Clinical Studies

Two randomized, placebo-controlled, double-blind studies demonstrated the elderberry extract, Sambucol, effectively inhibited both influenza A and B strains when given orally to patients in the first 48 hours of influenza symptoms.

The Earlier Study

27 individuals experiencing typical early flu symptoms were given Sambucol or placebo daily for three days–2 tablespoons (children) or four tablespoons (adults). Patients were followed for six days and symptoms monitored. Serum from all subjects was analyzed for antibodies to influenza A and B at the initial dose and during the convalescent phase.

In the treatment group, significant improvement in flu symptoms was observed in 93.3 percent of subjects within two days after initial dosing, while 91.7 percent of the control group demonstrated improvement after six days. A complete resolution was achieved in the treatment group in 90 percent of patients after 2-3 days, while the placebo group yielded similar results after six days. Of these 27 patients, 23 had laboratory confirmation of influenza B. (12)

The Second Study

60 patients (ages 18-54 years) experiencing early influenza symptoms were given 15 mL of Sambucol or placebo syrup four times daily for five days. Symptoms were monitored for eight days.

In the treatment group, the majority of patients reported “pronounced improvement” after an average of 3-4 days, while the placebo group required 7-8 days to reach the same level. (13) Department of Virology, Hebrew University-Hadassah Medical School, Jerusalem, Israel.

A standardized elderberry extract, Sambucol (SAM), reduced hemagglutination and inhibited replication of human influenza viruses type A/Shangdong 9/93 (H3N2), A/Beijing 32/92 (H3N2), A/Texas 36/91 (H1N1), A/Singapore 6/86 (H1N1), type B/Panama 45/90, B/Yamagata 16/88, B/Ann Arbor 1/86, and of animal strains from Northern European swine and turkeys, A/Sw/Ger 2/81, A/Tur/Ger 3/91, and A/Sw/Ger 8533/91 in Madin-Darby canine kidney cells.

Influenza 1993

A placebo-controlled, double blind study was carried out on a group of individuals living in an agricultural community (kibbutz) during an outbreak of influenza B/Panama in 1993. Fever, feeling of improvement, and complete cure were recorded during 6 days. Sera obtained in the acute and convalescent phases were tested for the presence of antibodies to influenza A, B, respiratory syncytial, and adenoviruses.

Convalescent phase serologies showed higher mean and mean geometric hemagglutination inhibition (HI) titers to influenza B in the group treated with SAM than in the control group. A significant improvement of the symptoms, including fever, was seen in 93.3% of the cases in the SAM-treated group within 2 days, whereas in the control group 91.7% of the patients showed an improvement within 6 days (p < 0.001).

A complete cure was achieved within 2 to 3 days in nearly 90% of the SAM-treated group and within at least 6 days in the placebo group (p < 0.001). No satisfactory medication to cure influenza type A and B is available.

Considering the efficacy of the extract in vitro on all strains of influenza virus tested, the clinical results, its low cost, and absence of side-effects, this preparation could offer a possibility for safe treatment for influenza A and B.  Department of Virology, Hebrew University-Hadassah Medical School, Jerusalem, Israel.

Norway Influenza

Elderberry has been used in folk medicine for centuries to treat influenza, colds and sinusitis, and has been reported to have antiviral activity against influenza and herpes simplex.

We investigated the efficacy and safety of oral elderberry syrup for treating influenza A and B infections. Sixty patients (aged 18-54 years) suffering from influenza-like symptoms for 48 h or less were enrolled in this randomized, double-blind, placebo-controlled study during the influenza season of 1999-2000 in Norway.

Patients received 15 ml of elderberry or placebo syrup four times a day for 5 days, and recorded their symptoms using a visual analogue scale. Symptoms were relieved on average 4 days earlier and use of rescue medication was significantly less in those receiving elderberry extract compared with placebo.

Elderberry extract seems to offer an efficient, safe and cost-effective treatment for influenza. These findings need to be confirmed in a larger study.