Nervous System Viral Infections, Complications & TCM
While SARS-CoV-2 becomes endemic and tests our collective immune response, the human nervous system can contract many different types of viruses. Once a virus gains access to the nervous system, there are several potential outcomes, including acute replication, persistence, and latency. During all three scenarios, local and peripherally derived immune cells mount a defense response and attempt to eradicate the pathogen and, in some cases, this immune defense results in severe disease.
Ideally the host eliminates the invading virus quickly without causing disease or death; however, some viruses can evade this stage and establish persistence or latency. Persistent viral infections display continual viral replication, whereas latency is a ‘dormant’ state during which the production of infectious virions is minimized or ceases entirely but the pathogen is not eliminated. Persistent and latent viral infections that stay within the nervous system can cause a vast array of symptoms including chronic fatigue, muscle weakness or tightness, body pain, numbness or coldness when the periphery nervous system is infected, as well as loss of smell or taste.
Types of Viruses Affecting the Nervous System
There are many different types viruses that can cause infection of the human nervous system. The rabies virus and the West Nile virus can infect the brain causing encephalitis. Poliovirus, a serotype of the species Enterovirus C is the causative agent of polio. Herpes simplex virus (HSV), usually type 2 (HSV-2) and enteroviruses (echovirus and coxsackievirus which tend to reside in the digestive tract) can infect the layers of the tissue that covers the brain and spinal cord, causing meningitis.
Many prominent childhood- and adult-onset neurological and psychiatric diseases are hypothesized to be due to infections by viruses such as the herpes virus and Cytomegalovirus (CMV) that occurred at a much younger age. CMV is a common virus for people of all ages. Once infected, the body retains the virus for life (half of the population over 40 carries it) A healthy person’s immune system usually keeps the virus from causing illness. However, in an unhealthy or immuno-stressed person, it can cause many neurological diseases which include Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, temporal lobe epilepsy, schizophrenia, bipolar disorder, and autism.
Rodent Born Viruses
Many arenaviruses, such as lymphocytic choriomeningitis virus (LCMV), which is a rodent-borne virus, do not kill host cells but instead cause a persistent infection if the host immune system cannot clear the virus. LCMV which can cause neurological diseases is transmitted when exposed to fresh urine, droppings, saliva, or nesting materials from infected rodents such as mice. A much more severe disease ensues when the infection occurs prenatally. LCMV can infect the fetal brain and retina, where it leads to substantial injury and permanent dysfunction.
Central nervous system (CNS) complications of Epstein-Barr virus (EBV) infection occur in 1 to 18% of patients with infectious mononucleosis and include encephalitis, meningitis, cerebellitis, polyradiculomyelitis, transverse myelitis, cranial and peripheral neuropathies, and psychiatric abnormalities. EBV may also exist in a latent state within the nervous system and reactivation of a latent virus can invade the CNS and cause myelopathic syndromes such as multiple sclerosis7.
Although it is hard to pin down the exact cause of chronic fatigue syndrome (CFS), researchers have long believed that many cases start with an active viral infection or by an infection that permanently alters the immune system before leaving the body. This is because the bodies of patients who suffer from CFS show signs of an activated immune system. A 2010 study linked enterovirus and EBV as two of the most common infectious triggers of CFS4.
Herpes and EBV
Human herpes viruses including EBV, which infects over 90% of the world population, is linked to CFS. Although B and T cells are supposed to help keep the virus at bay when it is reactivated, studies have found that both cell types were unable to remember EBV. This means that when reactivated, the virus would be able to thrive, reproduce, and cause symptoms such as chronic fatigue. Of the 400 participants in the study, 76% of them had impaired cellular memory in their immune system 2
Enteroviruses, which live and reproduce in the intestinal tract, show a connection to CFS. We understand now that enterovirus B serotypes such as coxsackievirus B and echovirus are capable of mutating during the acute infection into an aberrant viral form that can cause persistent low-level infections. These persistent non-cytolytic enterovirus infections are found in CFS. Finally, there have also been over 30 studies on enterovirus infections in CFS and most of the studies have found enterovirus present in CFS patients’ muscle, stomach, brain tissues, and blood cells.
Depression & Anxiety
Viral latency in the nervous system which can later be activated has been shown to cause cognitive and behavioral disturbances. Human herpesvirus when active has been shown to provide molecular evidence of causing major depression disorder.
