International Conference on Homeopathy and the Avian Flu: Paris Roissy-Charles de Gaulle Airport, France
November 19th 2005
By Richard Hiltner, MD, DHt
Is the Avian Influenza going to be a repeat of the infamous 1918 Spanish Flu which caused so much loss of life and suffering and also made Homeopathy renowned for its excellent response? This International Conference is a good start to analyze the known data and have a meeting of minds to be as well prepared as possible.
An impressive array of some of Homeopathy’s finest organizations have joined together to give their impetus to this effort. They included the International Foundation for Clinical Homeopathy [IFCH] with Dr. Marie-France BORDET Présidente. The Royal London Homoeopathic Hospital [RLHH] with Dr. Peter FISHER, President of the Conference Scientific Committee. The European Council for Homeopathy [ECH] with Dr. Michel van WASSERHOVEN, Research Coordinator. The American Institute of Homeopathy [AIH] with Joyce FRYE, President. And the Indian Institute of Homoeopathic Physicians [IIHP] with Dr. Niranjan MOHANTY, National President.
The Aims of the Conference were:
1] Prevention: “To review and discuss the different treatment options that homeopathic therapeutics has to offer. Likewise, to design protocols for evaluating the different preventive treatments suggested.”
2] In case of a pandemic: “To immediately mobilize technical resources so that all doctors can share their therapeutic results [successes, failures], in real time and homeopathy’s potential in this disease can be scientifically evaluated.”
This conference was designed to emphasize the input of each participant by breaking into groups in the morning and allowing everybody to give their input with reports in the afternoon.
Thiery Boiron welcomed the 115 conference participants from many countries and stated that this conference is also especially remarkable in that it was really only formally organized three weeks ago. Invitations were sent to all the major homeopathic organizations and associated individuals rather than a general advertisement. Just within those three weeks over 20 papers have been received by the Scientific Committee from 10 different countries with more arriving. Unfortunately, the committee did not have enough time to offer any specific opinions because of the paucity of time to review. However, many were handed out to participants for their future perusal.
Michel van WASSERHOVEN followed with a summary of the results of five questions on the survey done on the participant’s registration form.
1] Do you think that homeopathy could be used in an Avian Flu prevention strategy? The vote was 98% yes.
2] If yes, how should the prevention campaign be carried out?
A] By adopting a selective, individual approach? 57% yes.
B] By using a protocol that is applicable to a large number of people? 43% yes.
3] Which medicines do you consider the most important for the prevention strategy? 17% for Oscillococcinum and Influenzinum was a close second. The more common flu remedies such as Gelsemium and Eupertorium followed along with nosodes like Tuberculinum aviare and Bacillinum.
4] Would you be willing to participate in the compilation of case histories to evaluate the efficacy of homeopathy in the treatment of this pathology? 81% yes.
The next speaker, Dr. BORDET, emphasized five subjects: 1] Therapeutics, 2] Treatment, 3] Research, 4] New medicines and 5] Communication.
Dr. Fisher followed delineating the research options. He showed a number of slides developed along with Dr. Robert Mathie and Dr. Helmut Roniger from the Royal London Homeopathic Hospital.
Background
Most epidemiologists regard pandemic of Avian influenza as inevitable
‘Not if but when’. It has happened before…
Pandemic
Spanish ‘flu
Asian ‘flu
Hong Kong ‘flu Strain
A/H1N1, A/H2N2, A/H3N2
Year
1918-19
1957-8
1968-9
Origin
Unknown
China
China
Global Deaths
20-40 million
1 million
1-4 million
Factors in contagion and impact
Disease may be virulent: A/H5N1 strain
No prior infection or immunisation
High infection rates (>25%?)
Rapid dissemination via modern transport
Poorer countries would be most severely affected
Poor living conditions, nutrition, healthcare, etc.
Global mortality estimated 2-50m
CDC 2-7.4m
UK 50,000/60m population (0.33% of infected)
Economic disruption
Pandemic may be triggered by exchange of genetic material
‘Mixing vessel’ species (eg. pig) susceptible to both human and avian strains. Subtype capable of human→human transmission
Conventional prophylaxis/
Treatment of influenza
Neuraminidase inhibitors
Zanamivir, Oseltamivir (Relenza, Tamiflu)
Effective and safe (?) in epidemic influenza
Shorten duration of illness by ~1 day in adults
But in pandemic ‘flu: questions?
Effectiveness?
Shortages?
