Viral Disease and Medicine Survey

Hospitals & Asylums

Anti-Viral Medicine for the Treatment of Chronic Disease HA-24-4-11

By Anthony J. Sanders

Viruses are the smallest infectious agents. Outside living cells, viruses are wholly inert. Their sole activity is to invade the cells of other organisms, which they takeover to make copies of themselves, using genetic information. Viral infections range from warts, the common cold and other minor respiratory tract infections and hepatitis, to extremely serious diseases, such as rabies, AIDS, and at least 18% of all types of cancer. Highly effective vaccines prevent poliomyelitis, measles, mumps, rubella, hepatitis, yellow fever, human papilloma, rotavirus and post-exposure rabies. AIDS drugs have reduced HIV infection and mortality worldwide. The rotavirus vaccine (2006) reduced childhood ER visits for gastroenteritis by 85%. LigoCyte is beginning phase II trials of an intranasal norovirus vaccine. Teva Pharm is authorized to manufacture the adenovirus vaccine, discontinued in 1996, after epidemics took 5 lives. The FDA removed 600 cold and flu remedies and approved Allegra OTC. Corticosteroid inhalers discontinued for fluorocarbon concerns can substitute Flovent. Acyclovir, topical and pegylated interferon alpha-2B, Foscarnet sodium and Immune Globulin IV treat a broad spectrum of the viral vectors of chronic disease surveyed.

1. Virology

2. Respiratory Infections

3. Enteroviruses

4. Skin Eruptions

5. Hemorrhagic Fevers

6. Retroviruses

7. Viral Oncology

Table 1: Viral families

Table 2: Some laboratory procedures in diagnostic virology

Table 3: Stages of virus replication at which chemical inhibition of virus action is known to occur

Table 4: Diagnosis and treatment of respiratory infections

Table 5: Acute gastroenteritis (AGE) medicine

Table 6: Topical antiviral medicine

Table 7: Viral zoonotic fever

Table 8: Seven classes of retroviral medicine

Table 9: Common AIDS Symptoms and Medicine

Table 10: Some human cancers that may be caused by viruses

Table 11: Human viral pathogens and medicine

References

1. Virology

Infectious organisms belong to a wide range of classes and vary in size from the 2-nm poliovirus to 10-m tapeworms. Viruses are the smallest known types of infectious agent. Viral pathogens account for a major share of all human infections (Samuelson & von Lichtenberg ’94: 306). The number of different kinds of virus probably exceeds the number of types of all other organisms. Viruses are about one half to one hundredth the size of the smallest bacteria. Viruses are smaller than cells, ranging in size from 0.02 µm to 0.3 µm. A common unit of measure for viruses is the nanometer, which is 1000 times smaller than 1 µm and one million times smaller than 1 mm. Smallpox virus, one of the largest, is about 200 nm in diameter, polio virus, one of the smallest, is only 28 nm in diameter (Brock et al ’94: 185). Viruses that cause human disease are grouped into more than 20 large families (AMA ’89: 1052).

Table 1: Viral Families

Family	Disease	Family	Disease
Papovaviruses	Warts	Orthomyxoviruses	Influenza
Adenoviruses	Respiratory and eye infections, diarrhea	Paramyxoviruses	Mumps, measles, rubella
Herpesviruses	Cold, sores, genital herpes, chickenpox, herpes zoster (shingles), glandular fever, congenital abnormalities (cytomegalovirus)	Coronaviruses	Common cold
Poxviruses	Cowpox, smallpox (eradicated), molluscum contagiosum	Arenaviruses	Lassa fever
Picornaviruses	Poliomyelitis, viral hepatitis types A and B, respiratory infections, myocarditis	Rhabdoviruses	Rabies
Togaviruses	Yellow fever, dengue, encephalitis	Retroviruses	AIDS, degenerative brain disease and (possibly) various kinds of cancer
Calcivirus	Norwalk (Ohio) virus

Source: AMA ’89: pp. 1051

Not all viruses cause disease, but many do. Viral infections range from the trivial and harmless, such as warts, the common cold and other minor respiratory tract infections and hepatitis, to extremely serious diseases, such as rabies, AIDS, and some types of cancer. It is debatable whether viruses are truly living organisms or just collections of large molecules capable of self-replication under very specific favorable conditions. Their sole activity is to invade the cells of other organisms, which they takeover to make copies of themselves. Outside living cells, viruses are wholly inert. They are incapable of activities typical of life, such as metabolism. Unlike bacteria, viruses cannot be grown in a suitable culture medium; they can multiply only within living cells. Therefore, viruses must be grown in cultures of cells, which can be any of many types of animal or human cell that are easily made to multiply in test tubes (AMA ’89: 1050).

The study of virology involves the isolation and identification of viruses to diagnose specific viral infections. To achieve this, a tissue or fluid sample (such as a specimen of feces, sputum, blister fluid, blood, urine, cerebrospinal fluid, or even brain biopsy specimen, depending on the suspected virus, is needed. The specimen is exposed to a cellular culture and the cells are then observed for distinctive changes that occur when they are infected with viruses. Alternatively, virus particles must first be made to clump together by adding an antiserum (antibodies obtained from the blood of someone who has had the viral infection, and which will bind to the virus particles). Immunoassay techniques, in which “labeled” antibodies are added to the specimens and detected if they have bound to virus cell components, are another possibility. Another method of diagnosing viral infections is to look for antibodies produced by the immune system to combat the viruses. A rapidly rising level of antibodies to a particular virus can prove good evidence of infection Antibodies can be detected by types of immunoassay and other laboratory techniques (AMA ’89: 1050).

Table 2: Some laboratory procedures in diagnostic virology

Condition	Possible viral cause	Samples to obtain	Inoculation Procedure
Upper respiratory infection	Rhinovirus Coronavirus Adenovirus	Nasopharyngeal fluid or tracheal fluid (aspirate)	Human fibroblast culture
Pneumonia	Influenza	Nasopharyngeal fluid or swab	Human fibroblast cultures or embryonated eggs; Monkey kidney cells Human fibroblast culture; Look for characteristic virus particles with the electron microscope
Measles Vesicular rash Diarrhea	Measles virus Herpes simplex Rotavirus (infants) Norwalk agent (adults)	Nasopharyngeal fluid or swab; Vesicular fluid by aspiration; Feces or rectal swab	Human fibroblast or monkey kidney cultures
Nonbacterial meningitis	Enterovirus Mumps Herpes Symplex	Spinal fluid

Source: Brock et al ’94: pp. 503

Various serological techniques are extremely useful in the diagnosis of infectious diseases. If a person has been exposed to a particular infectious organism, antibodies (proteins with a role in immunity) directed specifically against the organism appear in that person’s serum some days after exposure. Their presence or absence in the blood can be detected by such laboratory techniques as immunoassay, including the ELISA test and radioimmunoassay. In other cases, serological techniques are used to identify parts of infectious organisms (antigens) by studying the reaction between the antigens (obtained by culture of a specimen taken from a patient) and serum samples known to contain certain antibodies. A series of tests may be carried out in which the unknown antigen is added to carious antiserums (preparations containing specific antibodies) in test tubes; a positive reaction is sometimes revealed by a color change. In addition to devising and carrying out such diagnostic tests, serologists may be involved in developing antiserums for passive immunization (AMA ’98: 895).

A virus is a non-cellular genetic element that enlists a cell for its own replication, and is characterized by also having an extracellular state. In this extracellular state, the virus particle is metabolically inert and does not carry out respiratory or biosynthetic functions. A single virus particle (virion) consists simply of an inner core of nucleic acid surrounded by one or two protective shells (capsids) made of protein. These capsids are built from a number of identical protein subunits arranged in a highly symmetrical form, usually either as a 20-faced solid (an icosahedron) or as a spiral tube. Surrounding the outer capsid may be another layer called the viral envelope. This layer also consists primarily of protein. In many cases, the viral envelop is lost when the virus invades a cell. The nucleic acid at the core is called the genome, it consists of a string of genes that contain coded instructions for making copies of the virus. Depending on the type of virus, the nucleic acid may be either DNA, in which there are two complementary intertwined strands of nucleic acid (the double helix) or RNA, consisting of a single strand (AMA ’89:1050).

Viroids are circular single-stranded RNA molecules that encode no proteins and are completely dependent on host-encoded enzymes. They are the smallest known pathogens ranging from Coconut cadang-cadang viroid which is 246 nucelotides in size to Citrus exocortis viroid which is 375 nucleotides, and causes a number of very important crop diseases. Unlike viruses, their extracellular form is the same as their intracellular form and they have no protein coat. Prions have an extracellular form that does contain protein, but it does not contain the nucleic acid that encodes that protein. The gene that encodes the prion protein is found in the host cell and the prion somehow modifies this protein product. Prion protein particles and various prions are known to cause a variety of diseases in animals, such as scrapie in sheep, bovine spongiform encephalopathy in cattle, and kuru and Creutzfeldt-Jakob disease in humans. Although they are very simple elements, life viruses, both prions and viroids are infective and are reproduced inside cells (Brock et al ’94: 234-235).

When a virus genome is introduced into a cell and reproduces, the process is called infection. The cell that a virus can infect and in which it can replicate is called a host. Viruses can have varied effects on cells. Lytic infection results in the destruction of the host cell. However, there are several other possible effects following viral infection of animal cells. In the case of enveloped viruses, release of virions, which occurs by a kind of budding process, may be slow and the host cell may not be lysed. The cell may remain alive and continue to produce virus over a long period of time. Such infections are referred to as persistent infections. Viruses may also cause latent infection of a host. In a latent infection, there is a delay between infection by the virus and the appearance of symptoms. Fever blisters (cold sores), caused by the herpes simplex virus, result from a latent viral infection; the symptoms reappear sporadically as the virus emerges from latency (Brock et al ’94: 183, 217-218).

Viruses gain access to the body by all possible entry routes. They are inhaled in droplets; swallowed in food and fluids; and passed through the punctured skin in the saliva of feeding insects or rabid dogs or accidentally on the needles of tattooists, those who pierce ears, or even physicians. Many viruses begin to invade cells and multiply near their site of entry. Some enter the lymphatic vessels and may spread to the lymph nodes, where many are engulfed by white blood cells, such as lymphocytes. Many pass from the lymphatic to the blood and within a few minutes are spread to every part of the body. They may then invade and start multiplying within specific target organs such as the skin, brain, liver, or lungs. Other viruses travel along nerve fibers to their target organs (AMA ’89: 1052).

Viruses cause disease in a variety of ways. First, they may destroy or severely disrupt the activities of the cells they invade, possibly causing serious disease if vital organs are affected. Second, the response of the body’s immune system to viral infection may lead to symptoms, such as fever and fatigue, or to a disease process. In particular, antibodies produced by the immune system may attach to viral particles and circulate as immune complexes in the bloodstream. The antibodies may then be deposited in various parts of the body and cause inflammation and severe tissue damage. Third, by interacting with the chromosomes of their host cells, viruses may cause cancer. Fourth, a virus may cause disease by weakening the cell-mediated arm of the immune system (i.e. the activity of T-lymphocytes). This is how HIV works, invading and disrupting one type of T-lymphocyte so that the normal defenses to a wide range of infections are lost (AMA ’89: 1052).

The immune system deals fairly rapidly with most viruses. Each mechanism of the immune system may be involved in resisting a viral attack – including white cells (macrophages) that engulf the viral particles, and lymphocytes that produce antibodies against the virus or attack virally infected cells. This leads to recovery from most viral infections within a few days to weeks. Furthermore, the immune system is often sufficiently sensitized by the infection to make a second illness form the same virus rare (as is the case with measles). With some viruses, however, the speed of the attack is such that serious damage or even death may occur before the immune system can adequately respond (as is the case with rabies and some cases of poliomyelitis). In other cases, a virus is able to dodge or hide from the immune system, so the infection becomes chronic or recurrent. This is common with many herpes virus infections (such as genital herpes and shingles) and with viral hepatitis B. Finally, the AIDS virus, by weakening the immune system, leaves the body open to many opportunistic infections (AMA ’89: 1052).

Viruses are more difficult than bacteria to combat with drugs because it is difficult to design drugs that will kill viruses without also killing the cells they parasitize. Nevertheless, there has been remarkable progress in the development of antiviral agents, especially against the herpes group of viruses. Such drugs may work by helping to prevent viruses from entering cells or by interfering with their replication in cells. Interferon refers to a group of natural substances, produced by virus-infected cells, that protects uninfected cells. Some interferons can now be produced artificially and have been tried in the treatment of various viral infections, including the common cold and viral hepatitis B. Otherwise, treatment of viral infections depends largely on alleviating the patient’s symptoms and trusting the body’s immune defenses to brings about a cure. A much more fruitful area in the fight against viruses is immunization. One viral disease, smallpox, has already been eradicated worldwide through a coordinated vaccination program. Highly effective vaccines are also now available to prevent many others, including poliomyelitis, measles, mumps, rubella, hepatitis B, yellow fever and rabies (AMA ’89: 1052).

Table 3: Stages of virus replication at which chemical inhibition of virus action is known to occur

Stage of replication	Chemical	Virus
Free virus	Kethoxal	Influenza virus
Adsorption	None known
Entry of nucleic acid (uncoating)	Amantadine, Carbobenzoxypeptides, 3-Methylisoxazole compounds	Influenza virus, Measles, Rhinoviruses (cold viruses)
Nucleic acid replication	Benzimidazole, guinaidine, 5-Fluorodeoxyuridine (FUDR), 5-Iododeoxyuridine (IUDR), Acyclovir, Rifamycin, Azidothymidine (AZT), Dideoxyinosine (ddI)	Poliovirus, Herpesvirus, Herpesvirus, Herpesvirus, Varicella zoster Vaccinia virus, Retrovirus (HIV), Retrovirus (HIV),
Maturation (or late protein synthesis)	Isatin-thiosemicarbazone	Smallpox virus
Release	None known

Source: Brock et al ’94: Table 11.9. pp. 432

Anti-viral medicine, such as Acyclovir (Zovirax), Amantadine (Symidine, Symmetrel), Idoxuridine, Trifluridine (Viroptic), and Zidovudine (Retrovir, Retrovis), are a group of drugs used in the treatment of infection by a virus. The RNA polymerase of vaccinia and other poxviruses is inhibited by rifamycin, since this antibiotic specifically inhibits the replication of these viruses, although it has no effect on a wide range of other viruses affecting animal cells. Another interesting chemical is asidothymidine (AZT) an inhibitor of retroviruses such as the virus which causes acquired immune deficiency syndrome (AIDS). Interferons are antiviral substances produced by many animal cells in response to infection by certain viruses. They are low-molecular weight proteins that prevent viral multiplication. Cloned gene technology has now made interferons available (Brock et al ’94: 432)

Drugs that kill viruses have proved difficult to develop because viruses live only within body cells and there is a danger that antiviral drugs will damage the host cell as well as the virus. To date, no drugs have been developed that can effectively eradicate viruses and cure the illnesses that they cause. Immunization is at present more important than drug treatment in fighting serious viral infections. Since 1989 a number of antiviral drugs have been developed and used to treat AIDS but they carry a high risk of anemia due to bone marrow damage. Most antiviral drugs destroy viruses by disrupting chemical processes necessary for viruses to grow and multiply within cells. Some antiviral drugs prevent viruses from actually penetrating cells. Most other antiviral drugs rarely cause side effects. Antiviral creams and ointments may irritate the skin, causing redness. Antiviral drugs given by mouth or injection can cause nausea and dizziness, and, rarely, in long-term treatment, kidney damage. (AMA ’89: 120).

