4

A Brief Look at Some Other Viruses

From Cytomegalovirus and Dengue to Shingles and Their Treatment Protocols

The underlying causes for the emergence of infectious diseases are anthropogenic social and environmental changes. These result from the combined weight of human numbers and their consumption patterns that are overloading the planet’s biophysical and ecological capacity. . . . If the human impact on the ecosphere continues to escalate, the rate of emergence of infectious diseases will only increase in the future.

Thijs Kuiken et al., “Emerging Viral Infections in a Rapidly Changing World”

There is currently a large and ever-expanding global population base that prefers the use of natural products in treating and preventing medical problems.

R. Hafidh et al., “Asia Is the Mine of Natural Antiviral Products for Public Health”

There are many other viruses that cause human illness that either are becoming resistant or are emerging more strongly into the world’s population of people. In this section I will look at cytomegalovirus, dengue virus, enterovirus 71, Epstein-Barr virus, herpes simplex viruses, varicella zoster (shingles), and a few gastrointestinal viruses such as rotavirus and norovirus. I am not going to explore the Coxsackie or ECHO viruses in this book at this time, nor am I going to look at the five hepatitis viruses or HIV. Viral hepatitis and HIV need, for the most part, highly involved treatment protocols that are beyond the scope of this book; they each need in-depth books of their own.

Cytomegalovirus

Cytomegalovirus (CMV) is a member of the Herpesviridae family of viruses, a very large group of DNA viruses that also includes the herpes simplex viruses, Epstein-Barr virus, and varicella zoster virus (chicken pox/shingles). It is sometimes referred to as human herpesvirus 5 (HHV-5). It usually causes minor problems in people with healthy immune systems but if immune function drops (especially in those with AIDS, those taking immunosuppressive drugs, or those whose immune function is simply becoming weak from either age or illness) or if the immune system has not yet developed fully (babies, in and out of utero) it can cause severe problems up to and including death.

Infection rates are high. In the United States somewhere between 50 and 80 percent of the adult population are asymptomatically infected. When people first become infected the usual signs are fever, fatigue, muscle tenderness, and tender and enlarged lymph nodes. Just like the flu. Then it passes, you feel fine, and you are an asymptomatic carrier.

As the years go by the virus periodically blooms, sending viruses to body fluids: saliva, tears, urine, blood, semen, vaginal secretions, and breast milk. From there it spreads to new hosts. It is a pretty good parasitic virus, and it usually doesn’t cause much trouble. However, in people whose immune function is impaired, the virus can cause a wide range of symptoms: encephalitis, myelitis, seizures, coma, psychosis, dysphagia, weakness, numbness in the legs, retinitis, visual impairments including blurred vision or blindness, pneumonia, gastritis, enteritis, colitis, diarrhea, ulcers in the GI tract, and hepatitis.

In babies, CMV is the most common congenital infection in the United States. For most it will not be a problem but for some it can cause severe and long-term difficulties: neurological problems, hearing impairment or loss, visual problems, seizures, or mental and physical disabilities. The worst problems occur in infants whose mothers become infected while the infants are in utero.

CMV is normally treated with the intravenous antibiotic ganciclovir (or valganciclovir), usually along with CMV-specific immune globulin. Treatment usually lasts 2 to 4 weeks, followed by a transition to oral valganciclovir. Unfortunately the virus is becoming fairly resistant to ganciclovir. Generally, this drug will not cure the infection but only lessen its effects. Again, the search is for a vaccine; however, early trials show that the vaccines in development only tend to lessen the effects of the disease, not eliminate it, for the majority of people using them.

Dengue Fever

Dengue viruses (DENVs) are single-stranded RNA viruses in the Flaviviridae family, specifically in the Flavivirus genus. This genus includes many of the encephalitis viruses such as West Nile, tick-borne encephalitis, Japanese encephalitis, Murray Valley encephalitis, St. Louis encephalitis, and so on. Yellow fever virus is also in this group. There are various serotypes of dengue (1, 2, 3, and 4). Each one produces a slightly different spectrum of symptoms. DENV-3 produces more musculoskeletal and gastrointestinal symptoms, DENV-4 has more respiratory and cutaneous symptoms.

Dengue fever, a.k.a. breakbone fever, is a mosquito-transmitted disease and is not infectious except through that route. There are about 100 million people infected with dengue each year; several hundred thousand develop dengue hemorrhagic fever, which is very serious, and about 22,000 die.

The disease is endemic pretty much everywhere, including the southern United States. Outbreaks have occurred in recent years throughout the Caribbean including Puerto Rico, the U.S. Virgin Islands, and Cuba. The disease is common in Tahiti, Singapore, the South Pacific, Southeast Asia, the West Indies, India, and the Middle East as well as throughout South America. The incidence of the disease is growing each year.

Once a mosquito bites a person, the virus enters the body and begins seeking out monocytes and macrophages, the primary parts of the body it infects. The symptoms develop in 3 to 15 days (normally 5 to 8). The symptoms are sudden-onset fever, headache, pain on eye movement, and low backache. Muscle and joint pain (which is often very severe — it’s called “breakbone” fever for a reason) occurs soon after, a fever, often as high as 104 degrees Fahrenheit, develops, heart rate and blood pressure drop. The eyes redden, a rash may occur on the face, lymph nodes often swell.

