AWAREmed Health and Wellness Resource Center offers to Doctors and patients alike a simple solution to combating the Flu Naturally. Using food as Medicine, Herbs and botanical as medicine, Exercise and laughter as Medicine. How to Prevent and combat the flu naturally by understanding how the viruses behave?

1. INFLUENZA
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2012
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1

2. Influenza Disease Burden in the United States in an
Average Year
Deaths*
Hospitalizations*
3,000
to
49,000
117,000
to
816,000
Physician
visits
~25
million
Infections
and
illnesses
50
to
60
million
*
All-­‐cause
hospitalization
and
mortality
associated
with
influenza
virus
infection.
Thompson WW et al. JAMA. 2003;289:179-186; Thompson WW et al. JAMA. 2004;292:1333-1340;
Couch RB. Ann Intern Med. 2000;133:992-998; Patriarca PA. JAMA. 1999;282:75-77; ACIP. MMWR. 2004;53(RR06):1-40;
MMWR. 2010; 59(33): 1057-1062.
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©
2012
AWAREmed
All
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Reserved.

3. South
Carolina
1996-­‐1997
DHEC
bulletin
malathia
influenzae
per
le
stelle
no
virus
CULTURE
influenza
A
RESULTS
influenza
B
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©
2012
AWAREmed
All
Rights
Reserved.

4. BUSINESS
Flu
Combating
Algorithm
STRATEGY
1. Understand
Your
*Food
as
Medicine,
Enemy
–
Virus
Flu
*Herbs
as
Medicine
2. Understand
its
strategies
Build
a
Stronger
*Exercise
as
Medicine
Immune
System.
*Sleep
as
Medicine
Enhance
the
body
own
power
and
deffence
tools
.
Use
ll
the
Natural
Love
as
Medicine
resources
ito
Laughter
asMedicine
achieve
a
safe
and
Spiritusality
as
Medicine
healthy
Winter
Copyright
©
2012
AWAREmed
All
Rights
Reserved.

5. FLU
Fighting
BUSINESS
Strategies
STRATEGY
Missions
and
Goals
Strategic
planning
Implementa:on
Know
Your
Enemy
Successfully
avoid
the
Flu
and
Understand
Viruses
Arm
yourself
with
remain
ealthy
and
aawell
and
all
there
the
tools
that
during
aaaaflu
aseason
behaviors
to
know
counteract
the
effect
how
to
properly
of
the
virus.
Combat
Them
1. Food
as
Medicine,
Build
a
Stronger
Immune
1. Understand
how
the
2. Herbs
as
Medicine
System.
Flu
Is
transmitted
3. Exercise
as
Medicine
Enhance
the
body
own
2. Recognize
early
4. Love
as
Medicine
power
and
deffence
tools
Symptoms
of
the
Flu
5. Laughter
as
Medicine
to
combat
and
prevent
flu
6. Spiritusality
as
Medicine
1. Interferon
Concept
Use
ll
the
Natural
1. Know
yor
Body
2. Enzyme
resources
ito
achieve
a
3. Replace
your
flora
safe
and
healthy
Winter
2. Know
Your
4. Healthy
PH
Friends
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2012
AWAREmed
All
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Reserved.

6. How
Ca
Virus
High
Mucosal
Cigarette
Acidity
Smoke
• Viruses
like
seeds
they
Poor
Mucosal
cannot
grow
and
germinate
Altering
defense
unless
all
they
have
opZmal
Flora
condiZons
High
SuscepZbility
Flu
develops
Copyright
©
2012
AWAREmed
All
Rights
Reserved.

7. The
Magical
Network
Spirit
–
Body
-­‐
Mind
Internal
Body
invironment
and
Immunity
External
Environment:
O2,
Toxin
Water,
Food,
Herbs,
Sun,
Supplement
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©
2012
AWAREmed
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Rights
Reserved.