2. Respiratory Infections

Coronaviruses are one of the viruses behind the common cold. Named for their crown of club-shaped thorns, which can be seen with an electron microscopes, they cause colds especially during the winter and spring. Coronaviruses need only about three days to multiply in the respiratory tract before their victim starts feeling miserable. On average the cold lasts for a week, a few days shorter than a typical rhinovirus cold, but with more nasal congestion. Coronaviruses are remarkably good at re-infecting their hosts, which is one reason why vaccines remain elusive (Biddle ’95: 49). Normally there is no treatment for coronaviruses other than a caution to wash hand and keep clean. For Severe Acute Respiratory Syndrome (SARS), a coronavirus, the treatment with no fatalities was to ventilate the patient and medicate with the antibiotic levofloxacin (Levaquin), and corticosteroids Methylprednisolone IV and then Prednisone (Kit-Ying ’06).

The rhinovirus genus is the most common cause of the common cold. Rhinoviruses come in hundreds of types, so a universal cure is hopeless. Rhinoviruses thrive at the average temperature of our nasal mucous membranes, about 93ºF. They are cousins of the poliovirus, in the Picornavirus family, possessing about half the same genes, and strike in late summer and fall, in the Northern hemisphere. A rhino cold lasts on average about a week, with peak misery on the second and third days. There is shaky evidence that heavy doses of vitamin C may reduce the length of colds, but not the frequency of catching them. Washing your hands is a lot is better. Concentrated rhinoviruses in snot survive for hours on skin, plastic, wood, Formica, steel and many fabrics. Stuff a cold and starve a fever (Biddle ’95: 119-120). A number of Over-the-Counter remedies are known to be effective with rhinoviruses ie. diphenhydramine (Benylin, Benadryl), chlorpheniramine (Telachlor, Chlo-Amine, Chlor-Trimeton, Aller-Chlor), brompheniramine (Bromphen, Nasahist B, Dimetane Extentabs) and Ipratropium intranasal (Atrovent).

Adenoviruses are a family of viruses, the ones that like people cause about 5 percent of all respiratory illnesses, from mild flulike symptoms to pneumonia, involving upper and lower respiratory tract infections (URI, LRI), swollen adenoids, conjunctivitis and diarrhea. The typical incubation period for gastroenteritis is 3-10 days; for respiratory tract infections it is between 2 and 14 days. Outbreaks of adenovirus-associated respiratory disease have been more common in the late winter, spring, and early summer; however, adenovirus infections can occur throughout the year. Most children, in urban areas, have been infected with the more common adenoviruses by the time they reach school age. Up to twenty cases a week per one hundred WWI recruits could be expected (Biddle ’95: 19). Adenoviruses are often isolated from apparently healthy individuals. The adenoviruses are a major family of icosahedral DNA containing viruses which have unique molecular biological properties (Brock et al ’94: 229). ARD is most often associated with adenovirus types 4 and 7, and more recently adenovirus 14, in the United States. Enteric adenoviruses 40 and 41 cause gastroenteritis, usually in children. An effective vaccine against Adenovirus serotype 4 (Ad4) and serotype 7 (Ad7) was approved in 1971. The economy-driven cessation of vaccine production by its sole producer in 1996 resulted in re-emergence of outbreaks, with Ad4 predominating in 98% of cases, 5 fatalities. On March 16, 2011, the FDA approved an adenovirus vaccine for manufacture by Teva Pharmaceuticals (Milvax ’11).

Echovirus is one of several families of viruses that affect the gastrointestinal tract collectively called enteroviruses. Echoviruses also cause respiratory infections. In the US, echovirus infections are most common in the summer and fall. It is transmitted by contact with stools contaminated by the virus, and possibly by breathing in air particles from an infected person. Serious infections with echoviruses are less common, but can be significant particularly in immune compromised patients. As many as 1 in 5 cases of viral meningitis are caused by an Echovirus. Complete recovery without treatment is expected in patients who have the less severe type of illness. Infections of organs such as the heart (pericarditis and myocarditis) may cause severe distress and can be fatal. No specific antivirals are available for the Echovirus other than hand-washing, when in contact with sick people, no vaccines are available. Immune Globulin (IGIV) may help people with severe Echo virus infections (Vorvick ’08).

Table 4: Diagnosis and Treatment of Respiratory Infections

Infectious Agent	Symptoms	Treatment
Common Cold
Coronaviruses	Upper respiratory tract infection (URI) lasting for a week, nasal congestion	None, clean. For SARS ventilate, medicate with antibiotic levofloxacin (Levaquin), and corticosteroids Methylprednisolone IV and then oral Prednisone
Rhinoviruses	URI, Swollen lymph nodes, upper respiratory tract infection, nasal infection, peak misery after two days, lasts a week	None, clean. Over-the-Counter: Diphenhydramine (Benylin, Benadryl), Chlorpheniramine (Telachlor, Chlo-Amine, Chlor-Trimeton, Aller-Chlor), Brompheniramine (Bromphen, Nasahist B, Dimetane Extentabs), Ipratropium intranasal (Atrovent)
Echovirus	URI, sore throat, skin rash, harpangia, croup, may inflame endocarditis, pneumonia, meningitis, prevalent in summer and fall in US	None, clean. Immune Globulin Intravenous (IGIV) for serious infections
Adenoviruses	URI and lower respiratory tract infection (LRI), may also cause conjunctivitis, bladder infection, inflamed pharynx, diarrhea and rheumatism of the lower extremities for a week, prevalent in late winter, spring and summer	None, clean. Vaccine re-authorized to Teva Pharm on contract with the U.S. Army. Get light exercise. Eat white rice for diarrhea. Clean. Avoid young children.
Flu Like Symptoms
Influenza A & B	Body or muscle aches, chills, cough, fever over 101° F, 38°C, headaches, and sore throat, incubates for two days, lasts two days, prevalent in winter.	Bed rest for one to two days. Vaccine ineffective. OTC Theraflu, Allegra (Sanofi-Aventis) and Children's Allegra (fexofenadine) and Allegra-D (fexofenadine and pseudoephedrine); Prescription Oseltamivir (Tamiflu) and Zanamivir (Relenza). Antibiotics for pneumonia
Parainflueza Types 1-4	LRI in children, URI in adults, prevalent in fall and winter	No vaccine, clean. Treat secondary infections with Antibiotics
Respiratory Syncytial Infection	LRI and breathing passages. Most otherwise healthy people recover from RSV infection in 1 to 2 weeks	Ribavirin (Virazole), asthmas inhalers ie. corticosteroids: flunisolide (Aerobid), beclomethasone (QVAR), (Flovent); triamcinolone, (Azmacort), Antibiotics for pneumonia or ear infection
Bacterial Agent
Whooping cough Bordetella pertussis	Sporadic epidemic respiratory infection begins with runny nose that lasts a week, before the infection descends to the lungs for six weeks of mild rheumatism and coughing	Antibiotics only cure if taken the first week before the infection descends into the lungs. Antibiotics taken later reduce contagiousness. Clean.
Strep Group A Rheumatic Heart Disease: Streptococcus pyogenes, acquired from young adults	Highly contagious URI, sore throat, lasting a week, rheumatic heart disease sets in after a week with a 25% chance of dying over 10 years, if untreated	Cured quickly with antibiotics and plenty of cardiovascular exercise. Eat vegan. No sugar. Clean. Stock up or get a refillable prescription for antibiotics. Give your infected friends, family and co-workers antibiotics.
Strep Group B Gout: Steptobacillus agalactiae acquired from nursing mothers	LRI infection, persistent endocarditis, hyper uremia and severe prolonged rheumatism of the lower extremities	Cured with a full course of antibiotics, long periods of light exercise, sunlight or Vitamin D for cripples. Eat vegan, no caffeine. Clean. Avoid nursing mothers and contaminated fabrics.
Pneumonia: Streptococcus pneumoniae, Chlamydia pneumoniae and Staphylococcus aureus acquired from hospitals, Strep + Staph = toxic shock syndrome	The term pneumonia is used to describe any severe respiratory infection, these strains are most highly contagious, also cause meningitis, ear and skin infection, endocarditis and mix and mutate with other resistant systemic bacterial and viral infections.	penicillin, ceftriaxone, cefotaxime and cardiovascular exercise. The corticosteroid Prednisone is also used, but is immune-suppressant. Ventilation in hospitals saves lives. Antitoxin for Step/Staph toxic shock syndrome. Eat vegan. Drink safely. Clean. Avoid people for their sake.

Human influenza is a highly transmissible respiratory illness that’s caused by the influenza viruses. We see yearly winter epidemics, called seasonal influenza that affect up to 30% of the population, killing on average 30,000 a year in the US or 350,000 globally. The incubation time for influenza (time from exposure to onset of symptoms) is short, about two days. The onset usually is sudden. It is marked by chills, fever, headache, lassitude and general malaise, loss of appetite, muscular aches and pains and sometimes nausea, occasionally with vomiting. Respiratory symptoms, such as sneezing and nasal discharge, may be present coughing, with or without sputum, may occur, and hoarseness sometimes develops. The fever of 101-105 ° F (40.6 º C) usually lasts for two to four days. Treatment consists of rest in bed, continuing for twenty-four to forty-eight hours after the temperature has become normal. Flu is dangerous to the extent that it can lead to pneumonia, especially for the elderly, the malnourished, or individuals stressed by chronic lung or heart problems. The viruses that cause flu are prone to antigenic drift, making vaccine manufacture difficult. Type A Influenza viruses are subdivided into groups based on two surface proteins, HA and NA, Influenza B or Influenza C based on protein composition. Type A viruses are found in many kinds of animals, including ducks, chickens, pigs, and whales, and also humans. The type B virus widely circulates in humans. Type C has been found in humans, pigs, and dogs and causes mild respiratory infections, but does not spark epidemics. Flu viruses last for hours in dried mucus (Biddle ’95: 79-85).

The FDA recently removed some 600 different types of flu remedies from the market. The most effective remedy has always been Over-the-counter Theraflu, most consumer are better the next day. The FDA has approved Allegra (Sanofi-Aventis) and Children's Allegra (fexofenadine) and Allegra-D (fexofenadine and pseudoephedrine) product lines to be marketed over-the-counter. The two prescription antivirals that are most commonly used these days are the neuraminidase inhibitors Oseltamivir (Tamiflu) and Zanamivir (Relenza). Systematic review of 51 studies found no evidence that the flu vaccine is any more effective than a placebo in children (Smith et al ’08). Studies published in 2008 found that influenza vaccination was not associated with a reduced risk of pneumonia in older people although it did contribute to a reduction in mortality (Jackson et al ’08)(Eurich et al ’08). Dangerous complications with influenza involve bacterial infections that cause pneumonia wherefore broad spectrum antibiotics that are effective against Haemophilus influenziae such as ampicillin (Principen) or levofloxacin (Levaquin) save lives.

Parainfluenza and respiratory synctial viruses (RSVs) cause bronchitis, bronchiolitis, sinus tenderness, swollen glands, red throat, croup and pneumonia, primarily in young children by members of the paramyxoviridae family of viruses, others of which cause mumps and measles. Para-influenza viruses, there are four types of medical interest, cause lower respiratory diseases in kids and upper respiratory problems in adults. The virus, that strikes in fall and winter, is responsible for approximately 40-50% of croup cases and 10-15% of bronchiolitis and bronchitis cases and some pneumonias. They are highly infectious through personal contact and need invade our bodies no deeper than our noses or throats to replicate in the mucus there. Most people grow immune to them, which is why parents at the playground aren’t hacking as much as the kids (Biddle ’95: 103). There is no vaccine. People usually recover without treatment. Theraflu was known to cure overnight. The FDA has approved Allegra (Sanofi-Aventis) and Children's Allegra (fexofenadine) and Allegra-D (fexofenadine and pseudoephedrine) for sale Over-the-counter. Corticosteroid inhalers and Prednisone may be effective for the treatment of chronic disease but they depress the immune system. Treat secondary infections with Antibiotics.

Respiratory syncytial virus (RSV) infections are usually mild and seem like a common cold. In most cases, RSV infections go away in about 10 to 14 days. Home treatment to ease symptoms and prevent complications is usually all that is needed. NSAIDS such as acetaminophen or ibuprofen may be taken to relieve suffering. Corticosteroids may be administered if the pneumonia worsens or does not go away on time. Antibiotics are not usually necessary but should be administered if an ear infection (otitis media) or pneumonia develop, both are caused by the same Streptococcus pneumonia bacterium, treated with antibiotics, eg. Penicillin, Streptomycin and Tetracycline, protected against antibiotic associated colitis with courses of metronidazole (Flagyl ER), a carcinogen. Children who develop lower respiratory infections, especially bronchiolitis, may need medicines, such as bronchodilators, for the rest of their lives. When selecting an inhaler for the first time, or choosing a new one after triamicinolone (Azmacort) was removed by the producer for fluorocarbon concerns, avoid salmeterol, salmeterol has been known to be fatal. Flovent (Fluticasone Propionate) seems a safe corticosteroid inhaler, available without prescription (Generics-Discount).

3. Enteroviruses

Norovirus infection, well known as "the stomach flu," is one of the most common causes of acute gastrointestinal epidemics (AGE), afflicting nearly 23 million Americans annually (LigoCyte ’10). Rotavirus is the most common cause of severe diarrhea among infants and children throughout the world and causes the death of about 600,000 children worldwide annually. The incubation period for norovirus-associated gastroenteritis in humans is usually between 24 and 48 hours (median in outbreaks, 33 to 36 hours), but cases can occur within 12 hours of exposure. Norovirus infection usually presents as acute-onset vomiting, watery non-bloody diarrhea with abdominal cramps, and nausea. Low-grade fever also occasionally occurs, and diarrhea is more common than vomiting in children. Symptoms usually last 24 to 72 hours. Dehydration is the most common complication, white rice water is the traditional remedy. Imodium (Loperamide) is available without prescription. 30% of rotavirus cases catch a secondary bacterial infection, for which metronidazole (Flagyl ER) is the preferred antibiotic. Rotovirus vaccine Rotarix (GSK) and Rotateq (Merck & Co.) were approved by FDA in 2006; and by 2010 it had reduced the number of babies and young children needing emergency department care or hospitalization for rotavirus disease by 85% (MILVAX ’11).

