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October 16, 2009
The September phenomenon
A report published in the October 13, 2009 issue of the Canadian Medical Association Journal revealed the results of a study conducted by researchers in Greece which found a significant reduction in mortality in several countries during the late summer months of August and September compared with the remainder of the year.
Acting on their finding of a decrease in September patient visits over the past decade, researchers at the Alfa Institute of Biomedical Sciences examined mortality statistics for Greece, Cyprus, France, Italy, Spain, Sweden, the United States, Canada, Australia, New Zealand and Japan for the past 2 to 57 years. Average daily mortality was calculated for each month of every year for which data was available.
For the five Mediterranean countries included in the study, September had the lowest average daily mortality. The lowest average daily mortality occurred in September for 4 of the 9 years evaluated for Cypress, 3 of the 11 years evaluated for France, 42 of the 47 years for Greece, 41 of the 57 years for Italy, and 34 of the 44 years evaluated for Spain. August emerged as the month with the lowest mortality for Sweden, Canada and The United States, with the lowest daily mortality occurring in August for 14 of the 20 years evaluated for Sweden, for 10 of the 16 years evaluated for Canada, and in 22 of the 34 years evaluated for the U.S. Although only two years of data were available for Japan, mortality was lowest in July for both years. For Australia and New Zealand, which lie in the earth's southern hemisphere, average mortality was lowest in March and February.
The authors did not include England, Wales, the Netherlands, Denmark and Portugal in their analysis because these countries had been evaluated in earlier research which revealed a pattern of mortality similar to that found in the current study. In their interpretation of the findings, the authors note that excessively cold or hot temperatures have been associated with increased deaths. They also speculate that summer vacations could have both psychological and physical benefits. "Greater exposure to sunlight leads to increased synthesis of vitamin D, which may have beneficial effects for cardiovascular disease, renal failure, certain malignant diseases, autoimmune disorders and infections, including influenza," they write.
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There are two main types of flu viruses: influenza A and influenza B. The most serious and deadly flu outbreaks are caused by influenza A because of its ability to genetically shift into new forms against which no person has developed immunity.
The immune response to the flu is complex and comprehensive. Almost immediately after sensing the virus, the body mounts a response that calls upon all facets of the immune system. This includes natural immune responses, such as the release of proinflammatory cytokines and enhanced natural killer cell activity, which includes the release of antiviral interferons. White blood cells called neutrophils and macrophages also flood the site of infection, producing yet more proinflammatory and fever-causing cytokines. This rapid, indiscriminate immune response is responsible for the sudden onset and continuation of symptoms, which usually peak by the second day of infection (Wright PF et al 2001; Yuen KY et al 2005).
Lactoferrin is a subfraction of whey and has antiviral, antimicrobial, anticancer, and immune-enhancing effects. Lactoferrin is concentrated in the saliva, where it comes into direct contact with pathogens and kills or suppresses them through a variety of mechanisms (Kawasaki Y et al 1993; Schoen P et al 1997). Lactoferrin may stimulate macrophages, which in turn may help induce cell-mediated immunity (Zimecki M et al 2002). Lactoferrin is present naturally in many mucous membrane secretions, suggesting an innate antimicrobial function (Nishiya K et al 1982; Zimecki M et al 2002). A recent study showed that lactoferrin inhibits viral infection by interfering with the ability of certain viruses to bind to cell receptor sites (Waarts BL et al 2005).
Studies show that a black elderberry extract (Sambucol) has antiviral properties against 10 strains of influenza virus. In a double-blind, placebo-controlled, randomized study, elderberry extract reduced the duration of influenza symptoms by 1 to 2 days (Barak V et al 2001; Zakay-Rones Z et al 1995).
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