The fever tends to last several days, then a sudden drop in body temperature occurs accompanied by extreme sweating. This passes, you feel fine, then it starts all over again. This time the rash covers the whole body except for the face.

Dengue hemorrhagic fever (DHF) usually affects children under 10 years of age. It causes severe abdominal pain, hemorrhage, and shock. Sore throat, cough, nausea, vomiting all occur. Somewhere from 2 to 6 days after symptoms begin there is sudden collapse, with cool, clammy extremities, weak pulse, and cyanosis around the mouth. The skin bruises easily; there is bleeding, spitting up of blood, blood in the stool, bleeding gums, nosebleeds. Pneumonia is common; inflammation of the heart may occur. The disease is associated with high levels of circulating von Willebrand factor. Normal treatment for DHF is transfusions, oxygen, and fluid replacement.

There are no pharmaceutical treatments for either form of dengue fever. There is no vaccine. However, recent research has shown that the antibiotic Geneticin is active against the virus. Its effectiveness in practice is unknown.

Enterovirus 71

Enterovirus 71 (sometimes called hand, foot, and mouth disease) is a single-stranded, nonenveloped RNA virus in the Picornaviridae family. Rhinoviruses (common cold), hepatitis A, and the polio virus are some of the better-known members of the family.

Enterovirus 71 was first identified in 1965; the first known outbreak was in 1969 in the United States. There are severe outbreaks every 3 to 4 years throughout the world with smaller annual episodes here and there. A huge outbreak in Taiwan in 1998 infected over 130,000 people, mostly children. The virus is usually spread by respiratory droplets or contact with an infected person’s body fluids. It is excreted in feces for weeks or months after infection.

The virus initially colonizes the GI tract and from there, if the disease does increase in severity, it invades the spinal cord and ascends to the brain. In the CNS and brain it produces high levels of cytokines: IL-1ß, IL-6, IL-8, and TNF-α. Enterovirus 71 is considered to be an emerging pathogen, with the number of cases increasing each year.

The most common symptoms of infection are fever, headache, fatigue, malaise, ear pain, sore throat, body rash, blisters on the palms of the hands or soles of the feet (they may also occur in the nostrils and buttocks), oral ulcers, loss of appetite, diarrhea, vomiting. Fever and sore throat are usually the first signs.

Unfortunately, there are some more serious complications that can occur during infection: high fever, meningitis, encephalitis, paralysis, cardiopulmonary edema, and sometimes coma and death.

There is no pharmaceutical treatment or vaccine.

Epstein-Barr

Epstein-Barr is a member of the Herpesviridae or herpesvirus family; it’s sometimes referred to as human herpesvirus 4 (HHV-4). It is the cause of mononucleosis and a very common cause of chronic fatigue syndrome. It is considered an oncovirus, meaning it can, under some circumstances, over long periods of time, cause certain forms of cancer. Most children become infected with it at a young age, in which case the symptoms are usually mild — it looks like a mild case of the flu. The older the person at infection, the more severe the symptoms. In teenagers it causes infectious mononucleosis. This is usually accompanied by a severe sore throat, fever, and extreme fatigue and malaise. The infected may also experience swollen throat, loss of appetite, enlarged lymph nodes, swollen spleen and liver, jaundice, petechiae. Some of the very serious complications are splenic rupture or hemorrhage, meningitis, peripheral neuritis, and pneumonitis. An autoimmune hemolytic anemia can occur as well, though it is much rarer.

There are no reliable pharmaceutical treatments for the disease. Acyclovir can help reduce viral shedding. Valacyclovir has been found to, sometimes, significantly reduce the viral load and thus the symptoms of the disease.

Herpes Simplex 1 and 2

Herpes is probably the most famous (or infamous) member of the Herpesviridae family of viruses. There are two types, herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2). The most common sites of infection are around the lips (cold sores, fever blisters) and on the genitals (herpes). Cold sores are usually caused by herpes simplex 1, genital herpes by herpes simplex 2. A less common form is infection of the fingers, called herpetic whitlow. It is caused by either type. There are some more serious forms of infection: ocular herpes (which infects the eyes, causing a form of keratitis), herpes gladiatorum (which broadly infects the skin), herpes encephalitis (which infects the brain), Mollaret’s meningitis (which infects the protective membranes covering the brain and spinal cord), and neonatal herpes (where the baby is infected as it is born or in utero).

Herpes, either oral or genital, is usually cyclic with long (or short) periods of remission between episodes. With genital herpes, once the virus enters a new host it travels along the nerve paths, where it takes up residence. For many people, after an initial outbreak, the virus may become dormant indefinitely. For others, every so often, the virus becomes active. It then travels back along the nerve paths to the surface of the skin, where it creates blisters that shed viruses, spreading the disease.

Just prior to a new episode, there may be a feeling of pain in the nerves in the genitals. Soon small blisters may appear; they eventually break open and produce very painful sores that scab over and heal after several weeks. Sometimes people with an active infection feel as if they have the flu, and the lymph nodes may be swollen.