Rotaviruses and Norwalk (Ohio) virus, are now known as Noroviruses. They cause billions of cases of diarrhea, mostly in children, every year and millions of deaths in poor countries. Both viruses were discovered in the early 1970s. Before then the pathogens behind most cases of gastroenteritis and epidemic diarrhea in young children were a mystery, bacteria such as Escherichia coli are more prevalent in older children and adults. Noroviruses and rotaviruses pass around through infected feces (Biddle ’95: 124). Noroviruses are part of the larger Calicivirus family, which also includes the genus Sapovirus and was created to classify. Currently, there are five recognized norovirus genogroups, of which three (GI, GII, and GIV) are known to affect humans. More than 25 different genotypes have been identified within these genogroups. Since 2002, variants of the GII.4 genotype have been the most common cause of norovirus outbreaks. Ligocyte trials for a Intranasal Norovirus VLP Vaccine, began with an injection in 2007 are entering stage II clinical trials. In 77 adults vaccination decreased the incidence of Acute Gastroenteritis (AGE) due to norovirus from 69.2 percent to 36.8 percent and the incidence of norovirus infection from 82.1 percent to 60.5 percent. The severity of illness was also significantly reduced in those vaccinated within the trial (LigoCyte ’10).

Table 5: Acute Gastroenteritis (AGE) Medicine

Rotavirus	Reo	Childhood diarrhea	Rotovirus vaccine (Rotarix GlaxoSmithKline GSK) (Rotateq Merck & Co.) Imodium (Loperamide)
Norovirus (Norwalk agent)	Calici?	Gastroenteritis	LigoCyte phase I/II trials for Intranasal Norovirus VLP Vaccine (2010) Imodium (Loperamide)
Coxsackie virus	Picoma	Pleurodynia, herpangina, hand-foot-and-mouth disease	None, usually recover in 7-10 days without medical treatment. Perhaps Immune Globulin (IGIV)
Poliovirus	Picorna	Poliomyelitis	Pentacil (DTaP-IPV/Hib, Sanofi-Pasteur), Kinrix (DTaP-IPV GSK), Ipol (Sanofi-Pasteur)
JC virus	Papova	Progressive multifocal leukoencephalopathy (opportunistic)	None, avoid immunosuppressant drugs. Perhaps cytarabine (DepoCyt) and Immune Globulin (IGIV)
Hepatitis A virus	Picoma	Acute viral hepatitis	Monovalent Hepatitis A Vaccine (HAVRIX GSK)) or VAQTA (Merck), Bivalent (Combination) Hepatitis A and Hepatitis B Vaccine (TWINRIX GSK)
Hepatitis B virus	Hepadna	Acute or chronic hepatitis	Monovalent Hepatitis B Vaccine (ENGERIX-B (GSK) or RECOMBIVAX-HB (Merck), Bivalent (Combination) Hepatitis A and Hepatitis B Vaccine (TWINRIX GSK); Pegylated interferon alfa-2b (Pegasys), Nucleoside/nucleotide analogues (NAs) adefovir (Hepsera), entecavir (Baraclude), lamivudine (Epivir-HBV, Heptovir, Heptodin), telbivudine (Tyzeka) and tenofovir (Viread)
Hepatitis C		Acute or chronic hepatitis	Combination of Pegylated interferon alfa-2b (Pegasys) and Ribavirin (Virazole)
Hepatitis D		With HBV, acute liver disease of several months or life-long chronic hepatitis that may lead to liver cancer	None approved. Pegylated interferon alfa-2b (Pegasys) may help. Liver transplantation
Hepatitis E virus	Norwalk-like	Enterically transmitted hepatitis lasting one or two weeks	None approved. Small meals, fluids, avoid medicines that may harm the liver, avoid alcohol and exercise regularly.

Coxsackieviruses belong to the family Picornaviridae and the genus Enterovirus, which also includes poliovirus and echovirus. Coxsackieviruses are transmitted primarily via the fecal-oral route and respiratory aerosols, and have been found in the respiratory tract up to 3 weeks after initial infection and in feces up to 8 weeks after initial infection. There are 24 serotypes of Coxsackievirus. Coxsackievirus A16 is the most frequent cause of hand, foot and mouth disease (HFMD), but other Enteroviruses, in a group including polioviruses, coxsackieviruses, echoviruses, especially enterovirus 71, can also cause HFMD. Group A coxsackieviruses tend to infect the skin and mucous membranes, causing herpangina, acute hemorrhagic conjunctivitis (AHC), and hand-foot-and-mouth (HFM) disease. Group B coxsackieviruses tend to infect the heart, pleura, pancreas, and liver, causing pleurodynia, myocarditis, pericarditis, and hepatitis. Both group A and group B coxsackieviruses can cause nonspecific febrile illnesses, rashes, upper respiratory tract disease, and aseptic meningitis. The development of insulin-dependent diabetes (IDDM) has recently been associated with recent enteroviral infection, particularly coxsackievirus B infection. Approximately 10 million symptomatic enteroviral infections are estimated to occur annually in the United States. From 2002-2004, an estimated 16.4-24.3% of these illnesses were attributed to coxsackievirus serotypes. For 2 of the 3 years, coxsackievirus B1 was the predominant serotype. There is no vaccine or drug treatment specifically for coxsackie infection (Rajnik et al ’09). Immune Globulin (IGIV) may help people with severe Echo virus infections.

Poliovirus is an Enterovirus that causes Paralytic poliomyelitis, which means inflammation of the spinal cord, has been eradicated, since the introduction of the injected Salk vaccine, made from killed viruses, in 1956 and oral Sabin vaccine, made from attenuated live viruses, in 1960, wherever immunization of children is routine. In America the childhood polio vaccine is marketed as Ipol (Sanofi-Pasteur) or in combination with Pentacil (DTaP-IPV/Hib, Sanofi-Pasteur), Kinrix (DTaP-IPV GSK). Yet about a hundred thousand cases and ten thousand deaths still occur every year around the world, mostly in Asia and Africa, where immunization is not routine. There are three distinct types of polioviruses, of varying potency, and they are the most dangerous members of the enterovirus group. Like other enteroviruses, polioviruses like to inhabit the alimentary canal. 99 percent of all infections do not exhibit obvious symptoms of disease. As an enterovirus, polio is passed among people via feces from infected individuals, which means that people living in societies with excellent hygiene are more likely to grow up without having their first, naturally immunizing encounter with polioviruses at an early age when serious disease is a less likely consequence. The prime age for polio in the US by the 1950s was five to nine years old, with two thirds of deaths in victims over fifteen. Polio became notorious for striking the best families who evaded exposure until later in life. Since 1988 the World Health Organization has led an effort to wipe out polio by the end of the century (Biddle ’95: 113-115).

Polyomaviruses constitute one genus of the family Papovaviridae. The primate polyomavirus SV40 was discovered in 1960 as a passenger virus in cultures of rhesus monkey cells. The 2 human polyoma species, JC and BK, were isolated from patients with the same initials in 1971. The virus is very common in the general population, infecting 70 to 90 percent of humans; most people acquire JCV in childhood or adolescence. It is found in high concentrations in urban sewage worldwide. The initial site of infection may be the tonsils, or possibly the gastrointestinal tract. The virus then remains latent in the gastrointestinal tract and can also infect the tubular epithelial cells in the kidneys, where it continues to reproduce, shedding virus particles in the urine. In the brain it causes the usually fatal progressive multifocal leukoencephalopathy, or PML, by destroying oligodendrocytes. Several studies since 2000 have suggested that the polyomavirus is also linked to colorectal cancer. Because of the invariably fatal outcome of PML, various antiviral drugs have been tried. The only drug that may have cured PML in 2 of 7 patients is cytarabine (DepoCyt). One should also avoid immunosuppression regimes, such as corticosteroids, in PML patients (Wong ’11).

Hepatitis is a term used to describe liver problems. Many things can inflame the liver, often to the point of causing jaundice, the yellowing of the skin and tissues that is a telltale sign of liver disease, including alcohol, drugs, and other environmental chemicals and microbes. The liver is also prone to infection by the amoeba E. histolytica for which metronidazole (Flagyl ER) is the most effective generic antibiotic, but it is carcinogenic and Hepatitis B increases the risk of getting liver cancer a 100 times. The hepatitis viruses, are A, B, C, D, and E. Most cases of hepatitis go away by themselves with favorable outcomes, though the illness can drag on for a month or two. Hepatitis B is the most dangerous. Some people with chronic Hepatitis B develop a Hepatitis D co-infection, which qualifies them for liver transplantation. Monovalent Hepatitis A Vaccine (Havrix GSK) or (Vaqta Merck) can be used for the prevention of Hepatitis A, but if already infected wait a few months before being vaccinated. A Bivalent (Combination) Hepatitis A and Hepatitis B Vaccine (TWINRIX GSK) and Monovalent Hepatitis B Vaccine (Engerix-B; GSK) or Recombivax-HB; Merck) are also offered by health care professionals.

Hepatitis A, the least dangerous virus, resembles the polio virus and consists of not much more than a bare strand of RNA in an icosahedral (twenty-sided) shell that reproduces only in the liver. Young infected children are almost never jaundiced, but are prime sources of contagion for adults, who usually show all the classic symptoms of nausea, vomiting, dark urine, and yellowish eyes and skin. The relatively uncommon hepatitis C virus, is encountered mainly in the context of blood transfusions, drug abuse, and ingestion of contaminated water. It is related to the yellow fever virus and is a leading cause of chronic liver disease and cirrhosis. Incidence of hepatitis C decreased by more than 50 percent in the US between 1988 and 1993. Hepatitis E travels from host to host via fecal-oral contact and contamination of water rather like hepatitis A is newly recognized (Biddle ’95: 70-73). Hepatitis C is treated with a combination of Pegylated interferon alfa-2b (Pegasys) and Ribavirin (Virazole), an antibiotic drug for certain viruses. By itself, ribavirin has little effect on HCV, but interferon increases its potency.

Hepatitis B virus is much more complex and is only found in humans. It can take as long as six months to incubate to the point of producing symptoms of disease, versus six weeks for hepatitis A. It passes from person to person in blood, saliva and semen, which places it among venereal diseases. The virus is extremely stable and can stay dangerous. Because the germ’s long term presence in the body often brings on liver cancer, it ranks as the world’s most common viral cause of cancer. Between 1985 and 1993 the incidence of hepatitis B fell by 59 percent in the US. Weight loss, no-protein, not alcohol diet and exercise are important for recovery from hepatitis like any other necrotic infection of the internal organs. Hepatitis D only thrives in cells also infected with hepatitis B, boosting the severity of the disease. Chronic viral hepatitis B is treated with Pegylated interferon alfa-2b (Pegasys), Nucleoside/nucleotide analogues (NAs) such as adefovir (Hepsera), entecavir (Baraclude), lamivudine (Epivir-HBV, Heptovir, Heptodin), telbivudine (Tyzeka) and tenofovir (Viread).

4. Skin Eruptions

Measles is the single most infectious common disease. One person with measles who blunders into a crowded room will give it to almost everyone. If there were no immunization measles would be universal. Epidemics used to happen like clockwork every two to three years. Measles is caused by a paramyxovirus, others of which bring mumps and sundry respiratory illnesses. The virus travels from victim to victim primarily in fine droplets sprayed by coughing or sneezing. About two week s after exposure, the well-known rash appears with high fever. New viruses will grow in cells throughout the body, but the mucous linings of the respiratory tract are the best breeding ground. Particularly in Africa, measles causes deaths from pneumonia, diarrhea, and malnutrition. People who recover are immune for the rest of their lives. The measles virus is not carried by any animal other than humans and it needs a local population of between 300,000 and 400,000 to set up a sustaining, continuous supply of virgin bodies. Otherwise it dies out. The disastrous effect of this germ on previously unexposed population was most spectacular during the early colonial era. It was instrumental in cutting the population of central Mexico from about 30 million to 3 million within fifty years of Cortes’ arrival. In the US only 70 percent of two year olds were immunized in 1990 (Biddle ’95: 90-94).

Mumps was described by Hippocrates for the painful swelling of the parotid (salivary) glands in children and in about a fifth of older male sufferers, of the testicles. Like measles, mumps is caused by a paramyxovirus transported into the respiratory tract via fine droplets form an infected person, but is far less dangerous and contagious. Mumps comes and goes with no apparent symptoms in about a third of all cases. Because the virus likes glandular and nerve tissue, mumps can be accompanied by complications in many organs, pancreas, brain, heart, thyroid, but they are seldom serious. Before vaccine became available in the 1960s mumps tended to be an urban affliction with fairly irregular occurrence. During WWI some 231,490 cases in the US Army resulted in 3,884,147 man-days of lost duty. Mumps ranked third, behind flu and gonorrhea, for putting otherwise healthy soldiers out of action. Mumps vaccine is usually given to one-year olds in combination with measles and rubella vaccine (MMR). The total of 1,692 cases reported in 1993 was the lowest number ever in the US. A worldwide immunization campaign could relegate mumps to archival status (Biddle ’95: 95-97).

