also enough to suppress immunity.

Food allergens. Due to a genetic quirk, some divisions of the immune army recognize an otherwise harmless substance (such as milk) as a foreign invader and attack it, causing an allergic reaction. Before the battle, the intestinal lining was like a wall impenetrable to foreign invaders. After many encounters with food allergens, the wall is damaged, enabling invaders and other potentially toxic substances in the food to get into the bloodstream and make the body feel miserable. This condition is known as the leaky gut syndrome.

Too much fat. Obesity can lead to a depressed immune system. It can affect the ability of white blood cells to multiply, produce antibodies, and rush to the site of an infection.
HOW YOUR IMMUNE SYSTEM WORKS
An army of millions of microscopic soldiers operates within you, each one ready to spring into battle against invading germs and to do sentry duty to prevent disease from occurring in the first place. How you feed these soldiers has a great influence on how well they protect you from germs and disease. Because of poor diets, many school-age children and adults have immune systems that don't operate at peak efficiency. They get sick more often. Here's how to have a well-nourished immune system.
Think of the immune system as an army in which each division has a specific job, depending on the enemy they are fighting. Let's meet the troops to see what each kind of defender does.

White blood cells are the body's infantry, the hard-working soldiers on the front lines. These cells patrol the highway of the body's bloodstream, preventing germs from gaining a foothold. There are millions of these microscopic fighters in each drop of blood. There are also many specialized units. For example, when enemy cells try to hide from the main white cell troops, specialized units of white cells, called macrophages (the word means "big eaters"), mount search-and-destroy missions, going into all the nooks and crannies of the body to gobble up harmful invaders.

Suppose a flu virus enters your body, multiplies rapidly, and threatens to overwhelm the circulating white cell army. The main troops can call out the reinforcements. These specialized cells include T-lymphocytes (white cells that originate in the thymus, a tiny gland in front of the heart) and even a special SWAT team called killer lymphocytes.

Chemical messengers and fighters. The immune army has a magnificent communication system. If a germ enters the body through a break in the skin or maybe an infection in the throat the white cells send out chemical messengers that quickly mobilize reinforcements and direct them to the area of infection. Once they reach the battle, these cells produce chemical fighters, known as cytokines (meaning molecules that move to the cells). These cytokines perform all kinds of functions around the infection site to surround the invaders and heal the havoc the enemy has created. They dilate the blood vessels, causing more blood flow and enabling more white cell police to enter the infected area of battle. One well-known cytokine, interferon, even sends a signal back to command headquarters to tell the brain the body needs to rest. This allows the body to concentrate its energies on the battle against the disease. Another important cytokine is called the tumor necrosis factor. It can gobble up cancer cells that are acting like traitors and weakening the body from within. Another task of these cytokine messengers is to tell the body to conserve supplies, such as important nutrients that are needed to win the infection battle. For example, the command center instructs the body to hold onto immune-boosting elements, such as zinc, rather than eliminating it through the kidneys.

Chemical weapons. The army of white cells and chemical messengers have a number of chemical weapons available. They can shoot gamma-interferon into the enemy, like a poisonous dart. This substance interferes with the body's ability to reproduce itself. Another special group of white cells, called B-cells, produces chemicals called antibodies, which act like smart missiles, seeking out and attaching themselves to specific germs. Some of these antibodies, called immunoglobulins, poke holes in the germs, so that in essence it "bleeds" to death. Others act like a chemical glue, making the germs stick together so that they can be rounded up easily by the white blood cells. The immune army also guards strategic entry points to the body, such as the respiratory and gastrointestinal tracts. Within the mucus that lines these passages, specialized immunoglobulin antibodies called secretory IgA patrol the walls and prevent bacteria and allergens from invading the tissues.

The most fascinating aspect of this immune army is the remarkable memory it possesses. It remembers every past battle and learns from experience. If the same, or a similar, germ tries to attack again, the army is ready for it. It recognizes the invader and pounces on it, winning every time. This is the rationale behind immunizations. The small dose of killed virus given in an immunization sets up a training exercise for the immune army. It uses the lessons learned in training to overcome threats from the real germ.

Problems in the ranks. While the immune system works well most of the time, some germs, like the herpes virus, are particularly adept at evading attacks. Herpes can lie undetected in the tissues for long periods of time, only to come out and spread when the army's defenses are down. Then it retreats back into its hideout, lying dormant for months or years before it wages another attack. Some viruses, such as HIV, can even hide within the immune system itself, infiltrating the ranks of the army and destroying it from within.

Cancer cells are another tough challenge to the immune system. These are cells whose internal control mechanism is damaged, allowing the cells to multiply out of control. Most of the time the immune army quickly recognizes these "criminal" elements and eliminates or jails them before they cause damage. Sometimes the cancer culprits go unnoticed for a while, and by the time they are detected, the immune system is powerless to stop them. The battle spreads to other parts of the body (a disease process called metastasis).

Sometimes the immune army mutinies and attacks the very organs it is supposed to defend. Examples of this include diseases such as arthritis (antibodies attacking tissues of the joints), diabetes (antibodies attacking insulin-producing cells in the pancreas), and perhaps multiple sclerosis (in which the immune system may be attacking the myelin sheath of the nerves).

Finally, there are times when the immune system overreacts, in effect, burning an entire village to kill a few terrorists. This hypersensitive response can be triggered with and allergy. The army of white cells not only engulfs the invading allergen, such as a particle from a dust mite in the bedroom, but also releases enough chemicals in this battle to cause other problems, such as wheezing or rashes.

BOOST YOUR CHILD'S IMMUNE SYSTEM
Do your children seem to catch more than their fair share of illnesses? Here are some ways you can boost their immune system and keep them in school. Take as many of these supplements as you feel is appropriate every day:

Echinacea - this natural herb will enhance your own immune system. Many research studies have proven its effectiveness. Click here for dosing information for you and your kids.
Vitamin C - this simple vitamin can fight off invading germs. Younger kids up to age 6 will benefit from around 250 mg per day. Older kids and adults can take 500 mg per day. Available as a powder, chewable, or capsule. Click here to read more about it.
Fruits and vegetable supplement - the immune-boosting properties of nature's food is remarkable. If your kids won't eat enough fruits and vegetables, I recommend Juice Plus fruit and veggie supplements. Click here to learn more.
Zinc - this mineral is a safe and effective way to boost the immune system. Children up to age 6 years can take 10 to 20 mg per day. Older kids and adults can take 20 to 40 mg per day.
Probiotics - the common name used for this is Acidophillus. These are healthy bacteria that live in our intestines and help with our immune system. The best species of probiotics are lactobacillus and bifidobacteria. Available as liquid, powder, and capsules, children and adults can take as directed.
Avoid weakening your own immune system - Click here to read what habits can weaken your own immune system.
IF YOU OR YOUR CHILD GET SICK, STARTING ECHINACEA AND VITAMIN C RIGHT AWAY MAY MAKE YOUR ILLNESS SHORTER AND MILDER


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Jhetta Quote  Post ReplyReply Direct Link To This Post Posted: July 17 2006 at 7:58am

'stimulate the immune system?'

A vague and possibly dangerous strategy
 
Many people who are forward thinking are looking for pharmaceuticals or supplements to 'stimulate the immune system.' Although this seems like a natural thing to do, it is probably counterproductive.

The H5N1 virus is not like the standard flu virus - one reason it is so lethal is that that virus stimulates the immune system so excessively that the immune cells destroys tissues in the lungs and blood.

There are many parts of the immune system, and stimulating one part often turns down other parts. The immune system has different 'postures' for defending against different invaders (bacterial, viral, fungal, protozoal). Many times the things that are labeled 'immune stimulants' stimulate one of these postures, which is only good if it leads to the right posture. The emphasis should be on stimulating the appropriate parts of the immune system based on the threat!

Limiting the spread of the virus is a good idea. So is limiting the cytokine storm (or inflammatory cascade). But simply 'stimulating the immune system' could increase the risk of death from the H5N1 virus. 
 
Here is a link that to an animation that explains how H5N1 induces a Cytokins Storm.
 

