We will discuss research collected over the years related to influenza A (H1N1).
The Mutation Problem
There are only a handful of FDA approved drugs for treatment of H1N1 today. One of the most common ones is oseltamivir (Tamiflu®). The problem arising is influenza virus proteins are mutating into drug resistant strains and multiplying. In the United States the 2013-2014 flu season 1.2% of patients infected with H1N1 had the strain resistant to oseltamivir [1]. In Norway, their 2015-2016 flu season 3% of influenza patients had the strain resistant to oseltamivir [2]. This shows how critical it is to monitor how these drug resistant strains are propagating and develop counter drugs.
Why Essential Oils Come in
As these synthetic drugs are showing a decrease in their effectiveness, novel research is diving into examining the antiviral effects of essential oils. The natural antiviral effects of plants could be key in creating a drug that kills these viruses. Plants natural ability to fight viruses would use compounds these viruses don't have a resistance to.
Essential Oils With Promising Effects Against H1N1
Lemon Balm
Lemon balm is a bushy plant in the mint family native to south-central Europe. A study conducted at Ardakan Univeristy examined H1N1 antiviral effects of Melissa officinalis (lemon balm) compared to oseltamivir [3]. The study received a sample of Human influenza A virus, 2009 pandemic new H1N1 strain from the Shiraz University in Iran. The virus was added to cell cultures with various concentrations of oseltamivir and Melissa officinalis. The results show all concentrations of oseltamivir reduced the levels of the virus by 100%. Melissa officinalis was not perfect but still significantly decreased the levels of the virus between 71%-93% depending on the concentration. The study concluded Melissa officinalis could be an important part in treating and preventing strains of the H1N1 virus. Especially when a new active ingredient is necessary.
Patchouli
A study published in the Journal of Natural Medicines described how Patchouli (Pogostemon cablin) has "potent in vitro antiviral activity (99.8% inhibition at a concentration of 10 μg/mL) against influenza virus A/PR/8/34 (H1N1)." [4]. It was observed that Patchoulol was the compound in Patchouli that has the fighting power against the virus.
The Big Picture
Experimental treatments for COVID-19 are actually exploring drugs that are used for H1N1 and HIV. A recent clinical trial of 138 patients in Wuhan, China, 89% of patients were given oseltamivir [5]. No effective outcomes were observed. Unfortunately we have very little data over Coronavirus. What we do have is information from previous pandemics of what we need to be aware of moving forward. This means once we have treatment for COVID-19, we must continue clinical trials to be one step ahead when the virus inherently mutates. This means continuing research into expanding our synthetic drugs as well as rapidly increasing our knowledge of the unique medicinal benefits of essential oils.
[1] Okomo-Adhiambo M, Fry AM, Su S, Nguyen HT, Elal AA, Negron E,
et al. Oseltamivir-resistant influenza A(H1N1) pdm09 viruses, United
States, 2013–14. Emerg Infect Dis 2015;
[2] Bragstad, K, Hungnes, O, Litleskare, I, Nyrerød, HC, Dorenberg, DH, Hauge, SH. Community spread and late season increased incidence of oseltamivir‐resistant influenza A(H1N1) viruses in Norway 2016. Influenza Other Respi Viruses. 2019; 13: 372– 381.
[3] Pourghanbari Marvast, Gholamhosein & jalali, parvaneh. (2016). Melissa officinalis efficacy against human influenza virus (New H1N1) in comparison with oseltamivir. Asian Pac J Trop Dis. 6. 714-717. 10.1016/S2222-1808(16)61115-5.
[4] Kiyohara, Hiroaki & Ichino, Chikara & Kawamura, Yuka & Nagai, Takayuki & Sato, Noriko & Yamada, Haruki. (2011). Patchouli alcohol: In vitro direct anti-influenza virus sesquiterpene in Pogostemon cablin Benth.. Journal of natural medicines. 66. 55-61. 10.1007/s11418-011-0550-x.
[5] Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. Published online February 07, 2020. doi:10.1001/jama.2020.1585