Table 6: Topical Antiviral Medicine

Viral Pathogen	Viral Family	Disease Expression	Drug Monograph
Measles virus	Paramyxo	Measles (rubella)	Measles, Mumps, Rubella and Varicella vaccine (MMRV, ProQuad, Merck & Co., Inc.) or Measles, Mumps, Rubella vaccine (MMR, M-M-RII, Merck & Co., Inc.) and Varicella vaccine (VARIVAX, Merck & Co., Inc.)
Mumps virus	Paramyxo	Mumps, pacreatitis, orchitis	Measles, Mumps, Rubella and Varicella vaccine (MMRV, ProQuad, Merck & Co., Inc.) or Measles, Mumps, Rubella vaccine (MMR, M-M-RII, Merck & Co., Inc.)
Rubella virus	Toga	German measles (rubella)	Measles, Mumps, Rubella and Varicella vaccine (MMRV, ProQuad, Merck & Co., Inc.) or Measles, Mumps, Rubella vaccine (MMR, M-M-RII, Merck & Co., Inc.) and Varicella vaccine (VARIVAX, Merck & Co., Inc.)
Vacciniavirus	Pox	Smallpox, Cowpox	Smallpox vaccine
Varicella-zoster	Herpes	Chickenpox, shingles	Measles, Mumps, Rubella and Varicella vaccine (MMRV, ProQuad, Merck & Co., Inc.) or Varicella vaccine (VARIVAX, Merck & Co.); Acyclovir (Zovirax), Valtrex (Valacyclovir)
Herpes simplex virus I	Herpes	Cold sore	Valtrex (Valacyclovir)
Herpes simplex virus II	Herpes	Genital herpes	Acyclovir (Zovirax)
Cytomegalovirus	Herpes	Cytomegalic inclusion disease	Acyclovir (Zovirax), Ganciclovir Sodium, Foscarnet Sodium (Foscavir) injection
Epstein-Barr (EBV) virus	Herpes	Infectious mononucleosis, 10 day fever and fatigue, nasopharyngeal carcinomas	Acyclovir (Zovirax), Foscarnet Sodium (Foscavir) injection
Papillomavirus (HPV)	Papova	Condyloma, genital warts, cervical carcinoma	Quadrivalent HPV vaccine (HPV4; Gardasil, Merck & Co, Inc.), Acyclovir (Zovirax), topical interferon alpha 2B
Molluscum virus	Pox	Warts, Molluscum contagiusum	Topical: trichloroacetic acid, imiquimod (Aldara), podophyllotoxin cream (Condylox), cantharidin (Cantharone)

Pox viruses are the most complex and largest animal viruses known and have some characteristics that approach those of primitive cells. Pox virus can be seen under the light microscope. Pox viruses, like all viruses, are not able to metabolize and thus depend upon the host for the complete machinery of protein synthesis. Pox viruses are DNA viruses which replicate in the cytoplasm. Thus, a host cell infected with a pox virus exhibits DNA synthesis outside of the nucleus, something that otherwise only occurs in intracellular organelles such as mitochondria. Smallpox was the first virus to be studied in any detail, and was the first virus for which a vaccine was developed (described by Edward Jenner in 1798). By diligent application of this vaccine on a worldwide basis, the disease smallpox has been eradicated, the first infectious disease to have been eliminated in this fashion. Other pox viruses of importance are cowpox and rabbit myxomatosis virus, an important infectious agent of rabbits and one which was intentionally used in an attempt to control the Australian rabbit population. Some pox viruses also cause tumors, but these tumors are generally benign. Most research has been done on vaccinia virus (cowpox) the source of smallpox vaccine. Vaccinia virus causes no serious health effects in human but is highly immunogenic. Molecular cloning methods have been used to express key viral proteins of influenza virus, rabies virus, herpes simplex type 1 virus and hepatitis B virus in vaccinia virus virions, and then the latter used as a vaccine (Brock et al ’94: 228-229).

The varicella-zoster virus, is a member of the herpes family, persists for decades in the body. Chicken pox, caused by the varicella-zoster virus, is the last holdout of the common childhood diseases. About 90 percent of Americans have suffered through an itchy, grumpy week of it by the time they reach adulthood. There are some very rare complications causing as many as 100 deaths among 3.7 million cases annually. The childhood attack of chicken pox does not give permanent immunity. Later bouts are usually just so mild as to be without noticeable symptoms. As people pass the age of fifty, the latent virus is more and more likely to trigger a painful skin rash called herpes zoster, or shingles. Some 300,000 cases occur yearly in the US. Half of people who live to be eighty-five will experience shingles, which is about 25 percent as infectious as chicken pox. In the 1970s Japanese scientists developed a chicken pox vaccine that has been given to about a million people in Japan and South Korea during the past ten years without incident. A similar shot has been tested on eleven thousand subjects in the US since 1982 and was submitted for federal approval in 1993. It is already allowed for children and adolescents with leukemia, who are at high risk for serious complications. Tests indicate that immunized people are less likely to get shingles (Biddle ’95: 156-157).

There are more than ninety members of the Herpes virus family that harass innumerable species, from human to the lowliest fungi. They have been around for eon. All have the capacity to survive for the entire life-time of their host, hiding in nerve cells, sometimes producing symptoms of disease, often not. They have been implicated in causing cancer. The term “herpes” from a Greek word meaning “to creep” has been used for thousands of years. In popular speech it refers to just two viruses, Herpes simplex 1 and 2. The first usually causes cold sores or fever blisters, first described by a Roman doctor, Herodotus, around A.D. 100 as “herpetic eruptions which appear about the mouth at the crisis of simple fevers”. The second type causes similar spots in the genital area and was not publicly reported until 1,600 years later, by a Frenchman named Astruc. A form of skin herpes named Herpes gladiatorum is found among college wrestlers and rugby players, who pick up form mat burns and other repeated abrasions. A drug called acyclovir (Zovirax) is currently the best defense against HSV outbreaks. It is not a cure, but it reduces the number and duration of attacks in people who experience them. Some 55 million Americans carry HSV-2, 11 million suffer periodic outbreaks and the numbers are rising by hundreds of thousands every year (Biddle ’95: 73-74).

Herpesviruses are a large group of double stranded DNA viruses which cause wide variety of disease in humans and animals, including fever blisters (cold sores), venereal herpes, chickenpox, shingles and infectious mononucleosis. Some herpesviruses also cause cancer. One of the interesting features of some herpesviruses is their ability to remain latent in the body for long periods of time, becoming active only under conditions of stress. Both herpes simplex, the virus that causes fever blisters, and varicella-zoster virus, the cause of chicken pox and shingles, are able to remain latent in the neurons of the sensory ganglia, from which they are able to emerge to cause infections of the skin. An important group of herpesviruses are tumorigenic, causing clinical forms of cancer. One herpesvirus which is tumorigenic is the Epstein-Barr virus, which causes Burkitt’s lymphoma, a common tumor among children in Central African and New Guinea. Burkitt’s lymphoma was among the first human cancers to have been linked to virus infection (Brock et al ’94: 227). Herpes Simplex I is treated with Valtrex (Valacyclovir) and Herpes Simplex II is treated with Acyclovir (Zovirax), both can be purchased online without a prescription (Generics-Discount). Acyclovir (Zovirax) is useful anti-viral drug of first resort for the treatment of most cancers.

Cytomegaloviruses, are in the Herpes family, and cause an enlargement of the cells. They are catchall, do-all, everywhere, everybody viruses that are almost as much a part of human life as carbon and oxygen. Ninety percent of adults have probably been hit by one of these, most without symptoms, but a small minority contracting liver disease, mononucleosis, or respiratory problems and are known to be the leading cause of birth defects in countries that have defeated rubella (German measles). More than 80 percent of toddlers, especially day-care kids, pick them up harmlessly as they pass around in saliva, tears, urine and feces and reactivate after long periods of time. The cytomegalovirus particle is one of the biggest of all animal viruses, but at 200 billionths of a meter (200 x10^{-9 meters}, or 200 nanometers) in diameter it is still way beyond the reach of optical microscopes. Years of searching for an infectious agent in certain cases of infant death led to isolation of the virus in 1956 from salivary-gland tissue (hence the medical nickname “salivary-gland virus”. Cytomegaloviruses often reside in blood vessels during infection, raising the fascinating possibility that they play a role in the cell changes that precede hardening of the arteries, or atherosclerosis (Biddle ’95: 52). Cytomegaloviruses resistant to Acyclovir (Zovirax) are treated with Ganciclovir Sodium, which is carcinogenic, or Foscarnet Sodium (Foscavir) injections.

The Epstein-Barr virus (EBV), in the Herpes family, is named for the two scientists who discovered it in 1964, causes mononucleosis, the “kissing disease” because it is spread by oral to oral contact, most commonly in the fifteen to twenty five age group (Biddle ’95: 61-62). Mononucleosis is a viral infection causing fever, sore throat, and swollen lymph glands, especially in the neck. The fever usually drops in 10 days, and swollen lymph glands and spleen heal in 4 weeks. Fatigue usually goes away within a few weeks, but may linger for 2 to 3 months. EBV has been implicated in the pathogenesis of four types of human tumors: the African form of Burkitt’s lymphoma, B-cell lymphomas in immunosuppressed individuals, some cases of Hodgkin’s disease and nasopharyngeal carcinomas. EVB infects epithelial cells of the oropharynx and B lymphocytes causing a latent infection that acquires the ability to propagate indefinitely. More than 90% of African tumors and 100% of nasopharyngeal carcinomas around the world carry the EBV genome (Cotran ’94: 286-290). Acyclovir (Zovirax) resistant EVB should be treated with Foscarnet Sodium (Foscavir) injection before becoming dependent on Immune Globulin (IGIV) and trying anti-neoplastics.

Over sixty-seven types of papillomaviruses are known to exist, and a link has been discovered between infection with certain ones and cervical cancer, which causes more than four thousand deaths every year in the US. Sexually transmitted types somehow interact with herpes simplex-2 and HIV to increase the risk of cervical cancer. The picture is not clear, however, since 10 to 50 percent of healthy women carry papillomavirus. This virus has an affinity for skin and mucous membranes. They are transmitted by direct contact and take an average of two to three months to produce a visible wart. Skin warts can be easily removed by freezing them with liquid nitrogen, but other kinds require more finesse. Use a condom (Biddle ’95: 102-103). The Advisory Committee on Immunization Practices (ACIP) recommends routine HPV4 vaccination of females aged 11 or 12 years, and catch-up vaccination for females aged 13 through 26 years. HPV4 is administered in a 3-dose schedule. The second dose is administered 1 to 2 months after the first dose, and the third dose is administered 6 months after the first dose (MILVAX ’10).

Quadrivalent HPV vaccine (HPV4; Gardasil, Merck & Co, Inc.) was licensed in 2006 for use in females aged 9 through 26 years, and in October 16, 2009 for use in males ages 9-26. On that same day October 16, 2009, the Food and Drug Administration (FDA) licensed bivalent human papillomavirus vaccine (HPV2; Cervarix, GlaxoSmithKline) for use in females aged 10 through 25 years. HPV vaccines are directed against two oncogenic types (HPV 16 and 18) and two nononcogenic types (HPV 6 and 11). HPV types 6 and 11 cause approximately 90% of 500,000 annual cases of genital warts and most cases of recurrent respiratory papillomatosis. Direct medical costs related to genital warts are estimated at $200 million per year. HPV4 has a slightly higher efficacy against HPV 16 and 18-related cervical precancer lesions. HPV 16 and 18 cause about 70% of cervical cancers; as well as vulvar, vaginal, anal, and oropharyngeal and oral cavity cancers and precancer lesions, caused primarily by HPV 16. HPV-associated cancers in males include certain anal, penile, and oropharyngeal and oral cavity cancers caused primarily by HPV 16.

5. Hemorrhagic Fevers

Yellow fever was the American plague. The virus is transmitted by certain female Aedes mosquitoes, which were not native to the Americas. A. aegypti, the classic carrier, likes to lay its eggs in containers of clean water, so it thrives around human settlements, especially in humid climates, with an average temperature above 72°F. The classic symptoms were yellow skin and black vomit. Individuals had a fifty-fifty chance of survival. African slaves were known to be relatively immune to yellow fever, malaria, and other diseases that ravaged Europeans and native Americans. A vaccine was developed in 1937 and given on a mass basis in 1939 Yellow Fever vaccine (VF-VAX, Sanofi-Pasteur) Today, yellow fever occurs mostly in underdeveloped, rural areas where control measures and/or immunization are lax. Mortality can be as high as 10 percent in large outbreaks, though the disease is often mild enough to escape detection (Biddle ’95: 163-165).

Colorado Tick Fever usually occurs 3-7 days after a Dermacentor andersoni tick bite, although the incubation period can be as long as 20 days. The initial symptoms of the disease often include fever, chills, headache, muscular and skeletal pain, and malaise. Other symptoms may include nausea, vomiting, stomach pain, light sensitivity and sore throat. About half of all patients experience a two-staged fever characterized by 2 to 3 days of acute fever followed by a brief remission of the fever, followed by a second acute fever. A petehcial (spotted) rash occurs in 5-12% of CTF cases. In rare cases, patients experience illnesses of the central nervous system (CNS) ranging from mild to encephalitis with coma and death. One can only treat the symptoms (ALDF ’10). Arenaviruses were first identified in 1933 during an encephalitis outbreak in St. Louis, Missouri. Some of the viruses cause meningitis and various hemorrhagic fevers when humans come into contact with infected excreta. Patients are attended by doctors in biohazard moon suit (Biddle ’95: 23-24).

There are more than 520 known Arboviruses, of which about a hundred cause disease in humans, usually with no apparent symptoms e.g. Encephalitis, yellow fever, dengue fever and many exotic tropical fever malaises. Epidemics are unlikely wherever the associated insects are kept under control (Biddle ’95: 23). Besides the Yellow Fever vaccine (VF-VAX, Sanofi-Pasteur) there is no prescribed medical treatment, although Ribavirin (Virazole) has been suggested. Encephalitis is an inflammation of the brain often caused by arboviruses carried by arthropods, such as mosquitoes, particularly the northern house mosquito (Culex pipiens) and ticks. The symptoms of West Nile Virus, St. Louis encephalitis and LaCrosse encephalitis are similar. Some persons may have mild symptoms, such as a fever and headache. Severe infection may produce a rapid onset of severe headache, high fever, muscle aches, stiffness in the back of the neck, problems with muscle coordination, disorientation, convulsions and coma, fatalities rarely occur. Symptoms usually occur five to 15 days after the bite of an infected mosquito. Infection with an arbovirus provides immunity to that specific virus, but not to other arboviruses (IDPH ’07).

An often mild or unapparent disease caused by a Flavivirus (an arbovirus genus) Zika fever is common in Africa and Asia and half of native Africans in some regions have tested positive for antibodies. Yellow fever, dengue, and several varieties of hemorrhagic fever and encephalitis are also brought by flavivuruses, but Zika is evidently not as dangerous as these others to humans. A closely related virus causes Spondweni fever, named after the South African district. The precise circle of infection for Zika and Spondweni is unknown but may involve livestock, which have also been found to carry antibodies (Biddle ‘95: 171). Marburg and Ebola are two exotic filoviruses from tropical Africa with high fatality rates, 25 percent for Marburg and up to 90 percent for Ebola (Biddle ‘95: 89).