Jun 14, 2006 (CIDRAP News) – Scientists in Hong Kong have reported new experimental evidence that avian influenza infections in human cells are more likely to trigger a destructive immune-system overreaction, or "cytokine storm," than human flu viruses are.

Writing in the July 1 Journal of Infectious Diseases, the researchers report that two avian flu viruses, a 1997 strain of H5N1 and a 1997 H9N2 strain, caused immune system cells in lab cultures to produce much greater levels of certain chemokines (a class of cytokine, or messenger protein) than such cells did when infected with an ordinary human flu virus.

"In general, the chemokines and chemokine-receptor responses of MDMs [monocyte-derived macrophages, a type of immune cell] to avian influenza viruses were much stronger than those to human virus, which may account for the high pathogenicity of avian viruses," the report states.

In addition, the H5N1 strain caused immune cells from adults to produce higher levels of certain cytokines than similar cells from newborn babies did. The authors say that finding may help explain why Hong Kong's human H5N1 outbreak in 1997 killed 5 of 9 infected adults (older than 12) but only 1 of 9 infected children. That sharp difference in adult and child mortality rates has not been seen in the current wave of H5N1 cases dating to late 2003.

Scientists have suggested that the cytokine storm played a role in the high death rate in the 1918 Spanish flu pandemic and is playing a similar role in human cases of H5N1 infection today.


Autopsies of H5N1 avian flu victims in Vietnam and elsewhere have revealed lungs choked with debris from excessive inflammation triggered by the virus. Similar severe lung damage was frequently reported in victims of the 1918 pandemic, which disproportionately killed people with the strongest immune systems—young, healthy adults.

The new study was conducted by a University of Hong Kong team that has previously reported experimental evidence of a cytokine storm in H5N1 avian flu. The team includes J. S. Malik Peiris and, as first author, Jianfang Zhou.

In view of the severe lung damage caused by H5N1 in humans, the team decided to measure the expression of four chemokines and two chemokine receptors induced in MDM cells by avian and human flu viruses. They also sought to compare the chemokine production induced by these viruses in adult-derived MDMs and in neonatal MDMs derived from umbilical cord blood.

Three viruses were used: a strain from the 1997 human outbreak in Hong Kong, a 1997 strain of H9N2 from quail, and a 1998 strain of H1N1 human flu from Hong Kong. The H9N2 virus is a precursor of the H5N1 virus, with which it shares six internal proteins, the report says. Because of the safety risks involved in working with H5N1 viruses, the team first did the experiment with the H9N2 virus and then repeated it with the H5N1 virus in a biosafety level 3 facility.

The investigators found that all three viruses replicated at similar rates in both adult and neonatal MDMs, as indicated by similar numbers of viral matrix gene copies in the cells. That suggested that differences in chemokine production are not due to greater growth of the avian viruses.

The MDMs generally showed much greater chemokine responses to the avian flu viruses than to the human flu virus, and the differences were often greater for the adult MDMs than the neonatal MDMs, the report says.

For example, the adult MDM responses to the H5N1 strain were roughly 20-fold greater than their responses to the H1N1 virus.

For one particular chemokine, called CCL3, the increase for adult MDMs was about 25-fold, but for neonatal MDMs, it was significantly lower—less than 10-fold, as shown on a graph in the report. For the other three measured chemokines, the responses of adult MDMs to H5N1 also exceeded those of the neonatal MDMs, but the differences were smaller.

Also, compared with the H1N1 virus, the H5N1 virus caused adult MDMs to express 6- to7-fold greater levels of the two chemokine receptors (CCR1 and CCR5). But the H5N1 strain induced no significant increase in expression of chemokine receptors by the neonatal MDMs.

"We have demonstrated that human MDMs have differential responses to human influenza virus H1N1/98 and avian viruses H9N2/G1 and H5N1/97, in spite of their similar infectivity and viral replication," the authors write. "Moreover, stronger chemokine and chemokine-receptor responses to avian influenza viruses were detected in adult MDMs than in neonatal MDMs."

They add that the higher CCL3 response to H5N1 by adult MDMs, as compared with neonatal MDMs, may be "one of the important factors" in the higher adult mortality rate in Hong Kong's 1997 outbreak.

They note that higher levels of CCL3, along with several other chemokines, have been found in plasma from people who died of H5N1 disease than in people who survived it.

Overall, the authors conclude, "These data suggest that host factors may influence the disease process or outcome."

The latest findings parallel evidence that Peiris and colleagues reported last November concerning the cytokine storm hypothesis. In that study, lung cells growing in a lab culture reacted much more intensely to two strains of H5N1 virus than to an ordinary human flu virus (see link below).

Zhou J, Law HKW, Cheung CY, et al. Differential expression of chemokines and their receptors in adult and neonatal macrophages infected with human or avian influenza viruses. J Infect Dis 2006 Jul 1;194:61-70 [Abstract]

See also:

Nov 16, 2005, CIDRAP News story "Lab study supports idea of 'cytokine storm' in H5N1 flu"

 

Why It may not be a good idea to use Elderberry Products... they promote inflammatory cytokines.

The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines.

Barak V, Birkenfeld S, Halperin T, Kalickman I.

Immunology Laboratory for Tumor Diagnosis, Department of Oncology, Hadassah University Hospital, Jerusalem, Israel. barak845@yahoo.com

BACKGROUND: Some herbal remedies are sold as food additives and are believed to have immune-enhancing properties.

OBJECTIVES: To study the effect of five herbal remedies--Sambucol Black Elderberry Extract, Sambucol Active Defense Formula and Sambucol for Kids (with known antiviral properties), Protec and Chizukit N (containing propolis and Echinacea,
claimed to be immune enhancers)--on the production of cytokines, one of the main components of the immune system.

METHODS:
The production of four inflammatory cytokines (interleukin-1 beta, tumor necrosis factor alpha, and IL-6 and IL-8) and one anti-inflammatory cytokine (IL-10) was tested using blood-derived monocytes from 12 healthy donors.

RESULTS: The Sambucol preparations increased the production of five cytokines (1.3-6.2 fold) compared to the control.

Protec induced only a moderate production of IL-8 (1.6 fold) and IL-10 (2.3 fold) while Chizukit N caused only a moderate increase in IL-10 production (1.4 fold). Both Protec and Chizukit N caused moderate decreases in IL-1 beta, TNF alpha and IL-6 production. Lipopolysaccharide, a known activator of monocytes, induced the highest levels of cytokine production (3.6-10.7 fold).


CONCLUSIONS: The three Sambucol formulations activate the healthy immune system by increasing inflammatory and anti-inflammatory cytokines production,
while the effect of Protec and Chizukit N is much less. Sambucol could therefore have immunostimulatory properties when administered to patients suffering from normal influenza (as shown before), or immunodepressed cancer or AIDS patients who are receiving chemotherapy or other treatments.

PMID: 12455180 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16283933&query_hl=15&itool=pubmed_docsum
 
 
Respir Res. 2005 Nov 11;6:135. Related Articles, < =1.2> < =1.2> Links
Click here to read Click here to read 
Proinflammatory cytokine responses induced by influenza A (H5N1) viruses in primary human alveolar and bronchial epithelial cells.

Chan MC, Cheung CY, Chui WH, Tsao SW, Nicholls JM, Chan YO, Chan RW, Long HT, Poon LL, Guan Y, Peiris JS.

Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region of China. mchan@hkucc.hku.hk

BACKGROUND: Fatal human respiratory disease associated with influenza A subtype H5N1 has been documented in Hong Kong, and more recently in Vietnam, Thailand and Cambodia. We previously demonstrated that patients with H5N1 disease had unusually high serum levels of IP-10 (interferon-gamma-inducible protein-10).

Furthermore, when compared with human influenza virus subtype H1N1, the H5N1 viruses in 1997 (A/Hong Kong/483/97) (H5N1/97) were more potent inducers of pro-inflammatory cytokines (e.g. tumor necrosis factor-a) and chemokines (e.g. IP-10) from primary human macrophages in vitro, which suggests that cytokines dysregulation may play a role in pathogenesis of H5N1 disease.

