ACCORDING to the the Centers for Disease Control and Prevention, upper respiratory tract infections such as influenza, respiratory syncytial virus (RSV), and Covid-19 increase during autumn and winter. These diseases present similar symptoms. For this column, we will focus on influenza.

This common respiratory virus can cause mild to severe respiratory illness, especially in young children, older adults, and individuals with weakened immune systems. In Ayurvedic medicine, we focus on prevention, which involves strengthening the respiratory system and boosting immunity through natural practices.

Several measures can be adopted to avoid and combat the flu. However, it is important to note that viruses, like influenza, frequently change its structure to evade the immune system, resulting in new strains that can bypass previous immunity. This constant change poses challenges for the development of new and advanced vaccines.

There is a growing need for effective medication to prevent the illness and enhance the body's natural immune response against these respiratory diseases. This is where natural healing modalities such as Ayurveda, Chinese medicine, Naturopathy, etc, are succeeding.

These holistic modalities focus on strengthening the natural immune response, so that the body can fight off viruses and infections, rather than suppressing them. Often, these measures have stood the test of time, and are essentially about going back to basic healthcare instead of looking for new medications to fight the common cold, new vaccines, etc.

What is influenza?

According to modern medicine, influenza, which is commonly known as the flu, is a contagious respiratory illness caused by influenza viruses. It can lead to mild to severe symptoms, including fever, cough, sore throat, body aches, fatigue, and sometimes complications such as pneumonia.

In Ayurveda, the clinical presentation of influenza-like illnesses can be correlated with what we call Vataja-Kaphaja jwara (a fever with the predominance of vata and kapha symptomology) such as general body ache, heaviness of the head, fatigue, chills, dry/wet cough with or without sputum, rhinorrhoea, etc.

The treatment of jwara (fever) aims at the digestion of ama, which is undigested metabolic waste that has accumulated in the body. It is expelled from the system through fasting and various ayurvedic formulations (single herb/polyherbal) containing ingredients having a bitter taste, hot potency, and pungent post-digestive effect.

Types of influenza

Influenza viruses are classified into three main types: A, B, and C.

These types differ based on their genetic makeup and ability to infect humans.

Influenza A: this type is the most common and infects a wide range of hosts, including humans, birds, and other animals. Influenza A viruses are further categorised into subtypes based on the combination of two proteins on the surface of the virus: hemagglutinin (H) and neuraminidase (N). There are 18 different hemagglutinin subtypes and 11 different neuraminidase subtypes. For example, the H1N1 and H3N2 subtypes have caused seasonal epidemics in humans.

Influenza B: this primarily infects humans and is less common than Influenza A. It does not have subtypes like Influenza A but is divided into two antigenically distinct lineages: B/Yamagata and B/Victoria. Influenza B viruses usually cause seasonal outbreaks of flu.

Influenza C: this type also infects humans but typically causes milder respiratory illnesses when compared to types A and B. Influenza C viruses do not cause widespread outbreaks or epidemics like types A and B. Influenza A and B viruses are primarily responsible for seasonal flu outbreaks in humans. They can cause a range of symptoms from mild to severe respiratory illness, and they can lead to complications, especially in vulnerable populations such as the elderly, young children, and individuals with compromised immune systems.

General Symptoms:

• Sudden onset of high fever.

• General weakness

• Chills.

• Body aches.

• Cough.

• Headache.

• Sore throat.

• Runny or stuffy nose.

• Tiredness or feeling run down.

• Diarrhoea or vomiting

The following Ayurvedic herbs have been proven to be effective in studies against Influenza:

• Yasthimadhu (Glycyrrhiza glabra): also known as licorice, has significant pharmacological actions that modulate the immune system, inhibit virus growth, produce anti-inflammatory activity, and deactivate viruses such as influenza.

Another study demonstrated that the active constituent Glycyrrhizin inhibits influenza A virus uptake into the cell. These findings suggest that Glycyrrhizin’s antiviral activity occurs through the cell membrane interaction, offering insights for the development of related compounds as effective anti-influenza therapeutics.

• Bhunimba (Andrographis paniculata): a randomised, double-blind, placebo-controlled clinical study investigated the effectiveness of Kalm Cold, an extract from Andrographis paniculata, in patients with Upper Respiratory Tract Infection (URTI).

The study suggested that Kalm Cold was effective in reducing URTI symptoms. Among various plants tested for conditions related to viral infection and inflammation, Andrographis paniculata showed the highest inhibition of RANTES secretion by human bronchial epithelial cells infected with influenza A virus (H1N1).

• Haridra (Curcuma longa): one study found that curcumin can block influenza infections by disrupting several cellular signalling pathways. Another study demonstrated that curcumin can directly hinder the replication of eight strains of influenza A virus during the adsorption stage.

• Shunthi (Zingiber officinale): Gingerol, found in ginger, is a strong compound against influenza. It blocks viral neuraminidase activity and enhances the immune response of specific white blood cells to the infection. This suggests that gingerol could be promising for treating human influenza.

What is the impact of fasting on immunity?

In Ayurvedic medicine, a healthy digestive fire is a sign of good immunity and health. A compromised digestive system will impact the entire metabolism of an individual leading to ill health and ultimately disease.

Immunity is the body's natural defense system against infections and diseases. It consists of nonspecific barriers that block a wide range of pathogens that adapt to fight particular diseases. When impacted by influenza for instance, Ayurvedic doctors may recommend that you fast for a specific amount of time for any metabolic waste (ama/pathogens) to be removed from the system.

It is a means to give your digestive system a break, so that it can remove any unwanted toxins. Fasting also helps restore the weakened digestive fire, reduces the effects of any disease, improves metabolism, and regenerates healthy immune cells. Ayurvedic doctors may recommend that you have something easily digestible, such as freshly prepared rice gruel which provides nourishment to the body.

Fasting is generally not recommended for children, the elderly, the weak, and pregnant women. Fasting, including intermittent fasting and calorie restriction, has been widely recognized for its health benefits. It can help reduce obesity, cardiovascular diseases, cancer, rheumatoid arthritis, metabolic syndrome, osteoarthritis, and fibromyalgia, and improve memory.

Fasting also reduces inflammation, boosts immunological memory, affects immune cell dynamics and mucosal immune responses, increases stress resistance and lipolysis, and promotes autophagy.

A recent study found that a compound called STIF boosts the immune response of human red blood cells against SARS-CoV-2 without affecting their ability to carry oxygen. This enhanced immunity persists even during periods of fasting and refeeding. Previous research had shown how fasting affects the immune functions of white blood cells, but its impact on red blood cells was unclear.

The study suggests that red blood cells can bolster defenses when white blood cell levels are low, particularly in their response to SARS-CoV-2. Another study showed the effects of dawn-to-sunset fasting and how it could enhance the immune system's response to SARS-CoV-2 during the pandemic by reducing chronic inflammation and oxidative stress, improving metabolic health, and reshaping the gut microbiome.

Dietary tips

- In winter, the flu is often aggravated by cold, heavy, mucus-forming foods.

- Prioritise eating warm, cooked foods with spices like cumin, ginger, and turmeric.

- Avoid cold dairy, fried foods, and excess sweets.

- When you have a fever, drink thin vegetable soups until the fever subsides and your hunger returns.

- Use spices such as ginger, black pepper, and turmeric in your meals.

Home remedies

- ¼ tsp dry ginger powder with honey acts as a great remedy for the respiratory system.

- Sip ginger tea at least three times a day to assist the body in removing metabolic toxins from the body and enhancing digestion.

- Prepare a warm herbal decoction with Tulsi, black pepper, dry ginger, cinnamon, and clove. This will help fight infections, soothe the throat, and enhance immunity.

- Add a pinch of ginger powder, turmeric powder, and black pepper. Then add a drizzle of honey to form a paste and have this when you have a sore throat; it will also clear up any phlegm.

Septilin by Himalaya Wellness is a potent immunomodulator that relieves the common colds and flu, sore throat, tonsillitis, as well as infections of the ear, nose, and throat.

- Koflet Syrup by Himalaya Wellness to relieve coughing.

- Add Menthol crystals and a few drops of eucalyptus essential oil to a bowl of hot water. Cover your head with a dry towel and inhale the steam until you feel relief from the congestion. Do this in the evenings before bed. Ten to 20 minutes of daily sun exposure helps produce Vitamin D and improve immunity.

- Stay hydrated - but only drink warm water, if and when you are thirsty.

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