Table 7: Viral Zoonotic Fever

Viral Pathogen	Viral Family	Disease Expression	Drug Monograph
Arboviral Encephalitis viruses	Toga Bunya	Eastern, Western, Venezuelan, St. Louis, LaCrosse, California group	None, mosquito protection, repellant and prevention
Yellow fever	Toga	Yellow fever	Yellow Fever vaccine (VF-VAX, Sanofi-Pasteur)
Colorado tick	Reo (Orbl)	Colorado tick fever	None.
Denguevirus 1-4	Toga	Dengue, hemorrhagic fever	acetaminophen (Tylenol); Early results of clinical trials show that a vaccine may be available by 2012.
Regional hemorrhagic fever viruses	Arena Bunya Filo? Hanta	Bolivian, Argentinian, Lassa Crimean-Congo, Hantaan, sandfly fever Ebola, Marburg disease Korean, USA pneumonia	None. Ribavirin (Virazole)
Rabiesvirus	Rhabado	Rabies	Rabies Immune Globulin (Human): Hyper RAV (Talecris); Imogram Rabies – HT (Sanofi-Pasteur) and Purified Chick Embryo Cells (PCEC) Rabavert (Novartis) or Human Diploid Cell Vaccine (HDCV): Imovax (Sanofi-Pasteur)
Parvovirus	Parvo	Erythema infectiosum, Asplastic anemia	None, Immune Globulin Intravenous (IGIV)

Today dengue occurs in the US only when brought by travelers from areas where it is endemic, like the Caribbean, Central and South America, Africa and Southeast Asia. Dengue fever is caused by an arbovirus transmitted mainly by bites of Aedes aegypti mosquitoes (which also carry yellow fever and viral encephalitis). American A. aegypti, firmly established in Texas and Florida, are not generally dangerous. An epidemic of more than a million cases occurred in the US in 1922 but the last endemic outbreak of dengue fever happened in 1986 in south Texas. Only a dozen or so confirmed cases appear every year in the US, local outbreaks usually occur when it is brought from abroad. Dengue is known for bringing on a sudden 104°F temperature, nausea, vomiting, horrendous headache, a rash that appears after a twenty-four hour pause in the fever, and long convalescence, but it is not deadly. Most cases are mild, treated with fluids and bed rest. There is a far more serious form of the disease, called dengue hemorrhagic fever, whose incidence has been increasing since first reported from Thailand and the Philippines in the mid-1950s (Biddle ’95: 52-53). Another Aedes mosquito, A. albiopictus, the “Asian tiger” can also transport the dengue microbe. Though aggressive tiger has not yet been found to carry dengue in the US, another dangerous arbovirus, eastern equine encephalitis, has been found on A. albiopictus around a tire dump in Florida (Biddle ’95: 54).

The virus that causes rabies is said to be “neurotropic” that is it seeks out nerve cells and drives its victims crazy in order to jump to the next host, via the saliva in the rabid animal’s bite wounds that break the skin in fact, the salivary glands actually become infected before most animals show any overt sign of rabies. The disease has a long incubation period, averaging a month or two in humans but sometimes years, depending a lot on the location (head, face, or hands are most dangerous) and severity of infective bites. This provides a window for treatment, which is generally futile after symptoms begin. Rabies victims at first feel a general malaise and restlessness, then grow increasingly agitated with painful spasms of the throat. Some start to hallucinate. Soon they cannot drink, which is why rabies has been called “hydrophobia”. Death comes within ten days after the appearance of symptoms, though modern care can make this somewhat less than inevitable. There is only one method for testing an animal, kill it and examine its brain. Washing a bite thoroughly with soap is the best first aid (Biddle ’95: 116-119). About thirty thousand deaths are attributed to rabies every year, the vast majority in poor countries. Since 1980, twenty cases have been reported in the US, half of which were imported. For persons who have never been vaccinated against rabies, post-exposure anti-rabies vaccination should always include administration of both passive antibody human rabies immune globulin (HRIG) either Hyper RAV (Talecris) or Imogram Rabies – HT (Sanofi-Pasteur) and either human diploid cell vaccine (HDCV) Imovax (Sanofi-Pasteur) or purified chick embryo cell vaccine (PCECV) Rabavert (Novartis) (ACIP ’08: 1).

Fifth disease is caused by infection with human parvovirus B19 that causes a mild, “slapped-cheek” rash most commonly in children that resolves in 7 to 10 days. The child may have a low grade fever or cold before the rash breaks out. This virus infects only humans. Pet dogs or cats may be immunized against "parvovirus", but these are animal parvoviruses, that do not infect humans, nor can a pet cat or dog catch human parvovirus B19, from an ill child. In a household, as many as 50% of susceptible persons, exposed to a family member, who has fifth disease may become infected. During school outbreaks, 10% to 60% of students may get fifth disease. Parvovirus B19 infection may cause a serious illness in persons with sickle-cell disease or similar types of chronic anemia. In such persons, parvovirus B19 can cause an acute, severe anemia. The typical rash is rarely seen in these persons. Once the infection is controlled, the anemia resolves. Persons who have leukemia or cancer, who are born with immune deficiencies, who have received an organ transplant, or who have human immunodeficiency virus (HIV) infection are at risk for serious illness due to parvovirus B19 infection and recommended Immune Globulin (IGIV) treatment (CDC ’11).

6. Retroviruses

The most interesting and complex families of animal viruses are the retroviruses. A retrovirus is one containing an enzyme, reverse transcriptase, that converts viral RNA into a DNA copy that becomes part of the host cell’s DNA. Retroviruses are RNA viruses but they replicated by means of a DNA intermediate. Under certain conditions, the retrovirus DNA escapes from the host chromosome, becomes converted back into RNA and forms mature virions which leave the host by budding off the cells membrane. (Cotran ’94: 286-290). Retroviruses were the first viruses shown to cause cancer. Retroviruses resemble bacterial viruses. The enzymatic activities found in the virus particle are reverse transcriptase, DNA endonuclease (integrase) and a protease. Some tumorigenic retroviruses are known to cause sarcomas or acute leukemia and possess a high oncological potential. Infection with one these viruses can cause cellular transformation, leading to the formation of a tumor. Retroviruses are the agents by which such gene is transferred from cell to cell. HIV the AIDS virus infects a specific cell type in the human, a kind of T lymphocyte that is vital for proper functioning of the immune system. Because viruses are not cells, but depend on cells for their replication, viral disease pose serious medical problems, it is frequently difficult to prevent antiviral drugs from doing some damage to host cells. Despite this, certain chemotherapeutic strategies have been devised for use in anti-viral drugs against viral pathogens, including anti-retroviruses (Brock et al ’94: 234).

Leukemia (reticulosarcomas) and lymphoma (lymphosarcomas) have a relationship to Epstein-Barr virus infection, which causes infectious mononucleosis, Hodgkin’s disease, nasopharyngeal carcinomas and leukemias. In addition retrovirus (oncornavirus, leukovirus) particles similar to those found in animal leukemias have been discovered (Lewis ’77: 114). Human T-Cell Leukemia virus type 1 HTLV-1 is an RNA retrovirus endemic to certain parts of Japan and the Caribbean basin but is found sporadically elsewhere. Leukemia develops in about 1% of infected individual after a long latent period of 20 to 30 years. HTLV-1 is also associated with a demyelinating neurologic disorder called tropical spastic parapareses (Cotran ’94: 286-290). In the United States the peak of acute lymphocytic leukemia occurs among children between 3 and 4 years of age, then the rate falls until the age of 35, when the incidence of predominantly chronic lymphocytic leukemia appears to rise. Radiation induces both chronic myeloid leukemia and acute leukemia, that has also been associated with exposure to such chemicals as benzene and chloramphenicol. The treatment of leukemia begins with Acyclovir (Zovirax) and professional treatment begins with Immune Globulin Intravenous (IGIV) and Pegylated interferon alfa-2b (Pegasys) injection. If that fails Imatinib (Gleevec) tablets are the first targeted anti-neoplastic therapy approved for chronic myeloid leukemia, the most common side effect is edema. Monoclonal antibodies are given in combination with other drugs.

AIDS, acquired immunodeficiency syndrome was recognized in the early 1980s. The World Health Organization estimates that 17 million people are infected with HIV and 4 million have AIDS. More than 90 percent of AIDS cases occur in Third-World countries. The largest number of cases, estimated at more than 2.5 million, is in sub-Saharan Arica, where there are more than 10 million HIV infected adults. In the United States, AIDS is still overwhelmingly an affliction of homosexual and bisexual men (47 percent of reported cases in 1993) and injecting drug users (28 percent of reported cases in 1993). Among racial and ethnic groups African-Americans and Hispanics account for both the majority of reported cases (54 percent in 1993) and the greatest annual increases. Heterosexual transmission, 42 percent of which was related to contact with an injecting drug user, occurred predominantly in these groups (78 percent of men and 74 percent of women in 1993). Factoring in age reveals an even grimmer picture: in 1993 minorities accounted for 51 percent of reported cases among adult and adolescent males and 75 percent of cases among females. Among children younger than thirteen years old, 84 percent of AIDS cases were minorities. The AIDS rate for black women was about 15 times greater than for white women and almost five times greater for black men than for white men. In 1991 AIDS was the leading cause of death among black and Hispanic males aged 25 to 44 and the third leading cause for women in the same age group, and the seventh leading cause of death nationwide (Biddle ’95: 74-76).

Southern Africa is the epicenter of the HIV/AIDS pandemic. One third of the global population living with HIV is in the Southern African Development Community (SADC) countries where 13.9 percent of the population was reported by UNAIDS to be infected in 2001. In 2001 an estimated 20.1 percent of adult population in South Africa was infected with HIV, although there is great variation among countries: from 0.1 per cent in Mauritius to 38.8 per cent in Botswana. 5 million South Africans live with AIDS and there are 660,000 AIDS orphans and have been 360,000 deaths in a total population of 43.8 million (Whiteside ’02: 2). The $8-10 billion invested in the Global Fund to Fight AIDS, Tuberculosis and Malaria Fund 2005-2008 increased the number of people in low and middle-income countries receiving antiretroviral therapy for HIV 10-fold. The HIV infection rate in South Africa declined 15.8% from 21.5% of the population in 2004 to 18.1% in 2005. This is largely due to a 58.3% increase in number of AIDS deaths from 3,600 in 2004 to 5,800 in 2007. Millennium Development Goal 6 to halt and reverse the spread of AIDS by 2015 is the only goal to have been achieved. South Africans don’t need to die to halt and reverse the transmission of the pandemic. In most other nations, during this same time period both the number of infected people and number of mortalities have declined, there is little doubt that HIV infection can be cured and AIDS tolerated like normal chronic disease. Everywhere, it seems except Washington DC where the infection rate has been reported to have risen to as high as 5% (Sanders ’10).

The immune system fights a long, ferocious, but ultimately losing battle against the AIDS virus. Healthy people have between 500 and 1,500 CD4 cells in a milliliter of blood if the number is less than 200 CD4 cells or if the CD4 percentage is less than 14%, the person has AIDS. A person’s viral load is also considered important in determining the danger of infection posed by AIDS. In late stages of the infection, victims lose and replace about 2 billion CD4 lymphocyte cells a day, while new virus particles appear at a rate between 100 million and 680 million a day. Other viral disease, such as leukemia, flu, or hepatitis may also trigger such high viral loads, but for a relatively brief time (Biddle ’95: 76-81). 9 out 10 people who test positive will develop further problems. The San Francisco study showed that without use of the latest therapies: 50% with HIV develop AIDS in ten years, 70% with HIV develop AIDS in fourteen years, and of those with AIDS, 94% are dead in five years. No antibodies have yet been found in a human being that are effective in the long term against HIV. That is why a vaccine is so difficult to find. Attempts have even been made to flood the bloodstream with small pieces of cell wall (CD4) so the viruses are unable to touch living CD4 white cells. According to a study in 14th International AIDS Conference, average annual cost of treating HIV-positive patients in the United States can vary from about $34,000 to $14,000, depending on the stage of the virus (HIV Symptoms ’11).

The newest and most effective combination AIDS drug is efavirenz/emtricitabine/tenofovir (Atripla) that promises to totally eliminate viral loads but comes with considerable hepatoxicity and hepadependence that can be mitigated with Pegalated interferon alpha-2B injections (Pegasys). The mint family (Lamiaceae) produces a wide variety of constituents with medicinal properties. Several family members have been reported to have antiviral activity, including lemon balm (Melissa officinalis L.), sage (Salvia spp.), peppermint (Mentha x piperita L.), hyssop (Hyssopus officinalis L.), basil (Ocimum spp.) and self-heal (Prunella vulgaris L.). Aqueous P. vulgaris extracts inhibited HIV-1 infectivity, primarily through inhibition of early, post-virion binding events. The ability of aqueous extracts to inhibit early events within the HIV life cycle suggests that these extracts (or purified constituents) responsible for the antiviral activity are promising microbicides and/or antivirals against HIV-1 (Oh Choonseok et al ‘11).

Table 8: Seven classes of Retroviral Medicine

Class	Drugs	Notes
Nucleoside analogue reverse transcriptase inhibitors (NRTIs)	zidovudine (Retrovir), lamivudine (Epivir), didanosine (Videx), stavudine (Zerit), abacavir (Ziagen), (Epcicom)(Trizivir) emtricitabine (Emtriva)(Truvada combination)	Inhibit the replication of an HIV enzyme called reverse transcriptase; side effect of zidovudine is bone marrow suppression, which causes a decrease in the number of red and white blood cells, 5 percent of people treated with abacavir experience rash, fever, fatigue, nausea, vomiting, diarrhea and abdominal pain, didanosine caused fatal liver disease. Symptoms usually appear within the first six weeks of treatment and generally disappear when the drug is discontinued.
Protease inhibitors (PIs)	saquinavir (Invirase), ritonavir (Norvir)(Kaletra, Aluvia) indinavir (Crixivan), nelfinavir (Viracept), amprenavir (Agenerase), lopinavir/ritonavir (Kaletra), atazanavir (Reyataz), tipranavir (Aptivus), Darunavir (Prezista) combination	PIs interrupt HIV replication at a later stage in its life cycle by interfering with an enzyme known as HIV protease. HIV particles become structurally disorganized and noninfectious. Darunavir is for people who haven't responded to treatment with other drugs. Darunavir is used with ritonavir and other anti-HIV medications. side effects are nausea, diarrhea and other digestive tract problems
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)	nevirapine (Viramune), delavirdine (Rescriptor), efavirenz (Sustiva), etravirine (Intelence)	Bind directly to the enzyme reverse transcriptase; side effect rash and aggravation of mood disorders.
Nucleotide reverse transcriptase inhibitors (NtRTIs) “nuke” family	tenofovir (Viread)(Truvada)	Inhibits both HIV and hepatitis B more quickly than NRTIs, side effects, nausea, vomiting, diarrhea and gas, HBV resurgence if discontinued.
Fusion inhibitors	enfuvirtide (Fuzeon)	Combination; Injection to suppress resistant strains of HIV
Integrase inhibitors	raltegravir (Isentress)	Combination; blocks replication of the HIV integrase enzyme; side effects include diarrhea, nausea, headache and fever.
Chemokine co-receptor inhibitors	maraviroc (Selzentry)	Highly effective treatment for a particular type of HIV infection called CCR5-tropic HIV-1; Side effects may include liver and cardiovascular problems, as well as cough, fever, upper respiratory tract infections, rash and abdominal pain.
Combination	efavirenz/emtricitabine/tenofovir (Atripla), emtricitabine-tenofovir (Truvada), abacavir/lamivudine (Epzicom) zidovudine/lamivudine/abacavir (Trizivir), lopinavir/ritonavir (Kaletra, Aluvia) zidovudine/lamivudine (Combivir)	Hepatoxicity and hepatic dependence noted for Truvada (2004) and Atripla (2006). Highest marks go to Atripla, the newest drug, that promises to totally eliminate viral loads. Hepatoxicity can be mitigated with Pegylated interferon alpha-2B (Pegasys) injections.