Since respiratory epithelial cells are the primary target cell for replication of influenza viruses, it is pertinent to investigate the cytokine induction profile of H5N1 viruses in these cells.

METHODS: We used quantitative RT-PCR and ELISA to compare the profile of cytokine and chemokine gene expression induced by H5N1 viruses A/HK/483/97 (H5N1/97), A/Vietnam/1194/04 and A/Vietnam/3046/04 (both H5N1/04) with that of human H1N1 virus in human primary alveolar and bronchial epithelial cells in vitro.

RESULTS: We demonstrated that in comparison to human H1N1 viruses, H5N1/97 and H5N1/04 viruses were more potent inducers of IP-10, interferon beta, RANTES (regulated on activation, normal T cell expressed and secreted) and interleukin 6 (IL-6) in primary human alveolar and bronchial epithelial cells in vitro.
Recent H5N1 viruses from Vietnam (H5N1/04) appeared to be even more potent at inducing IP-10 than H5N1/97 virus.

CONCLUSION: The H5N1/97 and H5N1/04 subtype influenza A viruses are more potent inducers of proinflammatory cytokines and chemokines in primary human respiratory epithelial cells than subtype H1N1 virus.

We suggest that this hyper-induction of cytokines may be relevant to the pathogenesis of human H5N1 disease.
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 17 2006 at 8:03am

I haven't had a chance to read this whole thing. But, I thought that those with the strongest immune systems suffered the worst when struck with the BF??

 

And, I thought I would add a few food items here which are called super foods, from a book called 'SuperFoods Rx' by Steven Pratt and Kathy Matthews, having large amoundts of phytonutrients, vitamins, ect.. very beneficial to our bodys well being (some items to seriously consider in preps):

Beans
Blueberries
Broccoli
Oats (Whole grain)
Oranges
Pumpkin  (a small can contains 350% Vit. A!)
Wild Salmon
Soy
Spinach
Tea
Tomatoes
Turkey
Walnuts
Yogurt
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 17 2006 at 8:23am
   Not sure Hope, according to the first wave it hit the youngest first , second and third guess it grabbed everyone else. Like anything else pros and cons to all advice,each person comfortable with the one that seems to help them. One doc tells us one thing one tells us anoher, some people think we are nuts for even caring about BF or any disaster, others think we are smart!!
Hugs everyone
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Be careful trying to manipulate immune responses.  The death rate is highest in children and young adults--those with the healthiest immune systems who can generate the most aggressive cytokine response.

I am a physician who does research in immune function is critical illness.  Although we know the names of a lot of cytokines, whe have only a very rudimentary understanding of how they interact.  Medical science has been trying for 20 years to manipulate the immune response to overwhelming bacterial infection by impacting cytokine production or receptor binding.  Studies of immune modulation in serious infection have been a failure, lacking in any reproducible impact on outcomes.  The cytokine signalling system is simply too complex for us to control chemically at this time.
 
Taking a food or drug designed to "boost the immune system" or decrease TNF-alpha (or any other cytokine) production is like invading Iraq to stabilize the middle east.  We don't yet understand the players well enough to imaggine all the possible outcomes.
 
Just eat a healthy diet, get good excercise and sleep, take a multi-vitamin if you can remenmber to do so.
 
hope for the best.
 
the gardener
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Post Options Post Options   Thanks (0) Thanks(0)   Quote VtDoc Quote  Post ReplyReply Direct Link To This Post Posted: July 17 2006 at 2:36pm
Vitamin C tops the list of immune boosters for many reasons. There has been more research about the immune-boosting effects of Vitamin C than perhaps any other nutrient...
 
Yes, there has been a lot of research about vitamin C.  It may do all sorts of wonderful things in a test-tube, but the weight of the evidence does not show that it is a miracle immune booster (unless you have scurvy before you start taking it.)
 
Gotta agree with gardener about the sensible approach to health. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote ShaRenKa Quote  Post ReplyReply Direct Link To This Post Posted: July 17 2006 at 2:58pm
Has anyone heard of: Astragalus Root (Astragalus membranaceous)

In China, this herb is considered one of the best for the immune system. The roots are usually sliced diagonally, making them look like a tongue depressor. Generally, the older root is of better quality. . The systems/organs that are affected by its use are the spleen, kidneys, blood and lungs. It is considered a tonic and an adaptogen (meaning it helps to normalize body functions).

PARTS USED: roots

WHAT IT IS USED FOR: it is used to increase energy, build resistance to illness, increase production of white blood cells, fight bacteria, promote T4 cell formation; stimulate appetite, fights fatigue, combat colds and lung problems. It may increase resistance to viral infections, aid in would healing, and reduce water retention in kidney complications, help to control blood sugar, and may reduce side effects of chemotherapy and other cancer treatments.

Even though it says it can strengthen your immune system, it seems to target much of the lungs. Any input on this?
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ps...I just wrote to the CDC on this root. I'll let you know what they say.
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Thank you... please post more often!
 
Originally posted by gardener gardener wrote:

Be careful trying to manipulate immune responses.  The death rate is highest in children and young adults--those with the healthiest immune systems who can generate the most aggressive cytokine response.

I am a physician who does research in immune function is critical illness Although we know the names of a lot of cytokines, whe have only a very rudimentary understanding of how they interact.  Medical science has been trying for 20 years to manipulate the immune response to overwhelming bacterial infection by impacting cytokine production or receptor binding.  Studies of immune modulation in serious infection have been a failure, lacking in any reproducible impact on outcomes.  The cytokine signalling system is simply too complex for us to control chemically at this time.
 
Taking a food or drug designed to "boost the immune system" or decrease TNF-alpha (or any other cytokine) production is like invading Iraq to stabilize the middle east.  We don't yet understand the players well enough to imaggine all the possible outcomes.
 
Just eat a healthy diet, get good excercise and sleep, take a multi-vitamin if you can remenmber to do so.
 
hope for the best.
 
the gardener
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After reading more on this subject than I ever wanted to, I believe the answer comes down to three simple facts:
 
1. Why do some get sick and die?
2. Why do some get sick and recover?
3. Why do some not get sick?
 
It all comes down to the immune system.   My theory is:
 
People with really strong immune systems will catch H5N1 but their immune systems wipe out the virus before it has a chance to multiply.
 
People with moderately strong immune systems get sick but their immune system eventually prevails over the virus and they get better.
 
People with poor immune systems can't control the virus and the body overresponds and goes into a cytoclonic storm.
 
I believe the inverted curve of "healthy young people" getting sick and dying at a higher rate is because the old and young with strong immune sytems aren't getting sick.  The people whose immune systems respond fast kill the virus and don't go into a cytoclonic storm.  People whose immune systems are slow to respond overreact to the H5N1 and thier body creates the cytoclonic storm.
 
Now factor in how Tamiflu works.  The clinical test data on Tamiflu clearly shows that Tamiflu is very effective to help one not get infected if Tamiflu is taken once or twice a day for 7 weeks PRIOR to being infected.  If taken within 48 hours of infection it only slightly reduces symptoms.  When taken after 48 hours it does nothing.
 
Why?  Tamiflu is an anti-viral.  Put some in your system prior to being exposed and it greatly helps kill the few virus that are in your body before the immune system even has a chance to gear up but after the viral load increases there isn't enough Tamiflu (or it is not that effective) to do much good and now your immune system alone decides whether you live or die.
 
If so, that would mean you want to have a strong immune system AND have as many anti-virals in your body as possible before getting infected. 
 
Good tips above on maintaining a healthy and strong immune system. 
 
Other anti-virals?  Garlic, resvatrol, Vitamin C, colloidal silver, glycyrrhizin, and even elderberry (Sambucol).
 
Suggestions on other anti-virals?
 
 
 
 
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To Jhetta and to all,

I have been lurking for months. I have avoided joining and posting because I am heavily involved in my own hospital's pandemic flu planning and I thought it might not be a good idea to get involved in a public forum. These posts on immune-modulation convinced me to break my silence because I believe forum members could be putting themselves at increased risk by taking supplements for the immune system. At the risk of acquiring the label of "anti-alternative medicine" (and I'm not, by the way,) I feel that I must warn forum members that immune modulation is nowhere near as simple as it seems. it is not a just a matter of strong or weak immune systems.   The immune system is more like a symphony. Symphonies aren't just loud or soft, they require a complex sounds and textures rising and falling at different times to create a pleasing harmony.

