Avian Flu (with Molly Punzo, MD)

March 1, 2006

by Text of NCH On-Line Chat

Tuesday, the 14th of March 2006

Moderator: Welcome, Dr. Punzo! Molly Punzo, MD was trained in Internal medicine in Hartford, CT. She worked in several Emergency Rooms and Intensive Care Units before going into private practice. Shortly after beginning outpatient medicine, she became interested in homeopathy through a friend and colleague. She attended a homeopathic lecture in NYC in 1992 and discovered this was her true calling. She has studied with numerous teachers including Jeremy Sherr, Jayesh Shah, Andre Saine and Massimo Mangialavore.

She is currently teaching Anatomy & Physiology and Acute Prescribing at the School of Homeopathy, NY, She will be teaching with Ann Croce at the Florida Academy of Classical Homeopathy in Fall 2006.

She is a member of the NCH Board of Directors, and serves on the Media/Marketing Committee and the Education Committee. Dr. Punzo and Ann Croce will be teaching the new NCH On the Road Course on First Response: Emergency Preparedness. This course will be held in Philadelphia at Drexel University the weekend of June 9-11th 2006. Please attend! (see February Homeopathy Today or www.homeopathic.org for details).

Her interest in Avian Flu gave her the opportunity to attend the Paris Conference sponsored by Boiron in 11/05. She represented the NCH at this conference and plans on staying actively involved in this effort, communicating information regarding this potential pandemic to the homeopathic community here in the United States.

Dr. Punzo welcomes your questions about the Paris Conference on Avian Flu, and also any questions you may have about FLU EPIDEMICS and PANDEMICS in general.

Irene: I thought that during a flu epidemic, different areas of the U.S. might use different genus epidemicus remedies, and also that these remedies could change, either over time and/or as different constitutional types succumb to the illness. Could you talk about this? Thank you.

Molly-Punzo: Well, let's start right out with depth! Ok. Yes, that's true that different areas could end up with a different variety of genus epidemicus remedies (in theory), but if you read about the Spanish Flu you see that all over the world, there were just a handful of remedies that helped tremendously (Gelsemium, Eupatorium) ...because the virus spreads SO fast, you tend not to see the variety you see in typical influenza....so the remedies will be more limited because of the very virulence of this avian flu.

Carole Summer:Is anyone now treating birds or chickens homeopathically? Do we have any results?

Molly-Punzo: At the Paris conference, there were a number of homeopathic vets who brought up this very same subject. Unfortunately, it will be difficult (very) to get the governments to allow such treatment. All they want to do at the moment is destroy the flocks. There are some vaccines being prepared for the poultry industry to help prevent spread in domestic fowl, but that is a very expensive proposition. I know that some of the Vets there will be trying to get their governments to treat homeopathically, but there didn't seem to be that much hope that this could be done easily.

Theresa and Mary: (combined question) Please give us an overview of the Paris conference and your overall suggestions for how we should be preparing (prophylaxis? other?).

Molly-Punzo: Overview: It was a one day "congress" sponsored and paid for in total by Boiron (makers of Oscillococcinum). There were 145 people/homeopaths there from 25 countries. The goal was to get the world of homeopaths united (for a change) and develop a comprehensive strategic plan for communication and information dissemination. There really were no good suggestions as to how to treat or prevent at this point, since the flu is not transmissible human to human (yet).

Ways to prepare: I would keep up-to-date with the various information web sites such as the CDC, the World Health Organization, www.PandemicFlu.gov, etc... As far as homeopathically.....keep up with the NCH and Boiron web sites, as I will continue to follow this now that I am officially in "the loop." Have your remedies on hand in good potencies (200C, 1M, 10M's). Read up on the homeopathic remedies for flu and pneumonia.

Alan: How is the Avian Flu threat different from the Swine Flu threat, in which more people suffered from the Swine Flu vaccination than people who actually had the Swine Flu? Is there any sense that this is simply another push by the drug companies to panic the public so that everyone runs for the vaccine? Also, in 1918 there were no antibiotics, and though less effective these days, with antibiotics and homeopathic remedies, do you really believe that a true pandemic could happen?

Molly-Punzo:This flu strain (H5N1) is ENTIRELY new to the human population...i.e. the masses have NO immunity for this particular viral strain. I follow the more scientific literature as opposed to the media for my information. The epidemiology and molecular biologists have been following this threat for YEARS (1997) and screaming about it to the various bodies of public health and government, but no one was listening until the last couple of years. We are due for a pandemic statistically, and the mortality rate (documented over and over) is staggering....greater than 50 % and up to 60% by more recent data. The 1918 Flu only had a 5-10% mortality rate by comparison and killed 20-50 million people worldwide. That's why there is so much concern. This one is VERY dissimilar from any previous flu strain since 1918 and has a scary and rapid clinical picture.

To answer the antibiotic question above: Antibiotics are completely ineffective in this flu. The virus kills within days and not from bacterial infection. It kills from the overwhelming immune system response of those infected. This is called a cytokine storm.

If most of the world were going to use homeopathic remedies for a pandemic like this, I for one wouldn?t worry as much. We need to spread the word about homeopathy and treat our families and patients as best we can in our own little corner of the world.

Combined questions from 4 people: Has any homeopath had the opportunity to treat or even observe a patient with Avian Flu? What are the symptoms that we should observe/use when selecting remedies? Have any nosodes been made up yet (which pharmacy?)?

Molly-Punzo: No homeopaths, at the conference at least, had had any direct clinical experience treating a patient with avian flu. Most of the patients have been from Asia (Cambodia, Vietnam, Tailand, China). Even if they did, it wouldn't matter because this strain is not the strain that will be the deadly strain that everyone is yapping about. So it wouldn't even matter if anyone had treated a patient up to this point...I mean in terms of treating the pandemic strain. It hasn't yet "shifted". When and if it does (most scientists say "when"), then the clinical picture will be different from what it is now....

The clinical picture right now is very vague from the literature and actual case reports. You wouldn't know it from any other flu from what I?ve read in the case reports...of course a homeopath would because they would look for the *Strange Rare and Peculiar* symptoms of the case. Journals don?t report that sort of thing. The only thing I can glean from reading the cases that seems a bit peculiar so far with these cases is that there are a lot of GI symptoms (diarrhea, abdominal pain) and conjunctivitis in addition to general flu symptoms you would expect. But again, it doesn't really matter yet, because the "picture" will change when the virus mutates to become a human-to-human transmission.

Lastly for this question, it would be GREAT to get a nosode of this one, but it is so deadly and so difficult to get your hands on, that no one at the conference could imagine how to get any tissue or discharges from an infected animal or person.

Irene: What's your opinion on using one's constitutional remedy as a booster or *preventative*?

Molly-Punzo: Of course!!! That would be the best prevention in my opinion. However, many people are on good similars, but not necessarily their simillimum. Also, you have to consider the issue of stronger dissimilar disease....the new disease is stronger than many people's vital force could withstand without specific treatment and/or prevention. I would opt to keep people on their chronic remedy but be sure to have the genus remedies on hand, and treat quickly once people begin to show symptoms in an actual pandemic.

From Carole and John: Is there a common symptom-picture of the people who have died of this flu? Are the symptoms pretty similar in all the victims? From reports in the media, it would seem that most victims are young and female. Is this correct?

Molly-Punzo: The victims DO have a very similar picture according to clinical reports. I don't know about the male/female ratio, but for sure, young, vital, healthy people seem to do the most poorly...this is because of a hyperactivity of their immune systems. It's called a "cytokine storm" response. It is the response of an over-stimulated immune system to the virus that kills, not the virus itself.

Teresa: What do you think of using Tuberculinum aviaire as part of the overall remedy picture?

Molly-Punzo:That came up at the conference, but wasn't discussed in depth because most people agreed that the BEST treatment and prevention would be a specific individualized remedy from the genus of the disease. If you think about it, there are lots of great pneumonia remedies, so why select just Tuberculinum? I'd love to hear your thoughts.

Robert: You mentioned the challenge of making a nosode from the H5N1 virus. However, since this virus seems to be similar to the Spanish Flu strain, is there a Spanish Flu nosode? If yes, any test results yet?

Molly-Punzo: I don't know if there is a nosode of the Spanish Flu. That strain was different, though...it was H1N1 (this is H5N1). I believe that Oscillococcinum originally was made from a duck infected with that very strain (H1N1), but that's not how Oscillo is made anymore. I'm just not confident that a nosode of the Spanish Flu would be good enough against this one. Again, the Spanish Flu had a 5-10 percent mortality rate (on average) and this one is estimated at 50-60% mortality. If you have nothing else, then using Oscillo would be better than nothing.