Source: PHD ’09 Sec. 345 F(1-7) pp.1341-1342, AIDSinfonet.org

HIV, which actually refers to two closely related viruses that cause AIDS in separate geographical regions, is part of a class of retroviruses known as lentiviruses traditionally associated with chronic arthritis and anemia. Lentiviruses are retroviruses that cause slowly progressive often fatal disease. HIV interferes with the body's ability to fight off viruses, bacteria and fungi that cause diseases such as pneumonia and meningitis, by damaging the immune system. The virus and the infection itself are known as HIV. HIV tests detect antibodies. HIV attaches itself to the T lymphocytes, that turn the immune system on and off, with a protein called DF4 on their surface, which is the actual hookup point for HIV. Once inside a T cell, the virus releases its genetic template (RNA) along with a chemical that allows it to be transcribed into the cell’s own DNA. All offspring of the altered T cell thus contain the virus’s genetic code. The T cell also may become a factory for new infectious HIV, which lyse it as they burst out (Biddle ’95: 76-81).

Two to fifteen years may pass between initial infection and onset of the AIDS syndrome. Acquired immune-deficiency syndrome (AIDS) is the name given to the later stages of an HIV infection (Biddle ’95: 76-81). Six to twelve weeks after HIV penetrates the body’s natural defenses and programs the white blood cells the first symptom to appear is flu-like glandular fever with swollen glands in the neck and armpits. Blood test will usually become positive at this time. HIV AIDS symptoms begin when the immune system starts to break down. Several glands in the neck and armpits may swell and remain swollen for more than three months. This is known as persistent generalized lymphadenopathy (PGL). As the HIV disease progresses, the person starts showing up other AIDS symptoms. A simple boil or warts may spread all over the body. The mouth may become infected by thrush (thick white coating), or may develop some other problem. Dentists are often the first to be in a position to make the diagnosis. People may develop severe shingles (painful blisters in a band of red skin), or herpes. They may feel overwhelmingly tired all the time, have high temperatures, drenching night sweats, lose more than 10% of their body weight, and have diarrhea lasting more than a month. The final stage is AIDS. Most of the immune system is intact and the body can deal with most infections, but one or two more unusual infections become almost impossible for the body to get rid of without medical help, usually intensive antibiotics (HIV Symptoms ’11).

Table 9: Common AIDS Symptoms and Medicine

Pathogen	Symptoms	Drug Monograph
persistent generalized lymphadenopathy (PGL)	Rapid enlargement of a previously stable lymph node or a group of nodes	Begin or intensify antiretroviral therapy, causes vary, use antibiotics, Cidofivir (Vistide) is the anti-herpes for AIDS substitute for Acyclovir (Zovirax), that may be improved with Foscarnet Sodium (Foscavir) injection
Coronavirus, Rhinovirus, Influenza A & B, Parainfluenza, Respiratory syncytial virus	Swollen lymph nodes, cold and flu-like symptoms lasting 4 days to a week, bronchiolitis, pneumonia	Cold remedies: Diphenhydramine (Benylin, Benadryl), Chlorpheniramine (Telachlor, Chlo-Amine, Chlor-Trimeton, Aller-Chlor), Brompheniramine (Bromphen, Nasahist B, Dimetane Extentabs) Bed rest for fevers. Flu vaccine ineffective. OTC Theraflu, Allegra (Sanofi-Aventis) and Children's Allegra (fexofenadine) and Allegra-D (fexofenadine and pseudoephedrine); Prescription Oseltamivir (Tamiflu) and Zanamivir (Relenza). Antibiotics for pneumonia, ampicillin (Principen), azithromycin (Zithromax), levofloxacin (Levaquin). Avoid asthma inhalers that contain corticosteroids, that suppress the immune system. Fatal adverse events with salmeterol inhalers. Smoke jimson weed for asthma and mullein for bronchitis.
Adenovirus, Norovirus, Echovirus and Rotavirus acquired from children	Upper and lower respiratory tract infections (URI, LRI), conjunctivitis, diarrhea	Rotovirus vaccine (Rotarix GlaxoSmithKline GSK) (Rotateq Merck & Co.), LigoCyte phase II intranasal norovirus, White rice water diet. Imodium (Loperamide), Immune Globulin IV for severe cases
Salmonellosis Salmonella spp bacteria acquired by ingesting contaminated food and water	Severe diarrhea, fever, chills, abdominal pain and, occasionally, vomiting, contagious when shed in bile	Hydration, white rice water diet, imodium (Loperamide), trimethoprim-sulfamethoxazole (Septra), metronidazole (Flagyl ER) 10 days max
Candidiasis Candida albicans acquired from antibiotic resistance	Inflammation of the mouth or genitals and thick white coating on the mucous, called thrush, usually found in children.	Antimycotics, antifungal drugs: topical clotrimazole (Fungoid Solution, Gyne-Lotrimin, Lotrimin, Lotrisone, Mycelex), topical nystatin (Mycostatin, Mykacet, Nystat-Rx, Nystop, Pedi-Dri), fluconazole (Diflucan), and topical ketoconazole (Extina, Nizoral, Nizoral A-D, Xolegel). Take metronidazole (Flagyl ER) to avoid antibiotic resistant Candidiasis
Cryptosporidiosis Cryptosporidium spp. Protozoal parasite acquired from soil, bird or bat droppings	Intestinal and bowel infection causes severe diarrhea, cramps, malnutrition and weight loss in AIDS patients	White rice water diet, Primary: nitazoxanide (Alinia) Alternates: metronidazole (Flagyl ER), Trimethoprim-sulfamethoxazole (Septra)
Cryptococcal meningitis Cryptococcus neoformans	Fever, hallucinations, headache, nausea and vomiting, sensitivity to light, stiff neck	Antimycotics: fluconazole (Diflucan), flucytosin (Ancobon), amphotericin B IV (Amphotec, Abelcet, AmBisome), Paromomycin Sulfate (Humatin)
Tuberculosis (TB) Mycobacterium tuberculosis acquired from cough or sneeze droplets	Only 10% develop pulmonary TB involving fever, dry cough, weight loss and abnormalities, 10% of these develop TB pleuritis that infects the lining between the lung and abdominal cavity and causes chest pain. TB kills two out of three with untreated symptoms, death rate is 5% with treatment	Isoniazid (Rifamate, Rifater), rifampicin (Rifadin, Rimactane, Rifamate, Rifater), pyrazinamide (Daraprim, Rifater), and ethambutol (Myambutol) for two months, then isoniazid and rifampicin alone for four months. Cured at six months (2 to 3% relapse). For latent tuberculosis, standard treatment is six to nine months of isoniazid. If the organism is fully sensitive, isoniazid, rifampicin, and pyrazinamide for two months, combination Rifater (sanofi-aventis) followed by isoniazid and rifampicin for four months, ethambutol need not be used. Hepatoxic
Toxoplasmosis Toxoplasma gondii Spread by cat feces	Enlarged lymph nodes, headache, mild fever, muscle pain, sore throat, in AIDS patients, retinal inflammation and seizures	Combination - Antibiotic: sulfadiazine ie. Trimethoprim-sulfamethoxazole (Septra) and Antimalarial : pyrimethamine (Daraprim) and Antidote: leucovorin (Wellcovorin) Alternate: Atovaquone (Mepron)
Varicella-zoster virus	Chicken pox and shingles	Measles, Mumps, Rubella and Varicella vaccine (MMRV, ProQuad, Merck & Co., Inc.) or Varicella vaccine (VARIVAX, Merck & Co.); Cidofivir (Vistide), Acyclovir (Zovirax), Valtrex (Valacyclovir)
Cytomegalovirus (CMV) herpes virus acquired from bodily fluids	After long latency causes damage to the eyes, digestive tract, lungs or other organs, tumorigenic	Cidofivir (Vistide), Acyclovir (Zovirax), Foscarnet Sodium (Foscavir) injection, topical interferon alpha-2B for eyes and epidermal eruptions
Kaposi’s sarcoma human herpesvirus-8 (HHV-8)	Bluish-red or purple bumps on the skin, caused by tumor of the blood vessel walls, may involve organs, in lung maybe bloody sputum, shortness of breath	topical interferon alpha-2B, Cidofivir (Vistide), Acyclovir (Zovira), Foscarnet Sodium (Foscavir) injection, intense AIDS drugs, Antineoplastic: Cisplatin (Platinol)
Lymphomas	Begin with painless swelling of the lymph nodes in neck, armpit or groin	Topical or pegylated interferon alpha-2B, Cidofivir (Vistide), Acyclovir (Zovirax), Foscarnet Sodium (Foscavir) injection, Antineoplastic: Cisplatin (Platinol)

Persistent generalized lymphadenopathy (PGL), swollen lymph nodes is usually the first AIDS symptom that develops and indicates that a person should begin taking antiretroviral therapy if they have not done so already. There are many causes for PGL, swollen lymph nodes, so antibiotics are used to treat bacterial infections, and Cidofivir (Vistide), the anti-herpes for AIDS, substitute for Acyclovir (Zovirax), are the first line of defense. The most common reason for swollen lymph nodes in the general population is the common cold. Otherwise it is necessary to diagnose and treat the cause of the lymphatic flare up. Coronavirus and Rhinovirus, are associated with the swollen lymph nodes of the common cold for which there are a number of OTC remedies such as Diphenhydramine (Benylin, Benadryl), Chlorpheniramine (Telachlor, Chlo-Amine, Chlor-Trimeton, Aller-Chlor), Brompheniramine (Bromphen, Nasahist B, Dimetane Extentabs), Ipratropium intranasal (Atrovent). Flu-like symptoms were formerly effectively treated overnight with OTC Theraflu but the FDA now approves Allegra (Sanofi-Aventis), Children's Allegra (fexofenadine) and Allegra-D (fexofenadine and pseudoephedrine). Because corticosteroids are immune-suppressant, and salmeterol dangerous, asthma inhalers are not advised for AIDS patients with asthma and bronchitis might prefer to smoke non-addictive jimson weed for asthma and mullein for bronchitis. Take these treatments only for the condition it is prescribed. AIDS patients may get swollen lymph nodes from the common disorders below or others causes.

The digestive tract is reputed to be responsible for 80% of the immune system and gastrointestinal problems and diarrhea are probably the most dangerous common manifestation of HIV/AIDS. Adenovirus, Norovirus, Echovirus and Rotavirus acquired from children are the most common viral causes of upper and lower respiratory tract infections (URI, LRI), conjunctivitis, diarrhea. There is a Rotovirus vaccine (Rotarix GlaxoSmithKline GSK) (Rotateq Merck & Co.) and LigoCyte is entering phase II of an intranasal norovirus vaccine clinical trial. Home treatment for diarrhea, that tends to suppress appetite, is white rice water diet, the objective is to eat white rice boiled for the proper time in 3 parts instead of 2 parts water, and drink the excess water to keep hydrated. Imodium (Loperamide) is an effective diarrhea remedy available without prescription. Immune Globulin IV can be administered for severe cases of viral diarrhea. It here that AIDS patients need a strong warning that antibiotics cause gastroenteritis in general and a particular condition called pseudomembranous colitis, known as antibiotic associated colitis, in particular, resulting from the proliferation of antibiotic resistant Clostridium difficile bacteria. Metronidazole (Flagyl ER) is an antibiotic and antiamoebic that treats antibiotic associated colitis as well as antibiotic associated Candidiasis, and does not disturb the gut, it is however carcinogenic and not very effective against viruses or funguses, although it causes the least antibiotic resistance. The most highly recommended broad spectrum antibiotic for AIDS patients against bacterial infection, while protecting the gut are sulfaminides such as trimethoprim-sulfamethoxazole (Septra).

Salmonellosis symptoms include severe diarrhea, fever, chills, abdominal pain and, occasionally, vomiting. It is caused by Salmonella spp bacteria acquired by ingesting contaminated food and water. Like all diarrheas salmonella is treated with hydration, white rice, and imodium (Loperamide), and because it has a bacterial cause trimethoprim-sulfamethoxazole (Septra) or metronidazole (Flagyl ER) 10 days max should be effective where other antibiotics only inflame the gut. Cryptosporidiosis occurs when contaminated food or water is ingested and the Cryptosporidium spp. protozoal parasite, acquired from soil, bird or bat droppings, that grows in the intestines and bile ducts, leading to severe, chronic diarrhea in people with AIDS. A white rice water diet, is needed. The primary treatment for Cryptosporidiosis is nitazoxanide (Alinia) and alternatively metronidazole (Flagyl ER) or Trimethoprim-sulfamethoxazole (Septra).

Candidiasis is a yeast infection that causes inflammation of the mouth or genitals and a thick white coating on the mucous, known as thrush. AIDS is often diagnosed by dentists noting the oral condition. Candida albicans the yeast causing Candidiasis is often acquired as the result of antibiotic resistance that metronidazole (Flagyl ER) is very effective at suppressing, and is the drug of choice for the treatment of mouth infections, to prevent the otherwise nearly inevitable antibiotic resistant Candidiasis. For the treatment of serious Candidiasis antimycotics, antifungal drugs, such as topical clotrimazole (Fungoid Solution, Gyne-Lotrimin, Lotrimin, Lotrisone, Mycelex), topical nystatin (Mycostatin, Mykacet, Nystat-Rx, Nystop, Pedi-Dri), topical ketoconazole (Extina, Nizoral, Nizoral A-D, Xolegel) and oral fluconazole (Diflucan), are used. Cryptococcal meningitis is a common central nervous system infection, caused by a fungus Cryptococcus neoformans that is present in soil, and may also be associated with bird or bat droppings. It’s symptoms are fever, hallucinations, headache, nausea and vomiting, sensitivity to light and stiff neck. Cryptococcal meningitis is treated with antimycotics: fluconazole (Diflucan), flucytosin (Ancobon), amphotericin B IV (Amphotec, Abelcet, AmBisome), and Paromomycin Sulfate (Humatin). AIDS doesn't appear to infect the nerve cells but can cause neurological symptoms such as confusion, forgetfulness, depression, anxiety, trouble walking and AIDS dementia complex, which leads to behavioral changes and diminished mental functioning (Mayo ‘10).