Doubts about safety
Immunisation/prevention
Likely to be effective, but 4-6 month delay for production of vaccine
Evidence for Homeopathy
Cochrane review
7 placebo-controlled trials of Oscillococcinum and similar
3 prevention (n=2265)
4 treatment (n=1194)
Only 2 trials had sufficient information
No evidence for prevention
Treatment reduced mean duration by 0.28 days
“Though promising, the data are not strong enough … to recommend Oscillococcinum in first-line treatment of influenza”
Jonas, 1999
Homeopathic nosode in tularemia-infected mice
Protection rates 22% better than controls
100% protection by standard vaccine
Influenza pandemic, 1918-19
Genus epidemicus approach effective in prophylaxis and treatment?
Gelsemium, Eupatorium?
Possible Research Questions
Prevention
Treatment
Medical efficacy
Effectiveness/cost
‘Prove’
‘Improve’
Possible Research Methods
Comparator
Controlled (randomised or cohort)
Uncontrolled
Treatment
Individualised
Fixed
Species
Animal
Human
Country
High income
Low-mid income
Scope
Local
International
Constraints
Ethical
Declaration of Helsinki: unethical to use placebo if treatment of proven efficacy exists
Financial
‘Opportunity risks’
Conventional immunisation must be priority
Political danger in appearing to oppose
Easier in lower income countries (e.g. Brazil, India)?
Lag period for conventional vaccine may make trial of homeopathy more acceptable
Possible study designs
1] Randomised Controlled Trial (RCT) of prevention in humans
Previous prevention trials have failed to find positive effects
Outcome measure unreliable?
Very large study required
Expensive
Ethically difficult
2] RCT of prevention in animals
Cheaper and easier
Laboratory or veterinary
Genus epidemicus / nosode
Hard outcome measures (mortality)
Outbreaks of Avian ‘flu are ongoing (China)
Positive findings may inform human study
Big impact if positive
3] Possible study designs
Multi-centre RCT of treatment in humans – fixed treatment (e.g. Oscillococcinum)
Similar to studies by Ferley and Papp
Controlled by placebo or usual care
Outcomes must be validated
Questions and challenges
Is it relevant to the intended effect
Recruitment through homeopathic physicians in primary care?
Highly defined patient sample
Ethics approval may be difficult
Expensive
4] Observational study of treatment in humans
Systematically record doctors’ normal treatment of ‘flu
Epidemic, later pandemic avian
Can improve homeopathic prescribing
Communication via website
Identify, disseminate genus epidemicus
Can inform controlled studies
May not require Ethics approval
5] Possible study designs-1
Comparative cohort cost-effectiveness study in humans
Similar to studies by Riley (2001), Güthlin (2004), Trichard (2005), Witt (2005)
Systematically record treatment of ‘flu
Focus on clinical & cost/utility outcomes
Time lost from work, treatment costs, adverse effects, etc.
Compare with conventional doctors’ data from equivalent patients.
6] Cohort cost-effectiveness study-2
Not randomised, patients seek homeopathy
Essential to correct for baseline differences
Age, smoking, co-morbidity etc
Compatible with observational study
Could be 2nd stage, use same network
Pandemic may come in several waves
Networks are difficult & expensive to create and maintain
Workshops and Discussion Groups
General Conclusions
The Conference participants then separated into five groups with appropriated translators in French, English, Spanish and Italian. Each person was able to express the opinions and questions on the subject of Avian Flu. The moderators then wrote the different ideas on a large sheet and everybody voted by placing a sticker on the subjects they felt to be the most essential. Later in the +afternoon slides were shown and moderators expressed the ideas of all five groups. The following is a summation of the most common consensus and a later evaluation by the Scientific Committee.
The need for a central website to obtain rapid changes of information.
Find a more appropriate and recent nosode of the Avian Flu virus. At this time it is too early to prepare a specific one because there will have to be a mutation or mixing of the virus before it is able to directly infect humans to humans. There also appears to be problems with various national medical/government organizations on preparing these nosodes because of fear of contagion. It was emphasized that the nosodes past the potentized 12C or 30X contain none of the original molecules of the virus.
Discover as soon as possible the correct Genus Epidemicus or homeopathic medicine/s which most closely fit/s the symptom picture.
Always consider the individual or constitutional medicine to aid the Genus Epidemicus to function optimally.
A Scientific Committee was established and included: Dr. Marie-France BORDET, Dr. Peter FISHER, Dr. Helmut RONIGER, Dr. MATHIE, Dr. Menachen OBERBAUM, Dr.Flavio DANTAS and Dr. John IVES.
Boiron Pharmacies have promised a million dollar grant for future research, procedures, networking, etc. to preparing for the prevention and, if necessary, the treatment of the Avian Flu.
This was indeed a historical conference where different opinions were expressed with toleration and respect for the greater good of humanity and homeopathy. Many thanks for all that were involved in this wonderful undertaking.