Human herpes virus type 6 (HHV6) is the virus that causes Roseola infantus (exanthema subitum), a common infectious disease in infants. Roseola is generally mild with symptoms including several days of high fever, followed by a rash. Almost all people are infected during their infancy and they carry the latent virus in their bodies. The virus remains dormant, but when the body is fatigued, HHV6 is awakened3. Some of the virus reaches and infects the olfactory bulb, the center in the brain connected to the sense of smell, by flowing up from the mouth to the nose3. A research team determined that if reinfection occurs, a certain protein, SITH1, is produced in the olfactory bulb3. By their production, excessive calcium flows into brain cells and kills them. The result of this leads to the development of depression.
Although major symptoms affect the respiratory system, neurological symptoms appear in some confirmed cases of COVID-19. The potential for significant neurological deficits recently became a concern following the report of a COVID-19 patient who demonstrated loss of involuntary control of breathing due to presumed involvement of the inspiratory area in the brainstem, as well as reports of SARS-CoV-2 infected patients developing ataxia, loss of smell, and convulsions8.
Covid and Sense of Smell
SARS-CoV-2 binds to a protein called ACE2 existing on the surface of potential host cells. ACE2 abounds on cells found in the nose and mouth. Researchers have found ACE2 on cells that surround and support nerve cells that detect scents1. It’s possible that infection of these surrounding cells could lead to levels of inflammation or damage that impact the ability to smell and therefore taste1. This inflammation can persist even after the patient tests negative for COVID-19 leading to prolonged symptoms of loss of taste and smell.
Several routes exist for coronaviruses gaining access to the CNS. For example, in a study done on mice, SARS-CoV seems to enter the brain via the olfactory bulb post intranasal inoculation before disseminating transneuronally to distal connected neurons8.
Nervous System Viruses & TCM
From a Traditional Chinese Medicine (TCM) standpoint we address viral infections and their complications as they present themselves: the Chinese have gained immense experience and knowledge in treating what presents as viral diseases. In this context, two classics sources, Shan Han Lun and Wen Bing, offer an arsenal of treatments. Because TCM is not linear, molecular based or even binary or polar, we approach diseases from a novel angle and unique scope. This way, we treat the root / pattern and take a different complementary approach compared to biochemical medicine. In particular, very often we identify the stages/level of the disease in terms of wei qi (protective/immune), ying qi (nourishing), qi and blood. Finally and also very important, if the infection is still on the exterior or has penetrated deep to the interior.
Covid in China
China treated up to 92% of Covid patients with herbal protocols which led to a reduced ICU occupancy rate by preventing mild cases turning into critical cases. We find here that now the Covid long haulers call for help as biochemical medicine just doesn’t always know what to do with them (and has no procedure code for the insurance companies). About 6 TCM formulas are standard of care and their biochemical components fit the TCM model into into a biochemical pharmaceutical model9. Chances are next year drugs for treating Covid will have started with a ancient Chinese decoction against Evil Qi!
In conclusion, a wide array of Chinese herbal products exists to treat viral infections. We choose and customize formulas based on stage of the infection, location, and severity. Consequently, we treat complications while also addressing their origin/root. In addition, acupuncture, cupping and Qi Gong help in conjunction with herbal medicine. Finally, it is essential to treat viral infections as early as possible and monitor symptoms closely for optimal results.
- Samaranayake et al. Sudden onset, acute loss of taste and smell in coronavirus disease 2019 (COVID-19): a systematic review. Acta Odontol Scand. 2020 Aug
- Loebel et al. Deficient EBV-specific B- and T-cell response in patients with chronic fatigue syndrome. PLoS One. 2014 Jan
- Nakamura, Michiko. “Researchers: Virus-Derived Protein Triggers Depression.” The Asahi Shimbun, 15 June 2020.
- Zhang et al. Microbial infections in eight genomic subtypes of chronic fatigue syndrome/myalgic encephalomyelitis. J Clin Pathol. 2010 Feb.
- Hayashi et al Inhibitory effect of cinnamaldehyde, derived from Cinnamomi cortex, on the growth of influenza A/PR/8 virus in vitro and in vivo. Antiviral Res. 2007 Apr.
- Martelius et al Clinical characteristics of patients with Epstein Barr virus in cerebrospinal fluid. BMC Infect Dis 11, 281 (2011).
- Pender M. P. (2011). The essential role of Epstein-Barr virus in the pathogenesis of multiple sclerosis. The Neuroscientist : a review journal bringing neurobiology, neurology and psychiatry.
- Cheng et al. Infectivity of human coronavirus in the brain. EBioMedicine. 2020 Jun
- Traditional Chinese Medicine (TCM) in the treatment of COVID-19 and other viral infections: Efficacies and mechanisms. Kai Huang,et al. Pharmacol Ther. 2021 Sep
- Wei Labs Practitioner materials & Case Studies