Oral herpes and herpetic whitlow symptoms are similar but occur around the lips and fingers respectively.

There are generally three types of ocular, or eye, herpes. Herpes keratitis is the most common form; it’s a viral infection of the cornea or surface of the eye. This usually heals without damage to the eye. Stromal keratitis is a deeper form, where the virus penetrates deeper into the layers of the cornea. It can cause scarring of the cornea and, sometimes, blindness. The final type is iridocyclitis. Here the iris and surrounding tissues of the eye are infected and become inflamed. There is often severe light sensitivity and blurred vision, and the infected eye is red. Sometimes this kind of infection can occur in the retina or inside lining of the back of the eye; it’s then called herpes retinitis.

Signs and symptoms of herpetic eye infections are swelling, tearing, irritation, foreign body sensation, redness, eye sores, discharge, light sensitivity.

The normal treatment for eye herpes is ganciclovir as an ophthalmic gel, five drops daily. Sometimes steroid eyedrops are used to decrease the inflammation. The infected cornea is sometimes scraped away. There is no effective cure; these interventions reduce the impact of the episode and, hopefully, prevent permanent damage.

Herpes gladiatorum is tremendously infective and is transmitted by skin-to-skin contact. It is essentially a cutaneous form of herpes, usually herpes simplex 1 (the same form of the virus that causes cold sores). It is somewhat common in sports clubs (which is where it got its name). In this condition, the sores, instead of being confined to the genitals or lips, are found in clusters over the body: neck, chest, face, stomach, legs. The lymph nodes are often enlarged, with fever, sore throat, headache. The blisters are very painful and take weeks to heal.

Herpes encephalitis and meningitis are uncommon but severe complications of herpes infection. Herpes meningitis is usually caused by the HSV-2 serotype and is an inflammation of the meninges, the tissue surrounding the brain and spinal cord. The normal symptoms are stiff neck, headache, fever, light sensitivity, fatigue, nausea, appetite loss, vomiting (sometimes). It is usually a self-limiting disease and clears on its own. For some people it recurs at periodic intervals just as genital and oral herpes do. In rare instances it may cause minor mental dysfunctions, slight confusion, and difficulty in problem solving that fail to resolve.

Herpes simplex encephalitis is usually caused by HSV-1. During herpes simplex encephalitis the temporal and frontal lobes are usually infected when the virus travels along the nerve lines into the brain. The usual encephalitic processes occur: inflammation of the brain, confusion, psychological alterations, fever, and in anywhere from 30 to 70 percent of those infected seizures, coma, and death. The infection is usually treated with IV acyclovir but there is still a 30 percent mortality rate. There is often long-lasting brain damage.

The usual treatment for herpes infections is valacyclovir, acyclovir (a.k.a. aciclovir), or famciclovir. All are forms of guanosine analogue antiviral drugs that, when taken, are metabolized by the body into an active form. These drugs are widely used to help control outbreaks of herpes simplex viruses, chicken pox, shingles, Epstein-Barr, and cytomegalovirus, all of which are closely related herpesviruses. They are strongest against the simplex types and have no effect on the viruses in their latent form in the nerve sheaths; they are effective only when the viruses become active. The drugs can shorten the course of the disease to some extent and help prevent spread. They do not cure it.

Herpesviruses are becoming resistant fairly rapidly to acyclovir, especially in those with compromised immune systems.

Varicella Zoster Virus (Chicken Pox/Shingles)

Varicella zoster virus is also a member of the Herpesviridae family; it’s sometimes referred to as human herpesvirus 3 (HHV-3). HHV-3 usually occurs first as chicken pox (i.e., varicella), later as shingles (herpes zoster).

During the initial infection, normally during childhood, spread via respiratory droplets in the air, the virus enters the bloodstream and travels everywhere, making spots all over the surface of the body. It takes about 2 weeks for the spots to appear and the infection period lasts for up to 3 weeks after that, until the spots crust over. At that point, still spotted, the child is no longer infected. (“Yes, you still have to go to school.”)

Though the disease was usually self-limiting and fairly benign vaccines are now commonly used in the West for chicken pox. However . . .

Regrettably, the virus, once the initial infection has passed, settles in the dorsal ganglion, part of the nerve structure of the central nervous system. There it lives quite happily for decades, until in later age, usually as a result of lowering immune function, it sometimes reappears as shingles.

The virus leaves its happy home, travels along the nerves, and emerges at the surface of the skin, often on the face, and makes life intolerable. There is often hemorrhage, edema, and lymphocytic infiltration of the affected nerves. Usually, the person can feel the event beginning — as the virus travels along the nerves it creates odd feelings, tingling, burning, numbness, and a very definite feeling that something is wrong. Then, quite quickly, the virus emerges out of the body onto the surface of the skin, creating tiny blisters filled with virus particles. The pain is often excruciating and little in the pharmaceutical armamentarium can help. Occasionally there can be fever, enlarged lymph nodes, chills, malaise, loss of appetite, and stomach upset. The lesions can last up to a week or so once they emerge. There can also, rarely, be more difficult complications such as encephalitis, peripheral nerve palsies, hemiparesis, and myelitis.

