Ebola and homeopathy

A few months ago I wrote a fairly patronising summary of the ebola situation as was, and optimistically opined that perhaps the problem had been exaggerated by the media. Annoyingly, the disease has yet to burn itself out and the most current data from the WHO reports that there have now been at least 13,700 cases and 4,900 deaths.

In the UK there has been only one, imported, case of ebola. This was William Pooley, who contracted the disease in Sierra Leone and was transferred to London in August. He was treated with the new drug ZMapp, made a full recovery and has returned to Sierra Leone to continue his help.

The vast majority of cases remain in the West African countries Guinea, Liberia and Sierra Leone, and so it remains quite unlikely that infected people from these areas will reach the UK and transmit the virus here. The risk is certainly not zero however, and so Britain is currently continuing with preparations for this possibility. Most trusts have published protocols and guidance for dealing with suspected ebola cases.

Spotted in a Birmingham Hospital's ITU

I attended a lecture at my hospital on the subject, and learnt about the procedures to reduce the risk of infection, such as extra PPE and keeping such patients isolated in negative pressure rooms. Importantly, the staff were warned not to transfer suspected blood samples to the lab via the pneumatic tube system we would usually use, in case the blood vials were to break and effectively aerosol the blood and virus all around the hospital.

Ebola not welcome: A sign on the entrance to an Edgbaston GP Practice

Perhaps the most important intervention will be the use of homeopathy to combat the epidemic. Resources should clearly be diverted to the development and distribution of a homeopathic cure, you can help by signing a petition to urge the WHO to do just this. Sign it HERE*.

The good news is that a team of homeopaths have been mobilised to frontline West Africa to begin this important work.

A cynical person might suggest that sending homeopaths to ebola zones is evidence of natural selection at work. This is a cruel joke, and meaningless too because evolution doesn't exist.

Some homeopathic pills to treat Malaria

Anyway, you can already easily buy homeopathic treatment for most diseases online, including pills for dengue, meningitis and tuberculosis.

And of course mercifully there are several homeopathic clinics in Africa many of which offer cures for HIV and AIDS. Not sure if I've mentioned on this blog but I went to Tanzania earlier this year. I’ve seen a little of how devastating HIV can be to communities and individuals, but luckily charities exist that aim to help reduce this suffering. This is one of them, http://www.homeopathyforhealthinafrica.org/ and it has characteristically virtuous aims:

- To relieve the suffering of HIV/AIDS patients using classical homoeopathy
- To identify the homoeopathic remedies most successful in treating HIV/AIDS
- To spread this knowledge throughout Tanzania and Africa
- To produce formal, ethical research
- To prove to the world what homoeopathy can do

For the unenlightened, homeopathy involves taking an ingredient that causes harm and diluting it significantly, thereby releasing its healing power. The standard dilution (such as for the linked cures for dengue and meningitis above) is “30C”, meaning the original drop has been diluted by 1 drop in 100, 30 times. So 30C means one part in 1060.
This level of dilution, such that there are zero molecules of ingredient left in the treatment, is vital for the homeopathy to work.

Regrettably however, the benefits of homeopathy are denied by some groups – for example educated people and "scientists". For example, some of these “scientists” published a paper in the Lancet that compared 110 studies of homeopathy with 110 conventional medicine studies and concluded that the effects of homeopathic interventions are merely placebo effects. (1)

The 2009 official WHO statement is similarly closed minded:

“There is no place for homeopathy in treating serious illness such as HIV, TB, malaria and infant diarrhoea in developing countries.”

Quite clearly a needlessly obstructive and unhelpfully negative attitude.

In all seriousness I wish the homeopathy team in Africa the very best and sincerely hope that they manage to avoid infection,  and especially so to prevent the spread of the disease further.



*Please do not sign this stupid petition


The reference for the paper I mentioned is:
1. Shang A, Huwiler-Müntener K, NarteyL, Jüni P, Dörig S, Sterne JA, et al. Are the clinical effects of homoeopathyplacebo effects? Comparative study of placebo-controlled trials of homoeopathyand allopathy. Lancet. 2005;366(9487):726-32.

On the Human Immunodeficiency Virus

Day 7

The HIV virus (Human Immunodeficiency Virus virus)

I have been interested in infectious disease since I did a few relevant modules in my undergraduate degree, but in the UK the topic is mostly confined to STIs - I’m not a fan. Tropical medicine is limited by geography (caveat something something global warming), the main reason I chose to come to Tanzania (I also span the globe at random). A common, important and interesting infection is HIV and today I had my first real exposure*. Since this is blog is kind of supposed to be about medicine I’ll be including small bits of science and stuff – I won’t be offended if any of my imaginary readers decide to skip it. Sorry if I patronise the imaginary medically-minded readers.

Every Wednesday and Friday patients attend the building next to our guest house for a monthly clinic to follow up their HIV infection, and I sat in on this morning’s. I have obtained a variety of different figures for the HIV prevalence here from different doctors, varying from 5-50%, but the clinic sees about 600 different patients each month. I suppose that there are large numbers of undiagnosed cases as it is asymptomatic in early stages and testing is infrequent (HIV status is not tested before operations), so the true number (locally, nationally and globally) is unknown. Unfortunately many patients at Machame will present late and may have cerebral complications (WHO Stage IV disease) such as toxoplasmosis causing hemiplegia (one-sided paralysis).

The running of the clinic and management of patients is much the same as in the UK and is run according to a sophisticated and extensive pro-forma. Patients have their health checked monthly, and CD4 count every 6 months. As on the NHS, treatment with combination anti-retrovirals is started when the count is below 350 or if the patient is pregnant, and the treatment is changed if it becomes ineffective or there are unmanageable side effects. TB co-infection is common - combination treatment is given as in the UK - and co-trimoxazole is often given as prophylaxis against PCP (PJP) pneumonia (which is either a protozoan or a fungus depending who you ask). The drugs are free for the patients, funded mostly by donations.

The briefest history of HIV
In the early 1980s a new disease spread quickly through gay communities in the USA. The causative agent itself was only identified in 1983 – a virus that spreads through blood-blood contact. Genome analysis indicates that it arose from a similar disease of other primates (SIV) around the Congo River basin, crossing to humans via human consumption of bushmeat: primates such as sooty mangabeys and gorillas.  Of the over 35million (and rising) people infected with HIV, 25% are in Africa, though the continent enjoys only 1% of the wealth. I read some time ago that 95% of new infections are in the developing world, and over half of these do not have access to treatment. I’m still impressed that such a devastating disease can arise, from nowhere, in such a short space of time.  

In the face of these depressing facts I was very pleased to learn that HIV seems to be well managed in Machame, and, (uncharacteristically for me) I think there are reasons to be optimistic. Globally there has been a large scientific response to the challenge; the disease is now quite well understood and education regarding transmission prevention is increasing (circumcision reduces transmission by 65%). There are even whispers of an eventual vaccine. The advent of combination antiretroviral therapy has completely changed the course of the disease such that in the UK patients who are treated for HIV actually have a slightly higher life expectancy than the general population – due to increased contact with health services and increased health awareness. 

Finally a brief internet update: the satellite at the hospital seems to be broken so I'm currently only online at this coffee shop in Moshi. Updates and communications might slow to a crawl. Do not adjust your set.

*i.e. exposure to HIV patients and treatment, not exposure to the virus personally – I think