Tuberculosis (TB) is the most common opportunistic infection associated with HIV, in developing nations, and a leading cause of death among people living with AIDS. Only 10% of infected population develops symptoms. Pulmonary TB involves fever, dry cough, weight loss and abnormalities, 10% of these develop TB pleuritis that infects the lining between the lung and abdominal cavity and causes chest pain. TB kills two out of three with untreated symptoms, death rate is 5% with treatmentThe DOTS treatment prescribed by the world health organization is a combination of Isoniazid (Rifamate, Rifater), rifampicin (Rifadin, Rimactane, Rifamate, Rifater), pyrazinamide (Rifater), and ethambutol (Myambutol) for two months, then isoniazid and rifampicin alone for four months. TB is cured at six months with only a 2 to 3% relapse rate. For latent tuberculosis, standard treatment is six to nine months of isoniazid. If the organism is fully sensitive, isoniazid, rifampicin, and pyrazinamide for two months, combination Rifater (sanofi-aventis) followed by isoniazid and rifampicin for four months, ethambutol need not be used. Antimalarials are Hepatoxic. Toxoplasmosis is a potentially deadly infection caused by Toxoplasma gondii, a parasite spread primarily by infected cats who pass the parasites in their stools, and the parasites may then spread to other animals. The treatment for Toxoplasmosis involves a combination of Antibiotic: sulfadiazine ie. Trimethoprim-sulfamethoxazole (Septra) or Atovaquone (Mepron) and the Antimalarial: pyrimethamine (Daraprim) with Antidote: leucovorin (Wellcovorin).

Varicella-zoster virus causes chicken pox in children and shingles in elders and AIDS patients. There is a Measles, Mumps, Rubella and Varicella vaccine (MMRV, ProQuad, Merck & Co., Inc.) or Varicella vaccine (VARIVAX, Merck & Co.). Shingles can also be treated with Cidofivir (Vistide), Acyclovir (Zovirax), Valtrex (Valacyclovir). Cytomegalovirus (CMV) is a common herpes virus, that is transmitted in body fluids such as saliva, blood, urine, semen and breast milk; after long period of latency the virus resurfaces causing damage to the eyes, digestive tract, lungs or other organs and is tumorigenic. CMV is treated with topical interferon alpha-2B for eyes and epidermal eruptions, Cidofivir (Vistide), the AIDS substitute for Acyclovir (Zovirax), and Foscarnet Sodium (Foscavir) injection if resistant.

Cancers common to HIV/AIDS are Kaposi’s sarcoma and lymphoma. Kaposi's sarcoma is a tumor of the blood vessel walls caused by human herpesvirus-8 (HHV-8). Although rare in people not infected with HIV, it's common in HIV-positive people. Kaposi's sarcoma usually appears as pink, red or purple lesions on the skin and mouth. In people with darker skin, the lesions may look dark brown or black. Kaposi's sarcoma can also affect the internal organs, including the digestive tract and lungs. The initial treatment is to intensify AIDS drugs, apply topical interferon alpha-2B on epidermal eruptions, Acyclovir (Zovira), then Cidofivir (Vistide) and then Foscarnet Sodium (Foscavir) injection, before taking toxic antineoplastics. Lymphomas usually begin in the lymph nodes with a painless swelling of the lymph nodes in the neck, armpit or groin. Lymphoma occurs when B or T cells acquire changes that allow them to grow uncontrollably. The abnormal cells accumulate in the lymphatic system. There are two types of lymphoma: Hodgkin and non-Hodgkin lymphoma. The majority of Hodgkin lymphomas are classical Hodgkin lymphomas, which consist of characteristic cells called Reed-Sternberg cells. Another much more rare type of Hodgkin lymphoma is nodular lymphocyte-predominant Hodgkin lymphoma. The most common are B cell cancers called diffuse large B cell lymphoma and follicular lymphoma. Other B cell non-Hodgkin lymphomas include Burkitt lymphoma, immunoblastic large cell lymphoma, precursor B-lymphoblastic lymphoma, and mantle cell lymphoma. T cell non-Hodgkin lymphomas include mycosis fungoides, anaplastic large cell lymphoma, and precursor T-lymphoblastic lymphoma. To treat cancer intensify AIDS drugs, take Cidofivir (Vistide) and then Foscarnet Sodium (Foscavir) and pegyated interferon alpha-2B (Pegasys) injections. The first resort antineoplastic therapy, that can be used alone or in combination to treat most cancers, is Cisplatin (Platinol).

7. Viral Oncology

A number of animal viruses have the oncogenic potential to change a cell from a normal one to a cancer or tumor cell. Of the various human DNA viruses three (papillomaviruses, Epstein-Barr virus (EBC) and hepatitis B virus (HBV) are known to cause cancer (Cotran ’94: 274). In 2002 it was reported that viral infections accounted for around 18% of all cancers worldwide (Burnett-Hartman ’08). Different viruses employ different strategies, some highly complex, to make copies of themselves once they have invaded a host cell. During replication of the viral nucleic acid, the viral genes may first have to code the manufacture of special enzymes called polymerases or transcriptases to assist in replication or may borrow these enzymes from the host cell. Sometimes the viral genome must invade the nucleus of the host cell and incorporate itself into the cell’s chromosomes before it can replicate. Sometimes if the viral genome invades the nucleus of the host cell, it may not at first replicate but may “hide” there, sometimes becoming reactivated months or years later. It may also interact with the cell’s chromosomes, a process that may convert the cell into a tumor cell (AMA ’89:1050). Genetic damage (or mutation) may be acquired (in somatic cells) by the action of environmental agents, such as chemicals, radiation, or viruses (Cotran ’94: 258-259).

The chromosomes in all normal body cells contain 50 or more genes (known as oncogenes) that are necessary for growth or differentiation of the cells. Certain retroviruses contain almost identical oncogenes. The oncogene is known as the src gene (src for sarcoma). Oncogenes, cancer causing genes, are derived from proto-oncogenes that promote normal growth and differentiation to suppress tumors. Oncogenes encode proteins called oncoproteins (Cotran ’94: 258-259). In the process of replication, these viruses may modify the chromosomes of the host cell. A small mutation in these can “switch on” the oncogenes inappropriately, thus prompting the cell to begin unrestrained division, leading to cancer (AMA ’89: 1052). Infection by certain types of animal viruses leads to a process called transformation, during which growth becomes uncontrolled. Because cancerous cells in the animal body have fewer growth requirements, they grow profusely, leading to the formation of large masses of cells called tumors. The term neoplasm is often used in the medical literature to describe malignant tumors. Not all tumors are seriously harmful. Noninvasive tumors are called benign. Other tumors, called malignant, invade the body and destroy normal body tissues and organs. In advanced stages of cancer, malignant tumors may develop the ability to spread to other parts of the body and initiate new tumors, a process called metastasis (Brock et al ’94: 219). A clinically detectable tumor contains 10⁹. The latent period before which a tumor becomes clinically detectable is unpredictably long, usually years, and is only diagnosed after they are fairly advanced in their life cycle. After they become clinically detectable, the average volume-doubling time for such common killers as cancer of the lung and colon is about 2 to 3 months. The range of doubling time is broad, varying from less than 1 month for some childhood cancers to more than 1 years for certain salivary gland tumors (Cotran ’94: 274).

Table 10: Some human cancers that may be caused by viruses

Cancer	Virus	Family	Genome	Antiviral Monographs
Adult T-cell Leukemia	Human T-cell leukemia virus (type I)	Retrovirus	RNA	Pegylated interferon alpha-2b (Pegasys) injection, Immune Globulin Intravenous (IGIV), monoclonal antibody: Imatinib (Gleevec)
Brukitt’s lymphoma	Epstein-Barr virus	Herpes	DNA	Topical interferon alpha-2B, Acyclovir (Zovirax), Foscarnet Sodium (Foscavir) injection, Immune Globulin (IGIV) Cisplatin (Platinol)
Nasopharyngeal carcinoma	Epstein-Barr virus	Herpes	DNA	Topical interferon alpha-2B, Acyclovir (Zovirax), Foscarnet Sodium (Foscavir) injection, Immune Globulin (IGIV); Combination with Cisplatin (Platinol)
Hepatocellular carcinoma (liver cancer)	Hepatitis B virus	Hepadna	DNA	Bivalent (Combination) Hepatitis A and Hepatitis B Vaccine (TWINRIX GSK); Pegylated interferon alfa-2b (Pegasys), Nucleoside/nucleotide analogues (NAs) adefovir (Hepsera) tenofovir (Viread); Antineoplastic Sorafenib Tosylate (Nexavar)
Colon cancer	Polyomavirus JCV SV40	Papova	DNA	topical interferon alfa-2b, Acyclovir (Zovirax), Foscarnet Sodium (Foscavir) injection monoclonal antibody: Fluorouricil (Adrucil) and antidote leucovorin (Wellcovorin)
Skin and cervical cancers	Papilloma virus	Papova	DNA	topical interferon alfa-2b, Quadrivalent HPV vaccine (HPV4; Gardasil, Merck & Co, Inc.), Acyclovir (Zovirax), Foscarnet Sodium (Foscavir) injection and Cidofivir (Vistide) antineoplastics: Fluorouricil (Adrucil) and cisplatin (Platinol)

Source: Brock et al ’94: Table 6.2 pp. 219

The basic assumption in cancer treatment is that all cancer cells must be killed or removed to achieve cure, and render the patient’s life expectancy the same as a normal life expectancy. It is comparatively easy to kill 99% of the malignant cells, but resistant ones are nearly always present, and from these recurrences result. Antineoplastic drugs work on the basis of the unique abnormal metabolism of malignant cells. Alkylating agents (cytotoxic compounds, Mechlorethamine (Mustargen) are able to kill malignant cells during all phases of their cycle by combining chemically with nucleic acids. Other generic alkylating agents include Thitepa, chlorambucil (Leukeran). Cyclosphosphamide (Cytoxan) used against Hodgkin’s disease and other lymphomas, lymphatic leukemia and certain solid cancers. Antimetabolites available commercially include Methotrexate (Trexall), mercaptopurine (Purinethol), Thioguanine, Fluorouracil (Adrucil), and cytarabine (DepoCyt). These agents usually kill cells at the time of DNA synthesis. Hormones like prednisone, are widely used in compound chemotherapy, diethylstilbestrol and ethinyl estradiol are estrogens effective in the treatment of breast carcinoma and in the carcinoma of the prostate, androgens (testosterone propionate, testosterone enanthate, testolactone) are also effective in the treatment of breast cancer, and the progestagens (hydroxyprogesterone, megestrol acetate) used to treat metastatic and recurrent endometrial carcinoma. Radioactive isotopes include iodine are readily taken up by the thyroid gland, where the destructive action of radiation may be effective in treating carcinoma of the thyroid (Lewis ’77: 127).

Radiation has been used for the treatment of cancer since shortly after the x-ray was invented in 1895. The fallout from Hiroshima and Nagasaki however made it painfully obvious that radiation causes cancer. Since the mass marketing of the automobile, television, computer and cell phone the number of cancer cases and mortalities increased dramatically before subsiding slightly at the beginning of the 21st century. DVD writers are radioactive, and if broken very radioactive, please remove broken devices, particularly if experiencing the symptoms of radiation poisoning - convulsions, vascular damage, cardio vascular collapse, keloids and cancers (Sanders ’11). Radiotherapy continues to be commonly used for the treatment of cancer and low relapse rates are reported. Public information on the topic of radiotherapy is however highly questionable. For instance, Wilhelm Reich M.D., a protege of Sigmund Freud, found that orgone, a measurable natural energy found everywhere pulsing with life and weather, was useful in the treatment of cancer, but was reluctant to call it a cure. Reich had been disgraced for his anti-fascist writing and found asylum from death sentences from both Hitler and Stalin, in the United States. In a unique judicial ruling, the FDA obtained a Federal Court Decree of Injunction, which ruled that the orgone energy “does not exist”. Several years later, Reich was charged with Contempt of Court, and died in federal prison in 1957. Recent clinical trials from hospitals in Germany found the somatic effects of the orgone energy accumulator were more powerful in the treatment of cancer than any other form of conventional or natural therapy they had tried. Pain was relieved, the appetite was stimulated, and the patients became more alert and active. The blood picture cleaned up, with red cells showing a stronger energetic charge, and fewer t-bacilli. Tumors ceased growing and in some cases, declined dramatically in size. Reich warned persons with a history of hypertension, decompensated heart diseases, brain tumors, arteriosclerosis, glaucoma, epilepsy, heavy obesity, apoplexia, skin inflammations or conjunctivitis not to use the accumulator, and in some cases, as the patient’s tumors began to disintegrate, they would become debilitated by the toxic break-down products of the tumor, and die of secondary complications, such as kidney or liver failure. Experimental orgone accumulator products such as boxes and blankets can be purchased online (Demeo '10) (Orgonics '88-11).

Epstein-Barr virus is a member of the herpes family that has been implicated in the pathogenesis of four types of human tumors: the African form of Burkitt’s lymphoma, B-cell lymphomas in immunosuppressed individuals, some cases of Hodgkin’s disease and nasopharyngeal carcinomas. EVB infects epithelial cells of the oropharynx and B lymphocytes causing a latent infection that acquires the ability to propagate indefinitely. More than 90% of African tumors and 100% of nasopharyngeal carcinomas around the world, carry the EBV genome that causes infectious mononucleosis (Cotran ‘94: 286). EBV provides multiple selective advantages to tumor cells, including promoting cell proliferation and inhibiting cell death. In the case of Burkitt's lymphomas, most current evidence indicates that the tumor requires the virus minimally to block apoptosis (Vereide ’09). Interferon Alpha2-B should be applied topically, Acyclovir (Zovirax) resistant EBV should be treated with Foscarnet Sodium (Foscavir) injection with Immune Globulin (IGIV) maintenance before antineoplastics. The primary drug treatment for Nasopharyngeal carcinomas and lymphomas is Cisplatin (Platinol) with Prednisone.

Hepatitis B virus is highly associated with liver cancer and infection increases the chance of developing liver cancer 200 fold. Worldwide, chronic infection with hepatitis causes 80% of all primary liver cancers and more than 500,000 people die each year from this lethal cancer. With chronic HBV infections on the rise in the United States, there is a growing incidence of primary liver cancer and it has become one of the three fastest growing cancers in the country. While the overall incidence of cancer has decreased, primary liver cancer is an increasing public health threat and has a five-year survival rate of less than 10%, making it the 2nd deadliest cancer in the U.S. Liver cancer can be cured only when it's found at an early stage, before it has spread. Bivalent (Combination) Hepatitis A and Hepatitis B Vaccine (TWINRIX GSK), Pegylated interferon alfa-2b (Pegasys), Nucleoside/nucleotide analogues (NAs) adefovir (Hepsera) and tenofovir (Viread) are quite effective at treating the underlying HBV infection. Surgery is recommended for those liver cancer patients who are healthy enough. Surgery involves mechanically cleaning and removing cancerous tissue, a partial or full hepatectomy and transplantation. There are many strange methods for treating liver cancer such alcohol (methanol) injection to the tumor site, and the surgery seems rushed. Sorafenib Tosylate (Nexavar) is a new targeted cancer cell therapy approved for the treatment of kidney and liver cancers.

