Safety and efficacy of hyptis suaveolens extract for therapy of influenza in healthy adults.

Objective: To determine the safety and efficacy of H.suaveolens extract for therapy of influenza in healthy adults. Methods: The study was randomized double blind placebo controlled study conducted in 15 community and general hospitals from May to August 2006. The study subjects were healthy adults who had influenza-like symptoms and positive preliminary diagnostic test for influenza A or B from respiratory secretions. They were randomized to receive H.suaveolens extract 500 mg 3 times daily or the placebo 3 times daily for 7 days. The subjects were evaluated for the severity of symptoms related to influenza, adverse effects of the medications and the presence of influenza viruses from respiratory secretions at entry, day 4 and day 7 after treatment. Results: There were 39 subjects in the placebo group and 46 in the H.suaveolens group. There was a significant improvement in symptoms of the patients in both groups on day 4 and day 7 when compared with that at entry. However, the average duration of fever of the patients in both groups was not significantly different (3.1 days in the placebo group vs. 3 days in the H.suaveolens group, p=0.749). The recovery rates of influenza A and influenza B viruses from respiratory secretions of the subjects on day 4 and day 7 after treatment in both groups were not significantly different. A trend of less positive culture for influenza A virus in the patients receiving H.suaveolens extract (32.5%) compared with those receiving a placebo (47.1%) was observed. The compliance to medications was satisfactory. No serious adverse effects due to study medications were observed. Conclusion: H.suaveolens extract 1.5 grams per day for 7 days is safe but it is not effective in relieving influenza-related symptoms in adults with influenza. The lack of efficacy of H.suaveolens extract might be due to an insufficient dosage of the extract.

Early containment of severe acute respiratory syndrome (SARS); experience from Bamrasnaradura Institute, Thailand.

BACKGROUND: On March 11, 2003, a World Health Organization (WHO) physician was admitted to Bamrasnaradura Institute, after alerting the world to the dangers of severe acute respiratory syndrome (SARS) in Vietnam and developing a fever himself. Specimens from the first day of his admission were among the first to demonstrate the novel coronavirus, by culture, reverse transcription-polymerase chain reaction (RT-PCR), and rising of specific antibody, but proper protective measures remained unknown. The authors instituted airborne, droplet and contact precautions from the time of admission, and reviewed the efficacy of these measures. MATERIAL AND METHOD: A specific unit was set up to care for the physician, beginning by roping off an isolated room and using a window fan to create negative pressure, and later by constructing a glass-walled antechamber, designated changing and decontamination areas, and adding high-efficiency particulate air (HEPA) filters. The use of personal protective equipment (PPE) was consistently enforced by nurse managers for all the staff and visitors, including a minimum of N95 respirators, goggles or face shields, double gowns, double gloves, full head and shoe covering, and full Powered Air Purifying Respirator (PAPR) for intubation. To assess the adherence to PPE and the possibility of transmission to exposed staff a structured questionnaire was administered and serum samples tested for SARS coronavirus by enzyme-linked immunosorbent assay (ELISA). Exposure was defined as presence on the SARS ward or contact with laboratory specimens, and close contact was presence in the patient's room. RESULTS: The WHO physician died from respiratory failure on day 19. 112 of 129 exposed staff completed questionnaires, and the 70 who entered the patient's room reported a mean of 42 minutes of exposure (range 6 minutes-23.5 hours). 100% reported consistent handwashing after exposure, 95% consistently used a fit-tested N95 or greater respirator, and 80% were fully compliant with strict institutional PPE protocol. No staff developed an illness consistent with SARS. Serum samples from 35 close contacts obtained after day 28 had a negative result for SARS coronavirus antibody. CONCLUSIONS: Hospitalization of one of the earliest SARS patients with documented coronavirus shedding provided multiple opportunities for spread to the hospital staff, but strict enforcement of conservative infection control recommendations throughout the hospitalization was associated with no transmission.