Many of the studies and theories on immune modulation are based on what we see in deficiency states, particularly in countries where nutrition is chronically inadequate. The diets of people with enough spare cash to afford a computer are rarely significantly nutrient deficient.   It does not necessarily follow that a nutrient whose deficiency creates immune suppression will "support" immune function in excess. A symphony that sounds bad without a piccolo wouldn't sound better with 100 of them.

When I said in a previous post that attempts to modulate the immune system with drugs or nutrition had failed, I glossed over the fact that in many if not most studies of critically ill patients, the group that received immune modulation actually had a higher mortality. Even studies in immune modulation by nutrition have demonstrated harm in groups of patients who have overwhelming immune responses.

I don't know or care much about immune modulation in healthy people who want to avoid getting a cold. It might work, it might be a waste of money.    I'm sure it's no replacement for a generally healthy lifestyle.

H5N1, in its present incarnation, is different from all the minor illnesses that people who promote things like echinacea hope to ameliorate. According to a meta-analysis published in the June edition of a European ICU journal roughly 65 % of patients developed organ failure, and or these 90% died. (Intensive Care Med. 2006 Jun;32(6):823-9.) Multiple organ failure in these cases is believed to result from an overwhelming inflammatory response. This is clearly a disease in which immune modulation is delicate and critical. Just the right cocktail may save lives, but the wrong cocktail could easily result in more deaths. I believe we are decades away from being able to understand things enough to come up with a supplement that is just right.

The only nutritional immune modulator that has been found to consistently improve outcomes in critically ill patients and hasn't been shown to worsen outcomes in overwhelming infection is glutamine. Glutamine is an amino acid, a component of protein. Most people get enough glutamine in their diets, at least when they are healthy . Glutamine supplements might benefit people who are sick and not eating well. Vitamin A, zinc, and selenium deficiency clearly hurt immune responses, particularly to viruses. Make sure your multivitamin contains these.

I see so many assertions on this forum about what foods you should take because they impact this or that cytokine.   Be cautious about anyone who is sure they know you what to do for your immune system. I know a whole lot about immune function in critical illness. I have no idea what to take or give my family to increase survival in pandemic flu except love and support, a comfortable home and enough food and water.

Focus on these things, and if you are a praying type, pray for mutations that decrease the virulence of the disease. If anyone wants to chat further about this, we should probably move out of the news section.

the gardener

"Life IS pain, your highness. Anyone who tells you different is selling something." -- Dread Pirate Roberts

p.s. I don't see many people stocking oral rehydration salts or the components of the WHO recipe for the same (much cheaper and easier to store than pedialyte). If anything in your medicine cabinet is going to improve your survival from flu, its that. Dehydration is the number one cause of death in children worldwide and a major contributor to death from regular influenza. Good luck.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Jhetta Quote  Post ReplyReply Direct Link To This Post Posted: July 18 2006 at 7:49am
Thank you Gardener for your post... very helpful information! It is wonderful to hear you addressing MOD's and to see that your expertise in immune function, etc in critically ill patients will help your hospital and colleagues in regard to pandemic planning ... best wishes to you and yours!
 
Please keep us updated if you learn more that could apply to our own planning!
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Thanks Jhetta and Gardener for posting people need to realize that H5N1 is not your average virus and doesnt resopnd the same way other viruses do.Aka cytokins Storm.It helps us average folks out.Wink
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    Gardener,Thank you so much for your input and taking the time to explain tings to us.I really appreciate it.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote nettie4263 Quote  Post ReplyReply Direct Link To This Post Posted: July 18 2006 at 9:24am
Gardener, it is known that Fish Oil (Omega 3's) has an anti-inflammitory property.  Would this be beneficial to take, in relation to cytokine storm?
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Thanks so much for the info Gardner..we need more like you!
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the short answer is:  I don't think so.
 
here's the long answer.  First of all, remember that my description of how we think it works is an oversimplification of knowledge we have gained by looking through a glass, darkly.  10 or 15 years from now we may have totally rewritten our understanding of the immune response.  Also note that most of this happens before you know you are sick.
 
There are 2 main branches to the immune response: the inflammatory response which is what you see when you get a cut on your skin (redness, discomfort, swelling, heat, ooziness) and the specific immune response (when your lymphocytes identify a specific foreign protiein and target anything carrying that protein for destruction.)
 
The inflammatory response is rapid and non-specific.  It alerts your brain and the rest of your immune system to the problem and primes the pathways for the specfic immune response to occur.  It "covers" by preventing spread of the infection while your specific immune respionse gets underway.
 
The specific immune response takes about 4 days to really start working effectively.   Ideally, once it takes over, the non-specific inflammatory response is suppressed.
 
if the inflammatory response is supressed too early or too vigorously, the spefcific immune response doesn't get properlyy revved up.  If the inflammatory response is supported  to the exclusion of the specific immune response, then by the time the inflammatory response is supposed to be downregulated, you are having a storm of cytokines and you get multiple organ failure and death.   Cytokines, by the way, aren't bad.  they are molecules of communication between different cells of the immune system and occaisionally the nervous system.  I imagine cytokine storm as everyone shouting at once instead of lymphocytes and macrophages having a rational conversation about what to do.
 
It also happens frequently that in the midst or aftermath of a cytokine storm the natural process of suppressing the inflammatory response has gone too far, and the patient is vulnerable to secondary infection.   Overwhelming inflammation and suppression of the specific immune response often exist simultaneously.
 
Unfortunately, the timeline and relative strength of each response is different for different people and different pathogens.  We have no way of looking at a patient, even with knowledge of the timeline of their illness, to tell where they are in the process or which system needs to be stimulated or suppressed.  Additionally, any of the "medicines" or foods that are supposed to be immune supportive or immune suppressive, pro or anti-inflammatory, are not as specific for these interrelated systems as we might hope or think. 
 
When you take any supplement or immune modulating medicine and give it to a group of patients, you probably help some and hurt others.  That's why most studies of immunonutrition have shown either no impact or slight degree of harm. We just don't have a way to identify which ones would be helped.  What we need is something to make the immune system behave nicely.  Perhaps a stern talking-to would help?
 
So, in a way, yes, Omega three fatty acids might help, if given to the right patient at the right moment.  we just have no way to figure out who or when that is.
 
So far it seems that the "immunonutrition" that really works in critical illness  is either
1) the molecules that maintain integrity of the mucosal barrier of the gut.  Some secondary infection may come from the gut when this barrier is compromised.  It may be that glutamine helps in this way, not becaus it changes the balance of cytokines.
 
or 2) molecules which are necessary components of immune fucntion and are either commonly deficient or rapidly consumed when a patient goes for days without decent food intake.  Seleium, for instance, is deficcient in the soils of china and some parts of africa.   Some viruses are known to mutate more rapidly in selenium deficienct individuals.  (selenium of course is toxic in overdose and rarely deficient in the US. )
 
does that help?
 
the gardener.
 
 
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Yes that helps... I have a question for you... have you seen any studies that suggest that H5N1 may disable part of the Immune response or do you feel there might be a lag in the immune resonse because we  have never been exposed to this particular strain?
 
I.E. "Overwhelming inflammation and suppression of the specific immune response often exist simultaneously."
 
Originally posted by gardener gardener wrote:

Cytokines, by the way, aren't bad.  they are molecules of communication between different cells of the immune system and occaisionally the nervous system.  I imagine cytokine storm as everyone shouting at once instead of lymphocytes and macrophages having a rational conversation about what to do.
 
It also happens frequently that in the midst or aftermath of a cytokine storm the natural process of suppressing the inflammatory response has gone too far, and the patient is vulnerable to secondary infection.   Overwhelming inflammation and suppression of the specific immune response often exist simultaneously.
 