The most problematic aspect of shingles is postherpetic neuropathy, i.e., pain, at the site of the eruption. It can be an unrelenting sharp, burning, or stabbing pain that can become highly debilitating. About half the people who get shingles also develop postherpetic neuropathy. The neuropathy is usually caused by the infection itself as it blooms at its emergence location. The local nerves are damaged by the inflammation and it takes them time, sometimes a very long time (7 to 10 months), to recover. The older the person, the longer they take to heal. As long as the damage lasts, postherpetic neuropathy will remain.

The usual medical treatment is the use of antivirals such as acyclovir, valacyclovir, or famciclovir. Corticosteroids may also be used to lessen the inflammation, especially if the complications are serious. Over-the-counter analgesics are often used, with varying success. The pain is sometimes so severe that opiates are necessary. Pharmaceuticals don’t heal the disease but they can help reduce the length of an episode and help with pain.

One of the better natural approaches for shingles is the use of herbs to increase immune function to reduce outbreak frequency and herbs that protect and restore the nerves. Specific herbs for nerve pain will also help tremendously, especially those that affect the P2X receptors in the brain.

Gastrointestinal Viruses (Rotaviruses and Noroviruses)

There are a number of common (and a few uncommon) viruses that cause gastrointestinal infections in people. The two primary ones are rotavirus and the Norwalk (norovirus) virus. Some countries now use vaccines against rotaviruses; there is none for the Norwalk virus, which is thought to cause 90 percent of all nonbacterial epidemic gastroenteritis worldwide and as much as half of all U.S. gastroenteritis infections. There is also an emerging group of viruses, discovered in the 1970s, the astroviruses, that are GI tract infectives. And the orthoreoviruses that are thought to only rarely cause human disease.

These groups of viruses are specialists in infecting human food plants and bind quite strongly to lettuce leaves, for example. They are the main cause of diarrheal outbreaks from agricultural food products. The symptoms are much the same for all: nausea, vomiting, diarrhea, abdominal pain, lethargy, weakness, muscle aches, headache, low-grade fever, dehydration. The diseases are usually self-limiting but they can be quite debilitating and a few people in the United States always die from them every year. Rotaviruses are still a major cause of child mortality throughout the world.

In essence this is what is usually called the stomach flu in the United States. It is a food-borne illness from virus-contaminated food, usually vegetables, and is commonly spread via salad bars or prepackaged spinach, bean sprouts, and so on.

The Treatment Protocols

Again, the protocols suggested in this section are only suggestions. There are many ways to approach treating these viruses; this is just a starting point. Comment: If encephalitis occurs from any of these viruses, the encephalitis protocol, with slight alterations for each virus, which would mean adding specific herbs to the protocol, should be used.

Cytomegalovirus (CMV)

Herbs (and supplements) that have been found active for this virus in vitro, in vivo, and in human clinical use are (in alphabetical order) Artemisia annua (or artemisinin), Astragalus membranaceus (astragalus), the berberine plants, Bidens pilosa (bidens), Bupleurum kaoi, Forsythia suspensa, Geum japonicum, Glycyrrhiza glabra (licorice), houttuynia, Hypericum perforatum, isatis, Lomatium dissectum, Nigella sativa, quercetin, Scaevola spinescens, Syzygium aromaticum (cloves), Terminalia chebula, Urtica dioica (nettles), Zingiber officinale (ginger).

Geum japonicum, licorice, isatis, and the berberines have been found as effective as ganciclovir in the treatment of CMV in vivo.

Treatment

To begin: Bidens is a potent systemic antimicrobial herb (it must be prepared from fresh leaves; for more information, see my book Herbal Antibiotics, second edition) and I would include it in any protocol for treating CMV. A systemic formulation that would be good is Bidens pilosa, houttuynia, isatis, licorice, and lomatium, equal parts of each of the tinctures, combined. Dosage: 1412 teaspoon of the tincture combination from 3–6x daily depending on severity of the infection.

Then, based on specific symptoms, add to this systemic formulation any of the following:

For GI tract symptoms: Berberine-containing plants are specific in this instance: goldenseal, phyllanthus, barberry, Oregon grape root, coptis, and so on will all work fine. My preference is for phyllanthus, barberry, or goldenseal. Dosage: 1412 teaspoon of the tincture 3–6x daily depending on severity of symptoms. The systemic tincture should also be used, with the same dosage range described above. The licorice will help any ulceration that has occurred.

For neurological symptoms: The encephalitis protocol (see page 84) plus bidens.

For pneumonia: Moderate to severe influenza protocol (see page 46) plus bidens.

