One of the terms that you’ll see used to describe health quackery, scams and pseudoscience is “snake oil”. Snake oil was a real product, sold in the early 19th century as a cure-all elixer in the “patent medicine” era. Popularized in movies, the snake-oil salesman would pull into town, and start the hard sell for his product that was promised to CURE everything from aches and pains to sore throats and dislocations. The original products apparently did contain snake, but soon other products appeared on the market that didn’t even contain any snake – they were an assortment of ingredients concocted to smell medicinal and seem medicinal, but had no therapeutic effects. These small-town sideshows would hype the products and try to sell as much as possible. In 1905 an article in Colliers exposed the patent medicine industry for what it was – health fraud. The Pure Food and Drugs Act (in the USA) followed, and eventually, modern drug regulations emerged as we know them today.

Case closed? Not quite. As a consequence of regulators worldwide implementing lower regulatory standards for supplements and natural health products, snake oil is back on the shelves. I highlighted this recently when I somewhat facetiously asked Is there anything the Natural Health Products Directorate Won’t Approve? After all, when sugar pills are approved as an insect repellant, how much more ludicrous can you get? But I was proved wrong, when Dianne Sousa pointed out that Health Canada has also approved homeopathic rabbit anus as “safe and effective”.

If I had to come up with a modern equivalent of the old bottle of snake oil, it would be oil of oregano. It is touted as a cure-all for almost every condition. It was one of the earliest posts on this blog, and it continues to get quite a bit of traffic – my 5th most popular article with over 25,000 views and counting. Updating the post, like I did over at Science-Based Medicine, takes no time at all. I search for any evidence of efficacy in the published medical literature. Finding none, I consult with the Natural Medicines Comprehensive Database, which continues to note a lack of evidence for any medicinal use. So I continue to reiterate my same conclusion:

Oil of oregano, and the claims attached to it, is a great example of how interesting laboratory findings can be wildly exaggerated to imply meaningful effects in humans. A few small studies have been conducted, mainly in the lab, and advocates argue this is evidence of effectiveness. The rest is all anecdotes. Despite the hype, there is no persuasive evidence to demonstrate that oil of oregano does anything useful in or on our bodies. And while it is popular, there is no science to support the use of oil of oregano for any medical condition. Suggesting that this herb is can effectively treat serious medical conditions like diabetes, asthma, and cancer is foolish and dangerous. If you’re ill, stick to the proven science, and save your oregano for cooking.

The lack of evidence, however, doesn’t stop purveyors from continuing to market it for all types of uses. But supplement manufacturer Enerex Botanicals of British Columbia pushed it a bit too far this week, advertising their oil of oregano product as a substitute for the pertussis vaccine. It seems that parts of British Columbia are in the midst of a pertussis (whooping cough) outbreak, like many other parts of Canada. And Enerex decided this public health problem was a marketing opportunity:

Enerex Botanicals Ltd. ran an ad in The Vancouver Sun claiming the herbal supplement is a “top-level defence for protecting yourself from whooping cough and a host of other viral and bacterial infections,” and that “vaccines aren’t the only choice to combat this highly contagious bacterial disease.”

And it’s partially true to say that “vaccines aren’t the only choice” if you consider taking an unproven product to be a reasonable choice. The scientific fact is that that there’s no evidence whatsoever to demonstrate or even suggest that oil of oregano can protect against pertussis infections. Even Health Canada, which as I noted seems to approve even the most absurd claims for natural health products, only approved this product with the recommended use “A source of antioxidants” (You can search NPN 80033279 and NPN 80033278 here to see the approval.

I’m heartened to see the Chief Medical Officer of Health of the Fraser Health Authority, Dr. Paul Van Buynder has taken decisive, public action about this misleading advertising. In a letter to the company he ordered an immediate retraction to be published in all media where these efficacy claims were advertised:

Your company purports to be able to control the infectious transmission of whooping cough with the application of oil of oregano. It markets your product as a viable and safe protection alternative to vaccination during a pertussis outbreak. Section 15 of the British Columbia Public Health Act clearly states “A person must not willingly cause a health hazard, or act in a manner that the person knows, or ought to know, will cause a health hazard.” Under the Act, a health hazard is defined as a condition, a thing or activity that: I. Endangers, or is likely to endanger public health or

II. Interferes, or is likely to interfere, with the suppression of an infectious agents or hazardous agents. It is my contention as the Chief Medial Health Officer for the Fraser Health Authority that your advertisement has produced a health hazard as defined above, in that it is likely to discourage people from vaccination and will hamper ongoing efforts of health authorities to overcome the current outbreak of pertussis in the lower mainland. The impact of this will be to place vulnerable small children in the community at risk of contracting pertussis, becoming hospitalized and even dying. I understand a number of complaints have also been submitted to Natural Health Products Division of Health Canada as your claim that oil of oregano prevents pertussis and is a safer alternative to vaccine is a Schedule A health claim (“acute infectious respiratory syndrome”) and may also be prohibited under section 3(1) and other provisions of the federal Food and Drug Act. In accordance with the broad powers granted to me by section 31(1) of the Public Health Act, I hereby order Enerex Botanicals Ltd. to take, without delay, the following steps to mitigate the public health hazard you have produced. 1. Publish an immediate retraction, at your expense, in the Vancouver Sun, and in any other media outlet in which the same or similar advertisement was published, advising that: a. oil of oregano has not been shown to be as effective as vaccination in the management of pertussis outbreaks;

b. oil of oregano has not been shown to prevent the transmission of pertussis at all; and

c.Enerex Botanicals Ltd. apologizes for misleading the public in these advertisements; and 2. This notice of retraction is required to be at least of the size and prominence of the original advertisement(s) that made the false claims and must be submitted to my office for approval prior to publication by no later than Tuesday 4th September. Failure to take steps to mitigate the health hazard as required by this order may result in further action by this office.

Wow. How’s that for calling a company out for unsubstantiated claims that threaten public health. I have a new public health hero, and it’s the Chief Medical Health Officer of Fraser Health. Pertussis is no trivial infection. It can kill the vulnerable. And it can be prevented – with vaccination. It’s appalling but perhaps not surprising that for every health issue, it seems there’s always someone ready with a bottle of snake oil to sell.