Unfortunately, the timeline and relative strength of each response is different for different people and different pathogens.  We have no way of looking at a patient, even with knowledge of the timeline of their illness, to tell where they are in the process or which system needs to be stimulated or suppressed.  Additionally, any of the "medicines" or foods that are supposed to be immune supportive or immune suppressive, pro or anti-inflammatory, are not as specific for these interrelated systems as we might hope or think. 
 
When you take any supplement or immune modulating medicine and give it to a group of patients, you probably help some and hurt others.  That's why most studies of immunonutrition have shown either no impact or slight degree of harm. We just don't have a way to identify which ones would be helped.  What we need is something to make the immune system behave nicely.  Perhaps a stern talking-to would help?
 
So, in a way, yes, Omega three fatty acids might help, if given to the right patient at the right moment.  we just have no way to figure out who or when that is.
 
So far it seems that the "immunonutrition" that really works in critical illness  is either
 
1) the molecules that maintain integrity of the mucosal barrier of the gut.  Some secondary infection may come from the gut when this barrier is compromised.  It may be that glutamine helps in this way, not becaus it changes the balance of cytokines.
 
or 2) molecules which are necessary components of immune fucntion and are either commonly deficient or rapidly consumed when a patient goes for days without decent food intake.  Seleium, for instance, is deficcient in the soils of china and some parts of africa.   Some viruses are known to mutate more rapidly in selenium deficienct individuals.  (selenium of course is toxic in overdose and rarely deficient in the US. )
 
does that help?
 
the gardener.
 
 
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 [I have a question for you... have you seen any studies that suggest that H5N1 may disable part of the Immune response?]
 
sort of.  The disease is new enough and there are few enough human infections that we don't have much reliable info.  If you search pub med for H5N1 and Immune you only get 35 articles.  Lymphopenia (low numbers of circulating lymphocytes, which are cells of the specific immune response)  has been reported in both humans and mice infected with H5N1.   In mice at least, it's apoptotic lymphocyte death (basically cell suicide) which has the effect of supressingf all immune function.
 
In some human patients  there is also an element of hemophagocytic syndrome  with H5N1.  Hemophagocytic syndrome is a pathologic description (read: how it looks under the microscope)  At autopsy you see immune cellls eating red blood cells.  It's basically a marker for a wildly disordered immune system and can occur with regular influenza, albeit rarely.  I have seen one case with influenza A.  The child died despite all the efforts of a major university hospital.
 
Virus associated Hemophagocytic syndrome is associated with cytokine storm, but since it doesn't get better until the body eradicates the underlying infection, immune suppressive agents are thought to be harmful.  The treatments that are applied to other forms of hemophagocytic syndrome (familial and EBV associated) don't seem to work.   Thus, for H5 N1 we basically have no treatment other than supportive (read: support all organ systems until the patient either dies or gets better, as nature originaly intended.)
 
 
There are 2 problems, ione is that this is the most virulent flu virus that anobody has ever seen.  the second is that most of the human population has never  been exposed to the strain.  The thing that people on this forum do not seem to realize is that once the virus goes pandemic, it isn't just going to go away.  Eventually we will all be exposed.
 
bummer, huh?
 
the gardener
 
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man didnt think I would open such a topic, but I got to thinking what you said gardner, and as I stated earlier I am sure no expert on if "boosting your immune system" is good or not, SO went to several people whome I feel are experts in this field. asked them , here is the first response to my emails. This first one is from CDC.. again I am here like the rest just trying to help, and one doc says one thing another says somehing else

you for your inquiry to CDC-INFO. In response to your request for information on boosting immunity and the possible spread of avian influenza (bird flu), we are pleased to provide you with the following relevant information.

Avian influenza (bird flu) is not the same as the seasonal influenza (flu) that circulates in the United States every winter.

Avian flu in birds can be caused by a variety of strains of influenza virus. The strain that has been reported in Asia, Europe and Africa is called influenza A (H5N1) virus. Bird flu viruses do not usually infect humans, but there have been a number of cases of human infection with the H5N1 strain of the avian influenza A virus and some deaths since 1997. Human cases of H5N1 influenza have been confirmed in parts of Asia and Africa. Regularly updated listings of countries reporting confirmed human and animal cases can be viewed on the CDC website at:
http://www.cdc.gov/flu/avian/outbreaks/current.htm

The current risk to Americans from the H5N1 bird flu found in Asia, Europe and Africa is very low. There is no evidence of H5N1 having caused disease in birds or people in the United States.

Because avian influenza viruses do not commonly infect humans, there is little or no immune protection against them in the human population. However, eating a diet rich in fruits and vegetables is part of a healthy lifestyle that the CDC recommends.

More information on the health importance of fruits and vegetables important is available at the CDC web site:
http://www.cdc.gov/NCCDPHP/dnpa/5ADay/faq/health.htm

A new publication, Pandemic Influenza Planning: A Guide for Individuals and Families, is designed to help you understand the threat of a pandemic flu outbreak in our country and your community. It describes common sense actions that you can take in preparing for a pandemic and is available at:
http://www.pandemicflu.gov/plan/tab3.html

Additional information on what you can do to prepare for pandemic influenza, including planning checklists, is available online at:
http://www.pandemicflu.gov/health/whatyoucando.html

More information about avian influenza is available online at:
http://www.cdc.gov/flu/avian/gen-info/qa.htm
and
http://www.cdc.gov/flu/avian

CDC would like to remind you that avoiding infection is one of the most important protective steps against a possible outbreak of any influenza virus. For most people, this will include ordinary measures such as avoiding close contact with people who are ill with influenza or who show symptoms of respiratory illness (e.g., coughing, sneezing). Regular handwashing, avoiding crowds, and remaining several feet away from people who are coughing could be useful protection strategies.

Thank you for contacting the CDC-INFO Contact Center. Please do not hesitate to call 1-800-CDC-INFO, e-mail cdcinfo@cdc.gov, or visit www.cdc.gov if you have any additional questions.

CDC-INFO is a service of the Centers for Disease Control and Prevention (CDC). This service is provided by Pearson Government Solutions under contract to CDC.

3-mv/jl

[THREAD ID:1-FC9MZ]

-----Original Message-----

From: ncid@cdc.gov
Sent: 7/18/2006 11:40:40 AM
To: "CDC-INFO" <CDC-INFO@cdc.gov>
Subject: Inquiry on preventing avian flu




Comments           this is my email to them :)
I hope that somebody here can help me, I just read the great article on
the avian flu of 1918- Could somebody please tell me, that if a person
boosted their immune system ie vit c, juices good food etc. would it
help if you contacted the flu or would it hinder a possible survial
rate? I know a lot of things would be taken in consideration ie health
of the person, but just need to know if boosting the immune system is
good or bad thank you so much
    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Fenwulfr Quote  Post ReplyReply Direct Link To This Post Posted: July 18 2006 at 6:07pm
That is a prescripted response if I've ever seen one. The same generic garbage they send to "asnwer" any such request for information, on a subject they don't want talk about. I couldn't imagine them responding with anything difinitive or that they might get quoted on.
Focusing on the obvious will lead to disaster. It's what you don't aniticipate that gets you killed.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Eagles Dancing Quote  Post ReplyReply Direct Link To This Post Posted: July 18 2006 at 6:31pm

Gardener

Where would someone find the rehydration salts?

Could you inform us on how to use them.  I think I know what you are talking about but not totally sure.

Thanks!  Glad you are sharing your knowlege with us on the forum.  Sounds like you have a wealth of information and can really helps us all out.

As for me and my house, we shall trust the Lord.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hand-washer Quote  Post ReplyReply Direct Link To This Post Posted: July 18 2006 at 7:28pm
Gardener, you're such a great addition to our forum.   Like Eagles Dancing, I'm wondering about the rehydration salts.   Is Ceralyte a good choice to keep on hand?    Thanks!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 18 2006 at 7:38pm
I couldnt agree more with you Fenwulfr ! !
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Post Options Post Options   Thanks (0) Thanks(0)   Quote glennstock Quote  Post ReplyReply Direct Link To This Post Posted: July 18 2006 at 8:24pm

I could be wrong but it is not true that the majority of deaths from the bird flu are under age 30 and that it is because they have such good immune systems? 