Dengue Fever Virus

Some herbs and supplements effective for dengue are (in alphabetical order) Alternanthera philoxeroides, Andrographis paniculata, Artemisia douglasiana, Azadirachta indica (neem), the berberine (and palmatine) plants, Cissampelos pareira, Cladogynos orientalis, Cryptocarya chartacea, Daucus maritimus, Distictella elongata, Ellipeiopsis cherrevensis, Eupatorium patens, Eupatorium perfoliatum (boneset), Flagellaria indica, Garcinia multiflora, Gastrodia elata, Glycyrrhiza glabra (licorice), grape seed proanthocyanidins, Hippophae rhamnoides (sea buckthorn leaf), houttuynia, Kaempferia parviflora, Lantana grisebachii, Momordica charantia, Ocimum sanctum (mildly active), Punica granatum (pomegranate juice), Quercus lusitanica (gall oak seed), Rhizophora apiculata, Salvia miltiorrhiza (Chinese or red sage), Stemona tuberosa, Tephrosia spp., Uncaria tomentosa. Oligomeric procyanidins (OPCs) are also specifically antiviral for dengue. They are common in cranberry juice, pomegranate juice, grape seeds, and unripe apple peels (for example). Any source can help, but that is the reason that pomegranate is included here. In addition pomegranate is a fairly potent synergist with a wide range of antimicrobial activity.

Many of the studies did not mention the serotype of dengue tested. Most of the herbs and supplements that did specify serotype have only been tested against type 2 (out of the four serotypes). The exceptions (that I can find) are andrographis, Momordica charantia (type 1), Ocimum sanctum (type 1), and Cissampelos pareira (all four serotypes). It is possible that many of these herbs are active against other serotypes but no testing has yet been done.

Treatment

I would suggest beginning treatment with the following: Cissampelos pareira, sea buckthorn leaf, boneset, houttuynia, licorice, pomegranate juice, and cat’s claw. Salvia miltiorrhiza is for hemorrhagic dengue as an adjunct.

Cissampelos pareira (in English, velvet leaf) is a widely used herb in Chinese medicine, Ayurveda, and South and Central America (where it is called arbuta). It is moderately findable, if you look for it. It is somewhat invasive in Florida in the United States and should be harvested for use in that region.

The herb is antipyretic, anti-inflammatory, immunomodulatory, antiplasmodial, antinociceptive, antiarthritic, antioxidant protective, antileukemic, cardioprotective, constipative, abortifacient. It should not be used if you are pregnant or wanting to become pregnant. You can use it either as a strong decoction or as a 50 percent alcohol/water tincture. It is the only herb that is considered to have strong action against all four serotypes of dengue.

Sea buckthorn leaf and boneset are both antivirals specific for dengue. The boneset, additionally, will help lower fever, reduce pains in the body, and stimulate the immune response. Houttuynia and licorice are good supportive antivirals, and both are active against dengue. (Unfortunately, all have only been tested against serotype 2.) Licorice will also act as a synergist and anti-inflammatory. Pomegranate juice constituents are antiviral for dengue and it is a good synergist and anti-inflammatory so it is perfect for keeping up fluids. Cat’s claw will protect the macrophages and monocytes from dengue infection (it is very specific for this). Chinese sage should be used in cases of hemorrhagic dengue; it will lower circulating levels of von Willebrand factor in the blood. Here is a suggested protocol:

For dengue encephalitis use the dengue protocol outlined in chapter 3.

Enterovirus 71

Some herbs and supplements effective for enterovirus 71 are, in alphabetical order, Amomum villosum, Ampelopsis brevipedunculata (porcelain berry, invasive), Azadirachta indica (neem), Elaeagnus oldhamii, Euchresta formosana (shan dou gen), Ficus pumila, Forsythia suspensa (lian qiao), Glycine tomentella, Glycyrrhiza glabra (licorice), houttuynia, Kalanchoe gracilis, Laminaria japonica (kombu), Ledebouriella divaricata (fang feng), Lemmaphyllum microphyllum, Lonicera japonica (Japanese honeysuckle, invasive), Melastoma candidum (invasive), Melissa officinalis (lemon balm), Ocimum basilicum (basil), Origanum vulgare (oregano), Phragmites communis (a.k.a. P. australis; invasive), Polygonum chinense (Chinese knotweed), Polygonum multiflorum (fo-ti), Psidium guajava (guava), Pueraria lobata (kudzu, invasive), Rheum officinale (rhubarb), Rosmarinus officinalis (rosemary), Schisandra chinensis (schisandra), Spatholobi caulis, Thymus vulgaris (thyme), Toona sinensis, Zingiber officinale (ginger).

Treatment

Enterovirus 71 is an emerging pathogen that has no reliable pharmaceutical treatment. Numerous invasives are specific for this disease. I would begin with these herbs as systemic antivirals (then add others specific to the symptom picture): porcelain berry, neem leaf, licorice, houttuynia, fo-ti, ginger.

Japanese knotweed (Polygonum cuspidatum), a.k.a. hu zhang (hu-chang), has not been tested for activity against enterovirus 71 to my knowledge but its constituents and actions are very similar to the two polygonums that have been tested. This is of interest to me because Japanese knotweed is an invasive and thus presents a large, easily available source of medicine.

Interestingly, a Chinese combination used for measles for several millennia has been found effective in the treatment of enterovirus 71. It is composed of black cohosh rhizome, kudzu root, red peony root, and licorice. It’s a nice combination, though I don’t know where you can easily find it already prepared in the West. The kudzu and the licorice are antiviral. The licorice is synergistic and immune potentiating, the kudzu and peony neuroprotective, and to some extent so is the licorice. The black cohosh is pain relieving. You can, however, buy the herbs, most of them, from 1stChineseHerbs.com (www.1stchineseherbs.com). Just because of my own preferences, I would approach my own formulation slightly differently.