8. TRANSMISSION
s AEROSOL
s 100,000
TO
1,000,000
VIRIONS
PER
DROPLET
s 18-­‐72
HR
INCUBATION
s SHEDDING
8

9. Influenza: Who s at risk?
s Everybody
s People with greater risk:
Ø ≥ 65 years old
Ø Patients with chronic diseases
Ø Asthma/Lung chronic disease
Ø Chronic Heart Disease
s ≤ 5 years old

10. s DECREASED
CLEARANCE
s RISK
BACTERIAL
INFECTION
s VIREMIA
RARE
10
Lycke
and
Norrby
Textbook
of
Medical
Virology
1983

11. RECOVERY
s INTERFERON
-­‐
SIDE
EFFECTS
INCLUDE:
s FEVER,
MYALGIA,
FATIGUE,
MALAISE
s CELL-­‐MEDIATED
IMMUNE
RESPONSE
s TISSUE
REPAIR
s CAN
TAKE
SOME
TIME
11

12. interferon-­‐alpha,
interferon-­‐beta
interferon
receptor
induction
of
induction
of
induction
of
a
2ʼ’5ʼ’oligo
A
synthase
ribonuclease
L
protein
kinase
ds
RNA
2ʼ’5ʼ’oligo
A
ds
RNA
activated
activated
activated
2ʼ’5ʼ’oligo
A
synthase
ribonuclease
L
protein
kinase
ATP
ATP
phosphorylated
initiation
2ʼ’5ʼ’oligo
A
factor
(eIF-­‐2)
mRNA
degraded
inhibition
of
protein
synthesis
12

13. ORTHOMYXOVIRUSES
HA
-­‐
hemagglutinin
NA
-­‐
neuraminidase
helical
nucleocapsid
(RNA
plus
NP
protein)
lipid
bilayer
membrane
polymerase
complex
M1
protein
type
A,
B,
C
:
NP,
M1
protein
sub-­‐types:
HA
or
NA
protein
13

14. ORTHOMYXOVIRUSES
pleomorphic
influenza
types
A,B,C
febrile,
respiratory
illness
with
systemic
symptoms
http://www.uct.ac.za/depts/mmi/stannard/fluvirus.html
14

16. CAUSE:
RNA
Virus
s file:///Users/outreach/ s
The
influenza
virus,
Desktop/DESKTOP commonly
known
as
the
%202008/curr flu,
is
an
infectious
%20project/Image-­‐3D disease
of
birds
and
%20Influenza%20virus
mammals
caused
by
RNA
viruses.
Commonly
confused
with
a
cold,
the
flu
is
a
much
more
severe
disease
and
http://en.wikipedia.org/wiki/Image:3D_Influenza_virus.png
caused
by
a
different
virus.

17. Key Influenza A Viral Features
Two Surface proteins(major antigens)
s Hemagglutinin (HA)
HA
s Site of attachment to host cells
• Antibody to HA is protective
s Neuraminadase (NA)
• Helps release virions from cells
NA Antibody to NA can help modify disease
•
17 severity

19. INFLUENZA
A
PANDEMICS
19

20. Type A influenza
16 HA subtypes
cannot be eradicated
9 NA subtypes
α2-6Gal
α2-3Gal
α2-3Gal
α2-6Gal
α2-3Gal α2-6Gal

21. where
do
new
HA
and
NA
come
from?
s 13
types
HA
s
9
types
NA
s all
circulate
in
birds
s pigs
s avian
and
human
21

22. where
do
new
HA
and
NA
come
from?
22

23. Reassortment

24. Pandemic Influenza 2009 - Natural history of swine influenza
North American Swine Influenza Eurasian Swine Influenza
(~last 12 years)
trH3N2
trH3N2
cH1N1
trH1N2
H3N2
cH1N1
trH1N1
PB2 = North Am. Avian
H1N1
PB1 = Human
PA = North Am. Avian PB2 = H3N2 swine
HA = Human PB1 = H3N2 swine
2009 swine-like H1N1
NP = Classical swine PA = H3N2 swine
American flu
NA = Human HA = Classical swine
M = Classical swine NP = Classical swine
NS = Classical swine NA = Eurasian swine
M = Eurasian swine
NS = Classical swine

25. 1918
H1N1 Spanish flu
>20 million deaths
1957
H2N2 Asian Flu
Pandemic influenza strains contain
~2 million deaths
genes from the avian reservoir
1968
H3N2 Hong Kong Flu
~700,000 deaths
1977
? H1N1 Russian Flu
2009
H1N1 American Flu

26. Neuraminidase Inhibitors
Surface glycoprotein genes “Tamiflu” “Relenza”
HA and NA
X
Release
HA NA
Master donor ER - Golgi
strain genes
AAAA
PB2 PB1 PA AAAA
AAAA
NP M
NS Packaging and Budding
Transfection of plasmids
into cells
Nucleus
AAAA
X
IFN
AAAA
Host mRNAs
Receptor binding and Entry
Uncoating
Amantadine X+
H
Endocytosis
“Symmetrel”
“Flumadine”

