LETTER OF THE DAY - Doc: Wonder drug to treat chikungunya
THE EDITOR, Sir: As Jamaica continues to struggle with chikungunya, it is becoming clear that we need some new thinking about this disease.
The news coming out of the Centers for Disease Control and Prevention in the United States, as well as from our Ministry of Health, is that there is essentially no treatment for the viral disease. As a practising physician, faced with the enormous physical and mental suffering of my patients every day, I find this point of view totally unacceptable.
There are antiviral drugs available that should be tried on this disease. The drug Acyclovir has been available in Jamaica for the last 20 years and is routinely used to treat chicken pox, shingles and herpes, both on the lip and on the genital area. In fact, it is used as a prophylactic in doctors or nurses who may get accidentally stuck by a needle when caring for HIV patients.
Acyclovir can be used off label to treat the chik-V disease. The dose is 400mg every six hours for three days. There is rapid improvement in the symptoms of chik-V on this regime.
As I said, this is an off-label use for a drug which is available in Jamaica and which was registered as a medicine here many years ago. It is a very safe drug and we should be using it more. The cost of the drug is J$70 per tablet. Two hundred and eighty dollars per day and a course will cost J$840.
I know that I will be getting a lot of flak over the suggestion to use Acyclovir to treat chik-V, but please tell me what other ideas are out there to help our people as they struggle with this unwanted visitor.
Incidentally, I would be interested in finding out if any of our HIV patients who are on antiretroviral drugs have come down with chik-V. Again, I think that these antiviral drugs, which keep the viral load under control in HIV, may protect against chik-V.
Don't give up and throw your hands in the air. Instead, let us put our thinking caps on and see if we can find the means to assist our people. I will be told that there are no double-blind studies showing the use of Acyclovir to treat chik-V. Fine. Let's set up this study and once again take the lead in the region in scientific thinking.
NEIL PERSADSINGH (Dr)