Oscillococcinum for influenza
Today, as I recover from the throes of my recent influenza or influenza-like-illness, I opened a package that has been sitting on my desk for a week, that came in the mail. It contained a free sample of oscillococcinum, the accompanying material claims that it is proven to reduce the severity and duration of the flu if given at the early onset of symptoms.
What is Oscillococcinum? The box says Anas barbarie hepatis et cordis extractum, aka heart and liver extract from the Muscovy Duck.
I did a Medline search and found this:
The Cochrane Database of Systematic Reviews,Volume (4),2004, Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes,Vickers, AJ; Smith, C. Here are some excerpts:
Conclusions: Though promising, the data are not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndrome. Further research is warranted but required sample sizes are large. Current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes.
That is a little different from the study quoted in the literature that came with my free sample, Casonova et al 1983. This is what the Cochrane review says about that study in particular:
The main difficulty is that one of the trials, Casanova (Casanova 1984), was not published in a standard medical journal, contains little experimental detail, does not report withdrawals and analyses a suspiciously round number of patients. Moreover, the difference between groups in the meta-analysis only just reaches statistical significance. It is arguable that a question as scientifically controversial as whether homeopathic medicines are always equivalent to placebo would require more statistically robust data.
A final word on the implications for further research from this study:
It is open to debate whether further research is warranted on homeopathic medicines to prevent influenza and influenza-like syndrome. Using the control event rate from the meta-analysis of Attena (Attena 1995) and Nollevaux (Nollevaux 1990) (24%), a minimal, clinically significant difference of five per cent and a power of 90 per cent gives 1457 patients per group. Such a trial would require significant resources, the investment of which is questionable given the equivocal nature of the current data.
My free sample is now in the trash, but for some the placebo effect may be worthwhile if it is cheap and safe. However what I find interesting is the homeopathic rationale for this treatment, 'let like be cured by like' based on the fact that these migratory waterfowl are the major reservoirs for the virus. It is also interesting that the method of producing this medicine dilutes it so extensively that a typical dose doesn't even contain a single molecule of the active ingredient(Kayne SB. Homoeopathic pharmacy 1997;Churchill Livingstone, Edinburgh.). If the 'like cures like' model were effective, I would think stopping in at KFC a couple of times a week would really do the trick.
Here is a story from Homeowatch that gives the history of this product's use and makes note of the fact that even the scientific name of the duck is wrong. It makes the use of this stuff seem just plain silly.