In addition to the systemic antibacterials, lemon balm, especially a prepared oil infusion, is specific for the blistering that enterovirus 71 can cause on the palms and soles of the feet. If neurological complications occur, you need to add specific anti-inflammatories for the brain and neural protectors. Kudzu is a good one, and a decent choice since it is active against the virus. My general preference for anti-inflammatories in the brain these days are Japanese knotweed, Chinese skullcap, greater celandine, and lion’s mane.

For simple, uncomplicated enterovirus 71, here is a suggested protocol:

For specific symptoms or complications, incorporate these additional formulations into the protocol:

For blisters: Lemon balm infused oil or cordial, applied topically to blisters, as many times daily as seems appropriate.

For diarrhea: Blackberry root infusion, consumed throughout the day as tea, with honey added as desired. Pomegranate juice is highly suggested as it is antiviral, will reduce the cytokine cascade in the body, replaces fluids, helps reduce diarrhea, and is a good synergist. A combination of pomegranate and cranberry juice is just about perfect for this.

For fever: Boneset tea, 4–6x daily. Pasque flower tincture, 5–10 drops every hour or so, can also help. It will also help reduce anxiety levels.

For encephalitis and meningitis: I would essentially use the protocol outlined in chapter 3. However, add a tincture combination of fo-ti, cordyceps, and Chinese skullcap, in equal parts, 1412 teaspoon (or more, depending on the severity of symptoms) up to 6x daily. This will reduce the cytokine cascade in the brain and CNS, protect neural structures, and reduce the symptom picture. Lion’s mane tincture, at the same dosage, will help restore neural function. If neurological symptoms are very severe, add greater celandine tincture, 30–60 drops, 3–6x daily for a max of 30 days.

Note: When treating a child, all dosages need to be adjusted for the child’s weight and age; see the appendix for specifics.

Epstein-Barr Virus

Some of the herbs and supplements effective for Epstein-Barr are Ailanthus altissima, Alpinia galanga, Andrographis paniculata, Artemisia annua (or artemisinin), Azadirachta indica (neem), Calendula officinalis, Chrysanthemum indicum, Coix lacryma-jobi, Cochlospermum tinctorium, Curcuma longa (turmeric), Eucalyptus spp., Ganoderma lucidum (reishi), Glycosmis arborea, Glycyrrhiza glabra (licorice), isatis, Morinda citrifolia (noni), Opuntia streptacantha (prickly pear cactus), Passiflora incarnata (passionflower), Polygonum cuspidatum (Japanese knotweed), Prunus persica (peach tree leaves), Scutellaria baicalensis (Chinese skullcap), Thelypteris torresiana, Thuja spp., Usnea spp., Wolfiporia extensa (a.k.a. Poria cocos, a.k.a. fu ling), Zingiber officinale (ginger).

Epstein-Barr acute episodes can often lead to severe chronic fatigue. Part of the fatigue comes from its impacts on mitochondrial function. It scavenges and damages mitochondria, so protecting mitochondria is important. The best herbs and supplements for this are cordyceps, Leonurus cardiaca (motherwort), Passiflora spp. (passionflower), rhodiola, schisandra, Pueraria lobata (kudzu), Scutellaria baicalensis, and N-acetylcysteine. Some of these are also very good immune herbs that will help raise immune function. Motherwort and passionflower will also help reduce anxiety and sleeplessness.

Epstein-Barr, during acute attacks, usually presents with a very severe, very painful sore throat, usually confined mainly to one pinpoint location just at the back of the throat from the mouth. I haven’t found anything that will truly relieve it. Echinacea angustifolia (not E. purpurea) tincture will help a bit, if you use the tincture full strength. Keep it on the tongue a bit, let the saliva be stimulated, then let the whole mix flow slowly over the affected area. (But it won’t do anything for the disease itself.) The root of Artemisia absinthium can also help if you chew a fresh root, just a bit when needed. It will really cool (almost creating a freeze sensation) the back of the throat.

Treatment

If spleen enlargement occurs, use red root (Ceanothus spp.). With enlarged liver, milk thistle. With meningitis use the protocols in this book for encephalitic swelling (see chapter 3).