Note: According to studies, Oscillo is not effective prophylaxis ...just for treatment of usual flu.

Patrick: Given the cytokine storm response you just described, and the fact that homeopathy is intended to strengthen the immune system ? do you have any thoughts about how to treat beyond what you?ve said? Would a lower potency possibly be useful, or at least safer? Or am I building empty theories??

Molly-Punzo: I don't know, Patrick. I "theorize" as well, that since the disease is SO virulent, you would have to match the intensity of symptoms with the intensity of the dose....i.e. choose the proper posology. When you read the treatment for pneumonias by the old masters, they used high potencies in very frequent repetition (every 30 minutes to an hour often in 10M and 50M potencies). This disease would need, I believe, to be treated "aggressively" with high potencies and frequent repetitions just based on what I've read on the treatment of deadly pneumonia before the advent of antibiotics.

Gloria:You mentioned some symptoms ? gastro-intestinal and conjunctivitis. I read about lung hemorrhage. What is the actual cause of death - which organ systems fail?

Molly-Punzo: Respiratory failure for sure. People's lungs fill with pus and mucus, and the lung tissue becomes massively hemorrhagic and filled with immune system "products" like white cells, red cells, fibrin, mucus, etc... You can't even ventilate people with a ventilator. So they die of oxygen starvation and therefore ALL the organs shut down in a rapid time (kidneys, heart, liver, etc.).

Dhyano: If so far the description is *young, vital and healthy with a hyperactive immune response*, I am wondering about Belladonna. What do you think?

Molly-Punzo: Don't know. The remedies for the Spanish Flu epidemic were Gelsemium, Eupatorium, Bryonia, etc... Maybe Belladonna would be good for the initial phase. We might have to think there may be multiple "phases" to a disease like this, and you need to treat the phase in front of you at that moment. Again, though, it's difficult to theorize because we really have NO idea what the clinical picture will change to once this mutates. We just have to keep abreast of what is happening and stay "tuned in" as homeopaths. We can do that now with all our technology.

Isaiah: Bottom line, how fast can this go? Should we provide flu kits to our patients? What should be in them? Who sells them? What remedies should one take when traveling to Europe or to Africa in the next few weeks? Can remedies survive the X-ray screening at security checkpoints?

Molly-Punzo: I think a good piece of advice to your patients would be to have 200C flu kits. I carry the stronger potencies in my office, but a 200C kit can save lives if remedies are used in a timely fashion. The standard flu remedies like Gelsemium, Belladonna, Eupatorium, Bryonia, Baptisia, etc... I have a handout I give students (attached at the end of this transcript) and there are some great articles about good flu remedies in back issues of Homeopathy Today (go on line to search the topic on the NCH web site). Any of the homeopathic pharmacies carry 200C emergency kits.

The X-ray question...I always try and ask that they not be x-rayed just to be sure. Apparently, the X-ray dose on the belt in security is much less than what they use on your luggage that you don't carry-on. I have heard from good teachers that the X-ray question is a matter of cumulative rads.....a few trips won't matter if they are X-rayed. They sell x-ray-proof containers at film stores and on-line. You can check with the pharmacies or on-line. If I were traveling a lot, that's what I would buy for my remedies.

I don't think you have to worry about traveling in the next few months. Just be careful handling poultry anywhere Avian Flu has been detected (before it is cooked and IF it were in fact, infected, or handling any products of the infected meat). There have been reports of people handling the eggs and the shells had infected material on them, also, a case where infected hay was imported to a farm from a farm that had had infected chickens. Eating infected poultry is only a problem if the poultry isn't cooked properly through to the right temperature. Properly cooked chicken isn't a problem. The problem is handling of uncooked infected chicken or poultry in areas that are endemic.

The disease predictions are for the next few years. There are no reported cases of human-to-human transmission at this point.

Kristy: Thank you, Dr. Punzo, for a great question-and-answer session. I hope you'll come back and talk to us again later this year. And thank you, participants, for sending us your questions. The Chat Transcript will be available in the NCH web site CHAT Archives next week. For those of you who live close to Berkeley Springs, WV, Dr. Punzo will be giving a lecture for the Grand Opening of Washington Homeopathic Products' new warehouse on March 26th. Go to www.homeopathyworks.com for more info.

Molly-Punzo: You're welcome! Don?t forget about the upcoming First Response Homeopathy Course in Philadelphia this June.