Colorectral cancer is the fourth most common cancer among men and third most common among women worldwide. In 2002, there were around a million new cases of colorectal cancer worldwide, accounting for 9.4% of all cancer. The cells of the human replicate at a relatively high rate with 10¹⁰epithelial cells being replaced every day. If the colonic epithelial cells accumulate mutations there is a hyper-proliferation of neoplastic growth, known as Adenomatous polyps (adenomas) that have the potential to develop into cancer. Other pathways for colorectal cancer include hyperplastic polyps and ulcerative colitis. The human intestine provides a habitat for over 500 different species of bacteria, with the highest concentration found in the colon. In addition to bacteria, the human colon is frequently exposed to viruses. Several studies since 2000 have suggested that the polyomavirus JCV SV40 is associated with more than 50% of colorectal cancers but many bacteriophages remain unexplored (Burnett-Hartman ’08). Chemical causes can’t be ruled out either. Surgery is very dangerous. Cytarabine (DepoCyt) has been reported to target the Polyomavirus JVC SV40, in progressive multifocal leuoencephalopathy, but may not be the most effective against colon cancer (Enam ’02). Fluorouricil (Adrucil) and antidote leucovorin (Wellcovorin) is the most likely antineoplastic treatment for colon cancer. Begin treatment for colon polyps and colon cancer with topical interferon alpha-2B applied to the colon and Acyclovir (Zovira).

Approximately 65 genetically distinct types of human papillomavirus (HPV) have been identified, many of which have been implicated in squamous papillomas (warts) and 85% of invasive squamous cell cancers and their presumed precursors (severe dysplasias and carcinoma in situ). Infection with HPV (human papillomavirus) is very common. About 20 million people in the U.S. are affected. HPV vaccines are directed against two oncogenic types (HPV 16 and 18) and two nononcogenic types (HPV 6 and 11). HPV types 6 and 11 cause approximately 90% of 500,000 annual cases of genital warts and most cases of recurrent respiratory papillomatosis. HPV 16 and 18 cause about 70% of cervical cancers; as well as vulvar, vaginal, anal, and oropharyngeal and oral cavity cancers and precancer lesions, caused primarily by HPV 16. HPV-associated cancers in males include certain anal, penile, and oropharyngeal and oral cavity cancers caused primarily by HPV 16. Quadrivalent HPV vaccine (HPV4; Gardasil, Merck & Co, Inc.) was licensed in 2006 for use in females aged 9 through 26 years, and in October 16, 2009 for use in males ages 9-26 but it does not cure people who are already infected. Regular pap smears help detect precancerous dysplasia. Imiquimod (Aldara), podophyllotoxin (Condylox), cantharidin (Cantharone) creams are used for warts; topical interferon alpha 2B for cancer. Acyclovir (Zovirax), Foscarnet Sodium (Foscavir) injection and Cidofivir (Vistide) should be tried before more dramatic treatment. Hysterectomies are fairly safe whereas the uterus is not a vital organ. The antineoplastics Fluorouricil (Adrucil) and cisplatin (Platinol) are a good start.

Cancer survivors avoid exposure to chemicals, eat vegan organic fruit and vegetables, plenty of berries and greens high in antioxidants, get plenty of exercise, and lead a religious life. In general the first line of pharmaceutical defense against tumorgenic activity is topical interferon alfa-2b and the oral anti-herpes drug Acyclovir (Zovirax) that can be purchased online without prescription. If online experimentation does not yield the desired results one should consult a physician to receive an injection of Pegylated interferon alfa-2b (Pegasys), Foscarnet Sodium (Foscavir) injection and Immune Globulin Intravenous (IGIV) while watching and waiting for the proper time to experiment with anti-neoplastic treatment or join a clinical study. Red sap from bloodroot (Sanguinaria Canadensis) has been used for the treatment of cancerous disease by the North American Indians living along the shores of Lake Superior. Applied as a salve daily, generally within 2 to 4 weeks the disease was destroyed, with the mass falling out in 10 to 14 additional days, leaving a flat healthy sore that usually healed rapidly. All cases illustrated remissions, if not cures. North American May apple (podophyllum peltatum) rhizome or underground stem was used by the Penobscot Indians of Maine to treat cancer and venereal warts (condyloma acuminate), and is the primary ingredient of the broad spectrum etopiside (Etoposide Etopophos, Toposar, VePesid) but is highly toxic (Lewis ’77: 124).

Table 11: Human Viral Pathogens and Medicines

Viral Pathogen	Viral Family	Disease Expression	Drug Monographs
Respiratory
Adenovirus	Adeno	Upper and lower respiratory tract infections (URI, LRI), conjunctivitis, diarrhea	Effective vaccine against serotype 4 (Ad4) and serotype 7 (Ad7) in 1971. On March 16, 2011, the U.S. Food and Drug Administration re-approved an adenovirus vaccine manufactured by Teva Pharmaceuticals under contract to U.S. Army (Milvax), Imodium (Loperamide)
Rhinovirus	Pirorna	URI	Diphenhydramine (Benylin, Benadryl), Chlorpheniramine (Telachlor, Chlo-Amine, Chlor-Trimeton, Aller-Chlor), Brompheniramine (Bromphen, Nasahist B, Dimetane Extentabs), Ipratropium intranasal (Atrovent)
Coronavirus	Corona	URI, SARS	None, 1 week mild cold; SARS: ventilation, levofloxacin (Levaquin), Methylprednisolone IV, Prednisone
Influenza A, B	Orthomyxo	Influenza	Bed rest for one to two days. Vaccine ineffective. OTC Theraflu, Allegra (Sanofi-Aventis) and Children's Allegra (fexofenadine) and Allegra-D (fexofenadine and pseudoephedrine); Prescription Oseltamivir (Tamiflu) and Zanamivir (Relenza). Antibiotics for pneumonia
Parainfluenza virus 1-4	Paramyxo	URI, LRI, croup	None. Same as Flu. Treat secondary infections with Antibiotics
Respiratory syncytial virus	Paramyxo	Bronchiolitis, pneumonia	NSAID, Prednisone; asthma inhalers without dangerous salmeterol corticosteroid flunisolide (Aerobid), beclomethasone (QVAR), (Flovent); triamcinolone, (Azmacort), antibiotics to prevent and treat bacterial infection in severe pneumonia
Enteroviruses
Rotavirus	Reo	Childhood diarrhea	Rotovirus vaccine (Rotarix GlaxoSmithKline GSK) (Rotateq Merck & Co.) approved by FDA in 2006; by 2010 reduced admission of babies and young children for rotavirus disease by 85%. Imodium (Loperamide)
Coxsackie virus	Picoma	Pleurodynia, herpangina, hand-foot-and-mouth disease	None, usually recover in 7-10 days without medical treatment
Echovirus	Picorna	URI, pharyngitis, skin rash	None, Immune Globulin Intravenous (IGIV) for serious infections
Norwalk agent (Norovirus)	Calici?	Gastroenteritis	Ligocyte phase I/II trials (2010), Imodium (Loperamide)
Poliovirus	Picorna	Poliomyelitis	Pentacil (DTaP-IPV/Hib, Sanofi-Pasteur), Kinrix (DTaP-IPV GSK), Ipol (Sanofi-Pasteur)
JC virus	Papova	Progressive multifocal leukoencephalopathy (opportunistic) known to be 100% fatal	None, avoid immunosuppressant drugs; Cytarabine (DepoCyt) cured two of eight (Enam ’02).
Hepatitis A virus	Picoma	Acute viral hepatitis	Monovalent Hepatitis A Vaccine (HAVRIX GSK)) or VAQTA (Merck), Bivalent (Combination) Hepatitis A and Hepatitis B Vaccine (TWINRIX GSK)
Hepatitis B virus	Hepadna	Acute or chronic hepatitis	Monovalent Hepatitis B Vaccine (ENGERIX-B (GSK) or RECOMBIVAX-HB (Merck), Bivalent (Combination) Hepatitis A and Hepatitis B Vaccine (TWINRIX GSK); Pegylated interferon alfa-2b (Pegasys), Nucleoside/nucleotide analogues (NAs) adefovir (Hepsera), entecavir (Baraclude), lamivudine (Epivir-HBV, Heptovir, Heptodin), telbivudine (Tyzeka) and tenofovir (Viread) dual HIV- HBV
Hepatitis C		Acute or chronic hepatitis, hospital acquired	Combination of Pegylated interferon alfa-2b (Pegasys) and Ribavirin (Virazole)
Hepatitis D		With HBV, acute liver disease of several months or life-long chronic hepatitis that may lead to liver cancer	None approved. Pegylated interferon alfa-2b (Pegasys) may help. Liver transplantation
Hepatitis E virus	Norwalk-like	Enterically transmitted hepatitis lasting one or two weeks	None approved. Small meals, fluids, avoid medicines that may harm the liver, avoid alcohol and exercise regularly.
Skin Eruptions
Mumps virus	Paramyxo	Mumps, pacreatitis, orchitis	Measles, Mumps, Rubella and Varicella vaccine (MMRV, ProQuad, Merck & Co., Inc.) or Measles, Mumps, Rubella vaccine (MMR, M-M-RII, Merck & Co., Inc.)
Measles virus	Paramyxo	Measles (rubella)	Measles, Mumps, Rubella and Varicella vaccine (MMRV, ProQuad, Merck & Co., Inc.) or Measles, Mumps, Rubella vaccine (MMR, M-M-RII, Merck & Co., Inc.) and Varicella vaccine (VARIVAX, Merck & Co., Inc.)
Rubella virus	Toga	German measles (rubella)	Measles, Mumps, Rubella and Varicella vaccine (MMRV, ProQuad, Merck & Co., Inc.) or Measles, Mumps, Rubella vaccine (MMR, M-M-RII, Merck & Co., Inc.) and Varicella vaccine (VARIVAX, Merck & Co., Inc.)
Vacciniavirus	Pox	Smallpox	Smallpox vaccine
Varicella-zoster	Herpes	Chickenpox, shingles	Measles, Mumps, Rubella and Varicella vaccine (MMRV, ProQuad, Merck & Co., Inc.) or Varicella vaccine (VARIVAX, Merck & Co.); Acyclovir (Zovirax), Valtrex (Valacyclovir)
Herpes simplex virus I	Herpes	Cold sore	Valtrex (Valacyclovir)
Herpes simplex virus II	Herpes	Genital herpes	Acyclovir (Zovirax)
Cytomegalovirus	Herpes	Cytomegalic inclusion disease	Acyclovir (Zovirax), Ganciclovir Sodium (avoid) highly carcinogenic), Foscarnet Sodium (Foscavir) injection
Epstein-Barr (EBV) virus	Herpes	Infectious mononucleosis, nasopharyngeal carcinomas	Acyclovir (Zovirax), Foscarnet Sodium (Foscavir) injection; radiation treatment; Antineoplastic: Cisplatin (Platinol) and Prednisone
Papillomavirus (HPV)	Papova	Condyloma, genital warts, cervical carcinoma	Quadrivalent HPV vaccine (HPV4; Gardasil, Merck & Co, Inc.) imiquimod (Aldara), podophyllotoxin cream (Condylox), cantharidin (Cantharone) for warts; topical interferon alpha 2B for cervical cancer, Acyclovir (Zovirax), Foscarnet Sodium (Foscavir) injection and Cidofivir (Vistide) injection; antineoplastic: Fluorouricil (Adrucil) and cisplatin (Platinol)
Molluscum virus	Pox	Warts, Molluscum contagiusum	Topical: trichloroacetic acid, imiquimod (Aldara), podophyllotoxin cream (Condylox), cantharidin (Cantharone)
Hemorrhagic Fevers
Arboviral Encephalitis viruses	Toga Bunya	Eastern, Western, Venezuelan, St. Louis, LaCrosse, California group	None, mosquito protection, repellant and prevention
Yellow fever	Toga	Yellow fever	Yellow Fever vaccine (VF-VAX, Sanofi-Pasteur)
Colorado tick	Reo (Orbl)	Colorado tick fever	None.
Denguevirus 1-4	Toga	Dengue, hemorrhagic fever	acetaminophen (Tylenol); Early results of clinical trials show that a vaccine may be available by 2012.
Regional hemorrhagic fever viruses	Arena Bunya Filo? Hanta	Bolivian, Argentinian, Lassa Crimean-Congo, Hantaan, sandfly fever Ebola, Marburg disease Korean, USA pneumonia	None. Ribavirin (Virazole)
Rabiesvirus	Rhabado	Rabies	Rabies Immune Globulin (Human): Hyper RAV (Talecris); Imogram Rabies – HT (Sanofi-Pasteur) and Purified Chick Embryo Cells (PCEC) Rabavert (Novartis) or Human Diploid Cell Vaccine (HDCV): Imovax (Sanofi-Pasteur)
Parvovirus	Parvo	Erythema infectiosum, Asplastic anemia	Immune Globulin Intravenous (IGIV)
Retroviruses
HTLV I virus	Retro	Adult T-cell leukemia; tropical spastic paraparesis	Acyclovir (Zovirax) Foscarnet Sodium (Foscavir) injection, Pegylated interferon alfa-2b (Pegasys), Immune Globulin Intravenous (IGIV), Imatinib (Gleevec)
HIV I and II viruses	Retro	AIDS	Combination efavirenz/emtricitabine/tenofovir (Atripla)(2006) once a day promises to eliminate viral counts, emtricitabine-tenofovir (Truvada), abacavir/lamivudine (Epzicom) zidovudine/lamivudine/abacavir (Trizivir), lopinavir/ritonavir (Kaletra, Aluvia) zidovudine/lamivudine (Combivir) Nucleoside analogue reverse transcriptase inhibitors (NRTIs): zidovudine (Retrovir), lamivudine (Epivir), didanosine (Videx), stavudine (Zerit), abacavir (Ziagen), emtricitabine (Emtriva) combination; Protease inhibitors (PIs): saquinavir (Invirase), ritonavir (Norvir), indinavir (Crixivan), nelfinavir (Viracept), amprenavir (Agenerase), lopinavir/ritonavir (Kaletra), atazanavir (Reyataz), tipranavir (Aptivus), Darunavir (Prezista) combination; Non-nucleoside reverse transcriptase inhibitors (NNRTIs): nevirapine (Viramune), delavirdine (Rescriptor), efavirenz (Sustiva), etravirine (Intelence); Nucleotide reverse transcriptase inhibitors (NtRTIs): tenofovir (Viread); Fusion inhibitors: enfuvirtide (Fuzeon); Integrase inhibitors: raltegravir (Isentress); Chemokine co-receptor inhibitors: maraviroc (Selzentry)

Source: Samuelson & von Lichtenberg ’94: pp. 308

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