Chocolate could be a surprising new weapon in the annual attack on winter flu, with scientists hopeful its molecular compound could become a key ingredient in a combination of virus-treating drugs.
Strains of illnesses, including influenza, bird flu and swine flu are gradually becoming more resistant to traditional forms of treatment, such as Tamiflu, doctors said.
That has placed greater focus on the development of new treatment to help those most vulnerable to severe bouts of flu and a wider uptake of the seasonal winter vaccine.
Research published in the Proceedings of the National Academy of Sciences, a peer reviewed journal of the National Academy of Sciences, found a mix of Theobromine – a compound found in chocolate – and Arainosone proved far more effective against a range of flu strains, including drug-resistant versions of bird and swine flu.
Doctify
The novel combination therapy targets a key weakness in the influenza virus – its ion channel, a microscopic gate the virus uses to replicate and spread. By blocking off this pathway, scientists were able to eliminate the virus’s ability to survive.
Scientists at the Hebrew University of Jerusalem, where the research took place, said the new approach could be a potential game-changer in the treatment of flu, and possible future pandemics. Studies have been completed only on animals but it is hoped clinical trials on humans could provide further insight into the effectiveness of the combination as new treatments for winter flu.
“We’re not just offering a better flu drug,” said Prof Isaiah Arkin, who led the study. “We’re introducing a new way to target viruses only – one that may help us prepare for future pandemics.”
Economic effect
Seasonal flu costs the US about $87 billion each year in health care and lost workforce productivity. Pandemics such as the 2009 swine flu outbreak and Covid-19 inflicted even deeper global economic carnage, while the cost of future pandemics could be as high as £18 trillion ($24.17 trillion) according to the University of Chicago and International Monetary Fund.
As viruses mutate and become resistant to existing drugs, science is battling to stay one step ahead to find new ways to treat viruses and limit the impact of outbreaks. The public health risk from bird flu remains low, with no recorded cases of human-to-human transmission.
However, there have been 26 reported human infections of bird flu worldwide, with 11 deaths in Cambodia, India and Mexico, from direct exposure to contaminated birds or poultry.
Existing flu drugs target a viral protein that can mutate easily, making treatment less effective over time. Circulating influenza viruses are monitored in the Southern Hemisphere winter each year, to predict which strains may be most likely to land in the Northern Hemisphere in October.
That helps health authorities develop a combination of existing vaccines that may prove most effective. Treatments, however, are required when someone experiences a severe bout of influenza, or if they have existing health conditions making them more vulnerable to symptoms.
Dr Atanas Hristov, an internal medicine specialist at NMC Royal Hospital, Dubai Investments Park, said flu cases at his hospital peaked in January.
“There is growing evidence that the existing armamentarium of medication that we have is weaning off in its efficacy,” he said. "As physicians we prescribe Tamiflu, as this has been the established drug for more than a decade but it is not the only one.
“It blocks a very important key enzyme, called neurominidase, which is vitally needed for the virus to multiply or replicate, using our own cells as resources. Tamiflu showed around 64 per cent protection or prevention in pneumonia in adults. The problem is that reality over the years has shown it is not the fact any more.”
Need for new antiviral drugs
Dr Hristov said Tamiflu and other drugs were prescribed to prevent complications from flu such as pneumonia, which can be life-threatening.
“When we prescribe these medications, even in outpatient departments, we want to reduce sickness time,” said Dr Hristov.
“With influenza, initially it was promising to be reduced by up to 1.4 days. Studies have since shown it is not that effective and reduces to just 0.3 days of sickness. Tamiflu remains a convenient, cost-effective treatment in terms of application but it is weaning off in efficacy.”
In November, NMC Royal Hospital recorded 282 cases of flu, which climbed to 311 in December and to 322 in January. The number of cases began to decline in February, with 287 in February, then 206 in March and only 89 in April.
While there were 1,291 primary diagnosis cases in total, doctors wrote 1,550 prescriptions of Tamiflu as it was also used as a preventive measure in some patients.
Focus on prevention
“In my clinical experience, non-immunocompromised patients typically over-request Tamiflu in the hope of shortening the length of their symptoms,” said Dr Jomana Karim, a family medicine consultant from Doctify and Medical Director at Novomed Centres in Dubai.
“This should be avoided, as the benefit to those with well-functioning immune symptoms is minimal and misuse of the medicine could contribute to the creation of Tamiflu-resistant strains of influenza.
“The first anti-influenza agents are no longer effective due to resistance.”
While most with flu recover quickly, World Health Organisation figures show there are still up to 500,000 related deaths each year. Vaccines tend to reduce the risk of illness by between 40 per cent and 60 per cent among the general population.
The UAE’s annual national influenza campaign is usually launched by the Ministry of Health and Prevention in September.
“At present, the best method of prevention is through vaccination and the accompanying herd immunity,” said Dr Karim.
