Oscillococcinum

Oscillococcinum is a homeopathic medicine, prepared from an extract of duck heart and liver, which is recommended for influenza-like symptoms. It is one of the relatively few homeopathic preparations that is made by a proprietary process, and has a trade name registered to the French firm, Boiron.

History
In 1892, the bacteriologist Richard Pfeiffer isolated what was, for decades, considered the cause of influenza, the bacterium classified today as Haemophilus influenzae. During the 1918-1920 influenza pandemic, the idea that it caused by a virus was rejected.

Oscillococcus was developed in the 1930's by Joseph Roy, who, as a physician, treated influenza cases during the pandemic, believed he recognized a bacterium in the blood of patients. He called this Oscillococcus, and considered it the cause of influenza. It was not until 1935 when the human influenza virus was isolated, so his assumption reflected a good deal of microbiological thinking. In 1892, Viral origin of swine influenza was established in 1933 and human influenza in 1935, so Roy's supposition that a bacterium caused the disease was within mainstream science of the time.

Roy believed that duck heart and liver were reservoirs of the bacterium, so used those as the starting point for preparing a homeopathic medication.

Efficacy
Cochrane meta-analyses covered three prevention trials (number of participants (n) = 2265) and four treatment trials (n = 1194). Only two studies reported sufficient information to complete data extraction fully.

In these two, there was no statistical support that Oscillococcinum prevented an influenza-like syndrome (relative risk (RR) 0.64, 95% confidence interval (CI) 0.28 to 1.43). Treatment, however, reduced the length of illness by 0.28 days (95% CI 0.50 to 0.06). Further it increased the chances that a patient considered treatment to be effective (RR 1.08; 95% CI 1.17 to 1.00).

The reviewers said the results showed promise for treatment, but not strong enough to use Oscillococcinum as a first-line treatment for influenza and influenza-like symptoms. Large-scale trials were needed to confirm the effect. The Cochrane review did not find evidence that Oscillococcinum showed a protective effect.

Further complicating future studies is complicated that while not all influenza-like symptoms are caused by the influenza virus, the drugs ostelmavir and zanamivir have demonstrated efficacy for both prevention and treatment of influenza virus; the Centers for Disease Control recommends vaccine as first-line prophylaxis in long-term care facilities, with prophylactic use of these drugs if influenza B virus is confirmed. There would be ethical questions if the availability of a vaccine, and chemoprophylaxis, would allow placebo-controlled trial in prevention. For significant confirmed influenza, Oscilloccinum would have to be compared against currently accepted drug therapy, not placebo.