27. Influenza virus Reverse Genetics
viral protein
translation
cap AAAA
mRNA
RNA polymerase II (pol II)
pIICMV pABGH
ATG--------- viral cDNA -------TAA
tI pIh
RNA polymerase I (pol I)
(-) vRNA ppp
3‘ 5‘

28. why
do
we
not
have
influenza
B
pandemics?
s so
far
no
shifts
have
been
recorded
s no
animal
reservoir
known
28

29. Spreading

32. Fig.
13.11

33. Anatomy
of
Nose
and
Sinuses

34. Anatomy
of
Nose
&
Sinuses,
cont.

35. Fusion Schematic
Fusion
Schematic
1)
HA
binds
a
cell
GP
at
a
Sialic
Acid
Binding
Site
http://ubik.microbiol.washington.edu/microm-­‐pabio445/MM_445_lec3_2002_files/MM_445_lec3_2002.ppt

36. Fusion Schematic
Fusion
Schematic
1)
HA
binds
a
cell
GP
at
a
Sialic
Acid
Binding
Site
Low
pH
2)
Clathrin-­‐Coated
pit
endocytoses
virion
http://ubik.microbiol.washington.edu/microm-­‐pabio445/MM_445_lec3_2002_files/MM_445_lec3_2002.ppt

37. Fusion Schematic
Fusion
Schematic
1)
HA
binds
a
cell
GP
at
a
Sialic
Acid
Binding
Site
3)
Conformational
Change:
Hydrophobic
binding
of
HA
to
vesicle
membrane
Low
pH
2)
Clathrin-­‐Coated
pit
endocytoses
virion
http://ubik.microbiol.washington.edu/microm-­‐pabio445/MM_445_lec3_2002_files/MM_445_lec3_2002.ppt

38. Fusion Schematic
Fusion
Schematic
1)
HA
binds
a
cell
GP
at
a
Sialic
Acid
Binding
Site
3)
Conformational
Change:
Hydrophobic
binding
of
HA
to
vesicle
membrane
Low
pH
2)
Clathrin-­‐Coated
pit
endocytoses
virion
4)
RNPs
are
released
into
cytoplasm
for
replication
and
transcription
(vRNA
and
mRNA)
http://ubik.microbiol.washington.edu/microm-­‐pabio445/MM_445_lec3_2002_files/MM_445_lec3_2002.ppt

39. Cellular
targets
B)
Inhibitors
of
cellular
factors
that
regulate
the
virus
life
cycle
Hillaire
et
al.
(P-­‐452)
Collectin
pSP-­‐D
Nicol
et
al.
(P-­‐449)
FLUPEP
DAS181 Budding
Adsorption
"
Packaging
Entry Posttranslational Actin
Processing Rab 11
Endocytosis Translation
Rabs, V-type ATPases
PKC
Fusion and
Release
RNP-
mRNA
Export
vRNA (-)
CRM1
Hsc70
Import
Importins
cRNA (+)
NUP153
NUPs

40. Cellular
targets
Viral
penetration
of
cellular
barriers
is
controlled
by
cellular
signaling
cascades
Budding
Adsorption
RTKs (e.g. EGFR)
Eierhoff et al. (2010)
PLoS Pathog (in press)
Packaging
PI3K Posttranslational Raf/MEK/ERK
Processing
Entry Pleschka et al. (2001) Nat Ce
Endocytosis Translation
IKK/NF-kB
Wurzer et al. (2004) Cell Micr
Wurzer et al. (2003) EMBO J.
Fusion and
Release
RNP-
mRNA
Export
vRNA (-)
Import
cRNA (+)

41. INTERFERON
41

42. INTERFERON
antiviral
state
antiviral
state
antiviral
state
antiviral
state
42

43. INTERFERON
antiviral
state
antiviral
state
antiviral
state
antiviral
state
43

44. INTERFERON
antiviral
state
antiviral
state
antiviral
state
antiviral
state
44

45. INTERFERON
THE
VIRUSES
ARE
COMING!
PAUL
REVERE
http://www.mfa.org/collections/one_hour/6.htm
45
http://www.paulreverehouse.org/midnight.html

52. Echinecea

53. Elder
Berry

54. Fruits

55. Garlic

56. Bee
Propolis

57. Olive
Leaf

58. Education
and
Awareness
s Consult their physician before taking other medication, including
OTCs
s Good hygiene
s Antiviral drugs are not cures but help manage
symptoms