Kansas
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Sitting on the sidelines learning lots, thanks gardener for joining the forum.
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Thanks gardener, for "breaking your silence" - this is all so helpful.  Your points about the complexity - the symphony - of the immune system are really enlightening.   I'm interested in hearing more about supportive care.   I'd like to think that doctors would make some sort of palliative (pain or anti-anxiety) medications available to ease the suffering of the most severely ill.  It's the suffering involved in this disease that is most frightening. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 19 2006 at 6:05am
    To handwashing and eagles dancing (great names, by the way)

getting ready: look at the bottom

Oral rehydration salts are the electrolyte solution that the WHO invented to help rehydrate people in the third world where diarrheal illnesses are common. It replaces essential salts lost in diarrhea. Pedialyte and ceralyte are take-offs of the WHO formula. They are great products, but they cost a lot more ( they probably taste better, too.)

To learn more thasn you ever wanted to know about oral rehydration salts, go to http://www.rehydrate.org .   As you can probably tell from the site they aren't trying to sell anything. This is a very simple website designed to teach everyone on the planet how to rehydrate safely and cheaply. They aren't talking about the dehydration you have when you mountainbike all day in the heat. They are talking about potentially fatal dehydration from viral illnesses. Dehydration is the leading cause of death in children worldwide. It's uncommon but not unhheard of in the US, and it is certainly a contributor to death from the regular seasonal flu. Fluids in this case aren't lost solely through diarrhea, but also from sweating, breathing fast, and leakage of fluid from capillaries into the tissues.

In the developing world, ORS and information about simple solutions to make at home have saved the lives of tens of millions of children without access to medical care. We all know that thhe US could quickly resemble a 3rd world country in a bad pandemic. Medical care will be rationed.

I don't think you can buy the UNICEF ORS at rehydrate.org, but they have low-tech recipes to replace ORS. They aren't quite as good, because they contain no potassium. The Unicef site has a free booklet for download called "facts for life" that contains similar information. I used to know the recipe for a potassium containing version by heart, but I'm an ICU doc now and I don't use things like that anymore.   I'll try to look it up. If I can find it I will post the info in family planning.   

I got my ORS from chinook medical gear.
http://www.chinookmed.com/detail.php?product_id=000187&limit_start=10
It was the cheapest source I could find at $1.65 (before discount) per package.   If you are part of a university tell them because you get like a 40 % discount. I went a little nuts buying it and plan to instruct my family to make it available to neighbors if their kids get sick. It's only by sticking together as communities and neighborhoods that the structure of society will survive a bad pandemic.

To getting ready: I am arguing agggressively to include a stockpile of palliative care meds like morphine and benzodiazepines to ease the sense of suffocation the patients have who will not be offered a ventillator.   As you all know, there are so many things we need to stockpile to save as many lives as possible during a pandemic. I am afraid palliative care may get the short shrift.

Hospital planing is so overwhelming and depressing. You get a sense sometimes that there isn't even a point in planing since chaos will likely reign.   Hospitals are dependent on daily and hourly deliveries of supplies of all types. We are full to bursting and operating n the narrowest margins. We have no money or space to store what would be needed. For instance, we get oxygen delivered several times per week. Our supplier has no pandemmic plan.   What hapens when that breaks down?

I guess that's why I needed to join the forum. Its so depressing to deal with this in isolation. Like you all, when I talk to my peers about it they glaze over. They jokingly call me the horseman of the appocalypse.

peace be with you,
the gardener
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jofg Quote  Post ReplyReply Direct Link To This Post Posted: July 19 2006 at 6:24am
Excellent posts - a very informative thread!!  Thanks to all who are contributing!!!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hand-washer Quote  Post ReplyReply Direct Link To This Post Posted: July 19 2006 at 6:50am
Gardener, you are just the best.... taking time for our questions with your excellent detailed answers when you are perhaps juggling more balls in your professional life than we can imagine.   Thank you.    

I am printing out info from the url you offered and will add it to the increasing file of materials I am accumulating in hard copy, in the event electrical power is ever limited and hence computer access absent.   That happened here recently in an electrical storm and we experienced a mini drill with power gone for only eight hours.   Sure made us think.   And work!

So gardener, thank you again.   We're glad you're here.
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as promised :here is a second response from Dr Sovia, infectious disease doctor here in san diego



Dear Mrs. Gilly-
>
> In general, most of us have pretty good immune systems. The "boost" that
> makes the most sense is through immunization, and so it is important for
> everyone to be immunized yearly against influenza, as well as to receive
> all the other appropriate immunizations. Lots of herbal medicines and
> dietaary supplements proport to "boost" the immune system...I don't know
> what they do...I suspect most of the time they cost money and do very
> little, but I have also seen people become ill from taking
> unapproved/non-regulated products.
>
> I hope this helps...
>
> Mia Savoia
>
>
> At 08:13 AM 7/18/2006, you wrote:
>> Dr Savoia,
>> I have a very important question that maybe you would please help me
>> with.
>>   In the event of the avian flu outbreak here in San Diego, or anywhere,
>> just using our city, Is it helpful to boost our immune system, and if so
>> why, or is harmful to us, and if so why? I cant thank you enough for your
>> help,

>> >>Mrs. Ruth Gilly
>
> Maria C. Savoia M.D.
> Vice Dean for Medical Education
> University of California, San Diego School of Medicine
> 9500 Gilman Drive
> La Jolla, California 92093-0602

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hand-washer Quote  Post ReplyReply Direct Link To This Post Posted: July 19 2006 at 3:51pm
gardener wrote:

"There are 2 problems, ione is that this is the most virulent flu virus that anobody has ever seen. the second is that most of the human population has never been exposed to the strain. The thing that people on this forum do not seem to realize is that once the virus goes pandemic, it isn't just going to go away. Eventually we will all be exposed."

These two things (actually three to me) seem to be the essence of what we need to convey to family and friends who blow us off when we attempt to convey the urgency of planning for a pandemic.    I have been thinking a lot about what was written.    I am deeply concerned about this portion: "Eventually we will all be exposed."    I know some here object to hearing others post about their faith, but without that, what hope is there?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote ImmuneConcerned Quote  Post ReplyReply Direct Link To This Post Posted: July 20 2006 at 7:58am
There is a wonderful thread devoted to the cytokin storm on this forum:  H5N1 Avian Flu Forum : Health Care Planning : Medical Interventions
 
I just e-mailed our pediatrician for his input on:  Resveratrol, Aloe Vera, scutellaria tea,  lei gong teng for anti-inflamatory & immunosuppressive effects comparable to prednisone, inosine to suppress lung inflamation & reduce toxicity, pneumotrophin PMG and more.  All these ideas came from this thread.  You might want to check it out yourself.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 20 2006 at 11:53pm

Thanks gardener for addressing palliative care and for being an advocate for preparation in the medical community.  Our best hope is for a less virulent strain or a few compassionate doctors who (after seeing the effects first-hand) may allow patients access to stronger medications that could ease their suffering and anxiety.  With projected shortages however (ventilators, medications, vaccines) even those MDs who are "willing" may not be "able," unless these issues are addressed now.  I keep thinking that there must be SOME way for the private sector to participate in covering the costs (a pre-pandemic community stock-piling fund?).  We are up against so many obstacles, even brain-storming becomes depressing.  Thanks for joining us and do let us know if any inspiration comes to mind for ways we can be influential in our own communities. 

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 21 2006 at 4:52am

thanks getting ready.  I figure folks on the forum should know that medical communities will absolutely have to ration care.   

There is no way to stockpile enough to prevent shortages in hospitals.  Ventillators are extremely expensive and we have roughly 1/8th of the number we could expect to need in a 1918-style flu.  H1N1 in 1918 of course ahd a 2.5 % overal mortality.  Currently we are looking at 57%, mortality with about 65 % of hospitalized patients having respiratory failure requiring mechanical ventillation.
 
In our hospital we get several daily deliveries to maintain our current stock of  less than 3 days of supplies of anything--drugs, IV cathters, oxygen tubing, ventillator ciruits, blankets (which are washed outside the hospital) gowns and masks, oxygen and food.  I suspect that we are rather advanced compared to other hospitals in that we have even assessed that fact.  Every hospital will have the same problem.  Our whole society is based on just-in-time delivery.   Operating at narrow margins and with a building packed to the gills we have no way to afford or store longer supplies of anything other than a very select group of items. 
 
The worst shortage, of course, will be staff.  The general anticipation ids that less than 50 % of hospital staff will show up to work.  I can't blame them.  If you had young kids at home, would you come in?  All the hospitals in this country have a chronic shortage of nurses, and we can barely staff the beds in use at this moment.  How in the world are we going to care for people in a pandemic?
 
If the pandemic virus is a virulent one we're screwed, technically speaking.
 
I am interested in discussing palliative care issues with anyone who is up for it.  The American medical system has never sat by and watched as people struggle to breathe and live or die according to their own strength.  We always intervene, with a ventillator if they have achance to live, or with morphine if family and medical team have agreed to let them go.    
 
We aren't holding out on you--there are no stronger drugs to relieve suffering.  Old-fashioned morphine is the best drug. "Stronger" means higher doses which suppress your drive to breathe.  That drive to breath produces the feeling of suffocation, which is terrifying and which we have traditionally considered suffering.   The difference in the way we will want to use in in pandemic flu compared with the way we use it in dying patients now is that patients who will be denied ventillators might have a chance of surviving.  I am afraid that if we use morphine to relieve the air-hunger of people who will be denied ventillators but might have a slim chance to live, we will later be accused of mercy killing.
 
what do you think?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 21 2006 at 6:58am
    gardener,
   I think its wonderful that you have joined our BF sight, however in this last statment of yours I would like to take a second to convey my own personal opinion on this.
   
        IF your saying, that a ventillator is the means to help a person survive the BF, and hospitals don't have the means to buy them, because they are to expensive, or the room to stock pile them, I find that very scary! I don't have room for all my preps and I find room, I don't have the funds to buy what I need and I manage, mine is a smaller scales then a hospital,sure thats true, hospitals job is differnet then mine. Sooo if hospitials don't have enough funds to purchase them I say find a way! the goverment the public WHATEVER It takes. Ventillators vs human life?
     
       So if me or mine come down with the BF, if we are first to the hospitials, we get to use one? geezzz. This is no better odds then the people in New Orleans" WE KNEW BUT DIDN'T DO" don't make me comfortable if I "have a slim chance" do all you can, that is why we have hospitial and doctors, or at least I thought so, and knowing what we know TODAY, RIGHT NOW, if you can't DO ALL THAT was in your power, I dont think its mercy killing, I think its just flat ass murder!
        Or maybe I should say why bother? gardener says everyone is going to be exposed! shaking my head, that is a horrible dooms day statment, exposed or not gardener lots of us will survive...
           As far as the medical staff goes,I can't speak for them, but I have a feeling wether they have families or not, (I think it will surprise you), unless they are dead or dieing, how many will show up to do their jobs. I am not giving up on them I have hope.I have lots of hope in this countires people, and like most of us I will do all I can to help as well,neighbors,hosptials, whatever it takes.
    So if my time comes and I need a ventillaitor don't offer me morphine, when you had time to offer me better! Like you in a smaller scale I couldn't lay to rest knowing I didn't do all that was in my power to help my family survive...
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 21 2006 at 8:13am
Getting ready, [sorry, I meant pebbles]

I guess I forget how awful this sounds to a layperson. As you read this please remember that I am not in charge of making these decisions. I am one of a few doctors on the hospital comittees that advise the administration.

About the fact that we will all be exposed eventually: Of course we will! After 1918, H1N1 didn't just disappear, it became just another one of our regularly circulating influenza viruses. Because it has been circulating in humans for almost 90 years, we have a fair amount of immuity to it. thats what will happen with H5N1. It will circulate with high transmission rates until enough of the population has been exposed and developed immunity that it fades into the background. The it will become just annother one of our seasonal influenza viruses.

About evil of not stockpiling ventillators: ventillators cost 20-30,000 dollars. We have 105, 000 ventillators in this country. for a 1918 style flu we would need 800,000. Thats 14 billion dollars worth of ventillators. Ventillators require highly trained personell to run them. Even if most people who aren't sick show up to work, we can't expect more than 75% staffing, and the respiratory therapists are stretched thin already.    ventilllators without adequate monitoring are dangerous in themselves.

Consider the current virus in circulation. Of the patients who come to the hospital, about 65 % have respiratory failure requiring ventillation. Of those, about 90% die, with all the supportiive care we have to offer.   With the current mortality statistics, at the very least 15 % of hospital staff caring for these people would contract the illlness and die.   Does that make any sense? kill off 15 % of the staff to save 10 % of the patients? Our live aren't more valuable than the patients, but they aren't less, either. Who is going to staff the hospitals in the second wave?

So far, the people who get sick enough to require pull out all the stops style tertiary care medicine almost all die no matter what we do. If we toook that 75 % of staff who show up and that 14 billion dollars and applied it to things like IV fluids and oxygen tubing, we could treat many more people and overall save many more lives.

Remember that I said that hospitals have only a few days of any supply? if the price of one ventillator would buy us a week's worth of IV's and IV fluids, oxygen tubing and antibiotics, we'd save scores of people for the price of the one life we saved with the ventillator.

Unfortunately, we don't know what strain of virus we will be dealing withor what interventions will save people. We won't know until the pandemic occurs. We have to make decisions on guesses and cold logic. none of this is satisfactor, I admit.

I absolutely respect that people have different opinions on this. That's part of why I am having this discussion here, so I can get a sense of how others feel. I only hope that we have enough information from patients so that we can respect their wishes.

I think I would be accurate in saying that most doctors who watch life and death on a regular basis will declare that dying is not the worst thing that can happen to you. I have watched a lot of people die of respiratory failure when support is withdrawn at the request of the family on the basis of futility. Personally, I'll take the morphine over a slim chhance of survival with certain prolonged suffering. I wouldn't give it to you if you didn't want it. Unfortunately, when a person is struggling to breathe, they don't make the same "rational" decisions they might have made when they could breathe freely. They aren't really in a place to give informed consent. I suspect they'll ask for anything rather than suffocate. if you truly have nothing else to offer them, what's the right thing to do? It's not clear to me.

About the alllocation of funds: imagine you are a hospital administrator dealing with the thousand pressures of keeping a major hospital together. University hospitals aren't rich; they are lucky if they operate in the black.   How do you decide how much of your limited budget to spend on a threat that is significant, but uncertain and impossible to asses.   The problems that would occur are on too large a scale to be fixed. There are other problems on a daily basis that are impacting the quality of care you are able to deilver to patients right now. How do you asses the importance of an indefinable future threat relative to the needs we have right now?

Imagine you are the government. Our government, having more pressing concerns, has decided to tell the american public that they are basically on thier own.   

People on this forum are unique in that they have decided that the threat of avian flu is so pressing that it would be better to forgo replacing the boilers in your basement in favor of buying preps. That's a rational decision and it'smy decision, but it is not the decision of all rational people. In fact, no one knows when this wil hit or how bad it will be. Scientists can't predict it with any certainty.   

If the pandemic it's not that bad, great, we dodged a bullet. If it's like the current virus in indonesia, I am teling you that there is no amount of preparations that hospitals can possible make to prevent war-like conditions and massive mortality. It's the in bewteen scenario that we have the opportunity to influence.   I struggle even with how much of my time to devote to thinking about this. At the moment Pandemic flu planing has taken over most of my work hours and a fair amount of my waking thoughts. Is that to much? If it's horrendous and if it comes soon, will I regret not having spent the last few months before it hits really living in the present, apreciating my family and my life?

As I am writing this, I don't like it, and I'm not proud to say it, but it's true. You can't prepare for every eventuality unless you abandon the present.

I welcome your thoughts,

the gardener
    
    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Frisky Quote  Post ReplyReply Direct Link To This Post Posted: July 21 2006 at 9:34am
   I agree gardener. Like you I feel I have spent way too much of my recent life on this topic. I work in a hospital which has the highest number of pneumonia admissions of any in a population of 6,000,000.  Four new ventilator patients  in a two hour period is about max for us. Beyond this the draw down of personnel begins to have a big negative impact on overall ER patient care. It is not really a matter of just insufficient ventilator numbers. It takes me 30 minutes minimum along with 3 to 5 highly skilled ancillary personnel just to start the process and then there is the constant ongoing 1 to 1 or 2 to 1 personnel management for possibly weeks (if the person lives that long). These constant care givers(i.e. nurses, intensivists, specialized techs etc) require prolonged training .There is also the constant ongoing need for medicatons, lab , X-ray. The public mostly does not understand the complexity and difficulty  involved.  ER Doc
It is better to give than to receive.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 21 2006 at 9:51am
   I cant tell you how both of these statments saddens me, Gardener I am not going to turn this into a personal debate between you and myself, this sight deserves better, if you wish to continue my email address . If I try and use my "laymen" respons it will just come out in anger.

ER doc glad somebody took the 30 mintues with my daughter, not once but twice, she is a brittle asthmatic, and because they did she is 26 years olds, today, and doing great, against all medical odds !!what some doctors seem to forget is their hands and minds are a tool of GODs. I understand your profession is a tough one, so is mine. when did life or death become a decision man makes!   
    
    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 21 2006 at 11:47am
Wow,
 
I didn't mean to debate or give the impression that I wouldn't do everything I could to treat a person.  I want you all to know that I wouldn't withold anything that could help a patient.  I am an ICU doc, and I go all the way to save lives all the time.  
 
I wish I could say that hospital shortages won't exist, but they will.I am trying to spark discussion  about situations which will someday occur, where we literally have nothing to offer to increase survival, but we might have something to offer to increase comfort.   I don't know what  is the right thing to do, so I wan t to hear whay you guys think.
 
pebbles, I will take up your offer to discuss this privately.  I welcome any opinions on the matter, however vehement. 
 
gardener
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Post Options Post Options   Thanks (0) Thanks(0)   Quote ImmuneConcerned Quote  Post ReplyReply Direct Link To This Post Posted: July 21 2006 at 1:31pm
RE:  MERCY  KILLING
I believe our society has evolved to the point of needing to directly resolve ussues such as appropriation of medical care & mercey killing.  We may not want to admit society's acceptance of man-made life and death decisions but I suspect most of us suspect these decisions are made all the time at least in indirect ways.  As  I am reluctant for our family to own a gun for protection or hunting (as it could also be used for suicide & murder)  I am reluctant for a hospital to have options for mercy killing.  Reluctance doesn't equate to opposition howver.  I  just  don't want to be the one holding the gun or making life & death decisions.  When & if such decisions are needed,  I'd like the most knowledgeable, competent and MENTALLY HEALTHY people making them. 
 
RE:  PANDEMIC & HOSPITALS
At the height of a panedemic, I was not planning on attempting to obtain  hospital care for potentially sick family members.  If the decision were put to vote, I believe  it would be unamious in this hoe.  Unlike Pebble's family, we've witnessed the futility of medical intervention (& for young children).  More than one family member has returned worse from a hospital visit than they were before.  Currently we are dealing with 95 yr old grandparents  requiring hospice type-care for years now.  Instead, I am trying to learn as much as possible in order  to minimize our family's chance of subcoming to H5N1 & obtain knowledge and supplies so care can be provided at home.   
 
Yes, living in the moment does suffer with all of the above.  I am extreemly uncomfortable permitting my kids to attend just two regular school classes this coming year as repeatedly their health declines during the school year and the vunerability to catch stuff has always seemed heightened to an extreeme (& education via computer has become good).  Should I keep them at home so they will be more physically healthy or let them go to school part time so they will be more mentally healthy?  These are my issues & concerns.  And, as everyone else has said, thank you Gardner for the time and effort you put into this.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 21 2006 at 4:32pm
    sounds fine gardener,
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 21 2006 at 5:35pm
Gardener & Frisky:
 
It is comforting to see medical professionals posting on this site.  If you don't mind, I have a question for both of you.  A lot of the posts here on this site are about interactions between people and their physicians.  A lot of people have asked for pneumonia vac and told they can't have them for various reasons.  Many have tried to discuss Avian Flu with their health care workers only to be told in so many words that it is 'no big deal'  The government wants us to stock up on meds but we can't get prescriptions.  My doctor will not give me a prescription for an antibiotic to keep on hand.   I would love to have some antibiotics, phenergran (sp) and a few other meds to ease the suffering of any of my family members who become ill.  I, like you, know the hospitals will be overwhelmed and it will be impossible to get treatment. We all are planning on SIP - Statements have been made that some won't chance exposure to their families and will not go to work for any reason but some of the same expect doctors, nurses, and other health care workers to be first in the 'line of fire' 
As an example of some medical personal who don't seem to get it, I went to my dentist last week and the conversation between the dentist and her assistant was about grocery shopping and how they both didn't like doing it.  I said 'You should do like I did.  Because of the threat of the Avian Flu, I followed Secretary Leavitts advice and made a little 'store' in my basement.  Then I am never out of anything.  My dentist's response was 'Yes the scientists do seem to be concerned about this.'  It was as though neither had heard very little about it. 
Anyway - long story short - what can we do or where can we go to get some on the medications that have been recommended by the government that we have on hand?  I don't want to order such an important prep on line or from some veterinary supply house. Don't know if either of you can answer this but thanks for 'listening' and double thanks for your contributions to this forum.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: July 22 2006 at 3:15am

Thanks once again for your thoughtful posts, gardener.  You've raised alot of issues for sure!  I don't know what the AMA, hospital officials or other organizations are doing to address a possible pandemic, but since most patients will be at home, is it possible to set up a protocol that would allow physicians to do phone or even on-line consultations?  I'm not a physician (went to school to be an RN but ended up an artist!) but I feel the hospitals will/do have enough challenges -and in the event of a pandemic they should be reserved for trauma, heart attacks, and the like.  I hope you understand that this is all personal opinion, but in my mind, the best scenario would be to provide  (government, community) funding to train individuals (retirees, volunteers, whatever) to perform a few basic medical skills -injections, IVs, vital signs, etc.-, maybe with limited equipment, which could be used in a make-shift hospital situation.  This could be overseen by a few physicians who could authorize medications.  The hospitals would still be compromised due to short staff, but it might keep people from rioting outside and dying in every hallway (not to mention it might protect hospital personnel from infection).  Local governments could sponsor paid training sessions in conjunction with local hospitals and even corporate sponsors.  Other potential responsiblities for such trainees could include alternate drivers for pharmarcies or food/water deliveries. etc.  Of course, this all requires alot of preplanning, but could do so much to help those who could not care for themselves. 

Another thing that could be done - and with even less effort - would be  a sort of mandate that would allow physicians/pharmacies to stock-pile both palliative as well as  life-saving medications (insulin, blood pressure meds, pain relievers, etc.) that could be dispensed immediately should a pandemic hit.  The government would have to issue a "cease-fire" on law suits - and people would have to be given literature in lieu of personal doctor's visits, but it would be a heck of alot better than nothing at all.
I agree that dying is not the worst thing in the world (it may even be a pleasant thing - my grandmother's face was lit with joy just before she passed on).  I would just hate to think of anyone having to watch their child or friend gasping for days.  And yes, I guess I would do whatever it took to make them feel better.  I think the governments of the world are wrong about one thing: avoiding what they call "panic" in order to keep the stock markets stable.  They misjudge us.  We're totally capable of rebuilding our economies, but we need to be taken seriously when it comes to concerns about the future and health of those we love.  
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Post Options Post Options   Thanks (0) Thanks(0)   Quote ImmuneConcerned Quote  Post ReplyReply Direct Link To This Post Posted: July 22 2006 at 7:18am
GettingReady,
 
DITTO   DITTO   DITTO
 
Good thoughts.  Great Post.   Thanks for putting it into words so well
ImmuneConcerned
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