Herpes Simplex Virus 1 and 2

There are many herbs (and supplements) useful against herpes simplex viruses; here are some of them: Actinidia chinensis (kiwi tree root), Agrimonia pilosa (hairy agrimony), Andrographis paniculata (andrographis), Aristolochia debilis, Artemisia annua (artemisinin), Artemisia anomala, Astragalus membranaceus (astragalus), Azadirachta indica (neem), the berberine plants, Bidens pilosa (bidens), Boussingaultia gracilis, Byrsonima verbascifolia, Caesalpinia pulcherrima (a strong decoction of the flower is strongest, followed by stem/leaf preparations), Carissa edulis (root bark), Centella asiatica (gotu kola), Cordyceps sinensis (cordyceps), Crossostephium chinense, Cryptolepis sanguinolenta (cryptolepis), Cynanchum paniculatum, Distictella elongata, Ganoderma lucidum (reishi), Geum japonicum, Glycyrrhiza glabra (licorice), honey, houttuynia, isatis, Juniper spp., Limonium brasiliense, Lindera strychnifolia, Melia azedarach (chinaberry leaves, invasive in the United States), Melissa officinalis (lemon balm), Ocimum americanum (hairy basil), Ocimum basilicum (basil), Ocimum sanctum (holy basil, strongest of the three), Patrinia villosa, Phyllanthus niruri, Pinus massoniana, Pithecellobium clypearia (a.k.a. Archidendron clypearia), Pongamia pinnata (seeds), Prunella vulgaris (self-heal), Psidium guajava, Punica granatum (pomegranate juice), Pyrrosia lingua, Rheum officinale (rhubarb root), Rhus aromatica (fragrant sumac), Rhus chinensis (Chinese sumac), Rhus javanica, Rosmarinus officinalis (rosemary), Salvia officinalis (sage), Sargassum fusiforme, Scutellaria baicalensis (Chinese skullcap), Serissa japonica (a.k.a. S. foetida), Sida acuta (sida), Stephania cepharantha (stephania), Syzygium aromaticum, Taraxacum mongolicum, Terminalia chebula, Thymus vulgaris (thyme), Usnea spp., zinc, zinc sulfate cream.

Byrsonima verbascifolia is a South American herb; it is particularly antiviral for these two viruses but is hard to get in the United States. Bidens, reishi, licorice, and houttuynia are also especially strong. A combination Chinese formula, yin chen hao tang, composed of Artemisia capillaris, Rheum officinale, and Gardenia jasminoides, has shown good effect against HSV-1 and HSV-2.

Terminalia chebula, Syzygium aromaticum, Rhus javanica, and Geum japonicum have all been found potent against HSV serotypes. They have particularly strong actions in the brain and are synergistic with acyclovir, enhancing its actions and impacts. The use of these herbs, singly, or in combination, has been found to prevent recurrence of HSV blooms in vivo (mice). All are traditional herbs, long used in community medicine. They all have activity against a variety of viruses.

Treatment

To prevent outbreaks, try L-lysine, in a tonic dose of 1,000 mg 3x daily. (Note: If you do have an outbreak anyway, increase the dosage, up to 3,000 mg 3x daily. However, if taken regularly, the tonic dose can help prevent outbreaks from occurring.) Another helpful supplement is vitamin B12, 500 mcg daily (a good B-complex is very helpful as well). Avoid L-arginine supplements and foods containing L-arginine such as nuts and chocolate. These can stimulate outbreaks.

To treat active sores, you can use zinc sulfate cream, applied 6–10x daily. This can reduce and eliminate sores within 3–5 days. The sore-relief concentrated herbal cream in the sidebar on page 117 can do the same even more quickly, within 3 days.

To reduce nerve pain, some of the things that can help are:

For some specific expressions of HSV, incorporate these additional formulations into the protocol:

For vaginal herpes: Prepare a douche by combining 1 ounce of a berberine plant (e.g., goldenseal, barberry) tincture and 1 ounce of lemon balm tincture in a pint of water and use it to douche 3x daily.

For herpes eye infection: Prepare eyedrops by combining 1 ounce each of dried licorice, houttuynia, and isatis in a heat-proof quart jar. Bring water to a boil, then pour it over the herbs, stir well, cover, and let sit overnight. Strain well the next day. Pour some of the infusion into a 1-ounce brown bottle with dropper. Store the rest in the refrigerator. Use the eyedrops throughout the day, a minimum of 6x daily. Just 1–3 drops in each eye every hour or two until the condition clears.

For herpetic encephalitis/meningitis: Use the protocols for viral encephalitis delineated in depth in chapter 3. An ethanol extract of Cynanchum paniculatum has been found to be very effective in protecting the brain and neural structures in some studies and may prove useful here.

Caution: The use of L-arginine during an active herpes outbreak can sometimes exacerbate the condition excruciatingly.

Varicella Zoster Virus (Chicken Pox/Shingles)

Although chicken pox (varicella zoster virus) tends to be a self-limiting disease a vaccine has been developed in the West; a variety of it has also been crafted for herpes zoster (shingles). Shingles tends to be the most problematic element of this virus; it is often extremely painful and somewhat difficult to treat well.

I won’t explore the use of herbs for chicken pox itself since, with the vaccine, episodes in the West are becoming rare. However, modifications of the protocols outlined for shingles will help with chicken pox, especially the systemic and topical formulations. Treatment protocols in this section are specific only for shingles.

Some of the herbs and supplements effective for herpes zoster (shingles) are Ampelopsis brevipedunculata, Astragalus membranaceus (astragalus), Clinacanthus nutans, Ficus binjamina (leaves), Garcinia multiflora, Glycyrrhiza glabra (licorice), isatis, Lonicera japonica (Japanese honeysuckle), Melissa officinalis (lemon balm), Polygonum cuspidatum (Japanese knotweed), Quillaja saponaria (Chilean soapbark tree, inner bark infusion/decoction, low dosing), Rhus succedanea, Ribes nigrum (black currant).

Concentrated Sore-Relief Herbal Cream

Ingredients

To make

Combine the herbs in a crock-pot with 32 ounces of water. Bring to a boil. Reduce the heat to barely under a simmer. Cook for 3 days. Turn off the heat, let cool, strain out the herbs. Return the liquid to the cleaned crock-pot, bring to a boil again, then reduce heat to just under a simmer. Let cook until the liquid is reduced to 2 ounces. (Caution: It can easily burn once it gets close, so watch it.) When reduced sufficiently, turn off the heat, let cool, and place the cream in a jar.

To Use

Apply 6–10x daily. This combination will eliminate sores, reduce pain, and promote healing very quickly, usually within 3 days or so.

Treatment

The basic treatment for shingles comprises 1) systemic antivirals, 2) immune formulations, 3) topical creams for skin outbreaks, and 4) treatments to reduce nerve pain and regenerate nerve cells.

  1. 1. Systemic antivirals. I would suggest both of the following:
  2. 2.Immune formulation. Tincture combination of astragalus, rhodiola, and cordyceps, in equal parts, 12 teaspoon 3x daily. This will increase immune function and help reduce the incidence of future outbreaks. (Lowered immune function due to age is the main cause of shingles outbreaks after age 50.)
  3. 3.Topical healing. A couple of formulations can help here:
  4. 4.Nerve pain. The herbs and supplements recommended for reducing the nerve pain of herpes simplex virus outbreaks (see page 113) will also help reduce the nerve pain that accompanies a shingles outbreak.

Herbs can also help prevent or cure the postherpetic nerve pain that comes from nerve damage after outbreaks by regenerating the damaged nerves. Two of the best regenerators (both very high in nerve growth factor) are Chinese senega root and lion’s mane; vitamin B12 is also very helpful:

Supplements for both deep healing and nerve pain:

Regular fruit intake can also be important. Low fruit intake (less than one serving per week) can lead to more frequent outbreaks.

Note: L-arginine intake can sometimes cause a shingles outbreak. If you have a history of shingles, I would recommend avoiding L-arginine supplementation. (Nuts and dark chocolate are fairly high in L-arginine; caution is warranted.)

Rotavirus and Norovirus

Rotaviruses are the best studied of the viral gastroenteritis diseases, in terms of herbal treatments, but for all of them, tannin-containing plants are indicated for one big reason: they inactivate the viruses. In the case of the Norwalk virus, for example, tannic acid inhibits the binding of the viral proteins to HBGA (histo-blood group antigen) receptors, thus preventing infection. There have been a number of double-blind studies using tannic-acid-containing plants in the treatment of viral gastroenteritis, and all have shown good success. Researchers have tested plants traditionally used for this kind of condition and found many of them active. The most common and strongest: Musa spp. (the green, unripe banana fruit, usually cooked), Potentilla erecta (leaves), Potentilla tormentilla (root), and Psidium guajava (guava).

The plants found effective for rotaviruses are Aegle marmelos (unripe fruit), Artocarpus integrifolia (bark), Byrsonima verbascifolia, Eugenia dysenterica (a.k.a. Stenocalyx dysentericus), Glycyrrhiza glabra (licorice), Haemanthus albiflos (bulb), Hymenaea courbaril, Lomatium dissectum, Myracrodruon urundeuva, Myristica fragrans (seeds), Panax ginseng, Potentilla erecta (leaves), Potentilla tormentilla (root), Wolfiporia (a.k.a. Poria) and Polyporus in combination (as a decoction), Psidium guajava (leaves), Punica granatum (pomegranate leaves and juice), Quillaja saponaria, Sophora flavescens, Spondias lutea (a.k.a. S. mombin; leaves and bark), Stevia rebaudiana, Vaccinium macrocarpon (cranberry juice).

Plants have not been tested to any extent against astroviruses though Detarium senegalense and Dichrostachys glomerata are both active against the viruses. For orthoreoviruses, the barks of both Castanea (chestnut) and Schinopsis (quebracho) are active antivirals as well as tannin sources in general.

In essence, any plant that is strongly drying on the tongue is going to work: oak leaves or bark, Krameria (rhatany) root, pine needles (mature), acacia, agrimony, pinedrops (Pterospora), rose, raspberry, blackberry, and so on. Roots, leaves, and bark tend to be the most astringent parts of such plants. In my experience rhatany root, blackberry root, and pinedrops are some of the strongest, followed by quebracho, oak, and pine needles, but really, any astringent plants will do. It is just that the stronger they are, the faster they work.

Other useful plants are:

Treatment

The treatment of these viral gastroenteritis diseases is straightforward, and while you can get fancy with this, it primarily entails the use of any plants strong in tannins, in large quantities. My preference is for their use as decoctions but even that is not necessary; unripe banana is especially useful in the regions in which it grows, for example, and is usually used as a mashed, cooked ingestible. Plants high in tannins bind the viruses while, at the same time, reducing fluid loss through firming up the stool.

Some suggestions: