BY now all Jamaicans must be aware that the Zika virus (ZIKV) is in our region, and the threat of it coming to our shores is imminent. In the meantime, what can we do?

The Ministry of Health in conjunction with the University of the West Indies and the Pan American Health Organization have started to mobilise the nation with regards to ridding the domestic space of mosquito-breeding sites and the need to contain the mosquito population. The destruction of breeding sites for the mosquito is paramount in this fight. This must be the cornerstone in our fight against this virus.

Remember that all it will take is a single individual with the virus to come to our shores, and with the Aedes aegypti mosquito here the epidemic can start.

Of course, we can all help by wearing long-sleeved shirts, long pants, sleeping under nets. and using insect repellents to protect our bodies from being bitten by a mosquito that may transmit the virus.

Therefore, the public health aspect of the fight against this disease must be emphasised.

People of certain vintage will recall that we did not have any good medicines to prevent yellow fever or malaria. Yet, here in Jamaica, by following sound public health practices, we eradicated both of these diseases from our shores.

Acyclovir

However, we are still concerned about therapeutic agents which can be used against this virus and especially about the use of the antiviral drug Acyclovir.

Granted that there are no clinical trials of the use of this drug against the Zika virus, but it is a very effective antiviral, and is used against the herpes virus and as a prophylactic against HIV, for example when a surgeon or nurse gets stuck by a needle that had been used on a HIV-positive patient.

The time to start thinking about this trial is now.

Acyclovir is already registered in Jamaica and is easily available in all pharmacies. It is a relatively safe drug and it is not that expensive.

What about the other antiviral drugs which are used in HIV infections?

Has any thought been given to the use of these drugs in the fight of the Zika virus? We must remember that Zika is a RNA virus. HIV is also an RNA virus. At the very least we should be thinking about a therapeutic challenge against the Zika virus using the known antiviral drugs which we have and which are available.

The question of testing against the Zika virus has apparently been solved, and we now have rapid test kits out of Brazil. This was announced last week.

Gamma globulin

This naturally leads to the next question: What about the use of gamma globulin in this disease

Gamma globulin is a protein produced by the body when it is infected by a virus. This gamma globulin can be isolated by electrophoresis, purified, and then concentrated and stabilised to give it shelf life. When it is needed it can be reconstituted with water and injected into an infected individual to boost their immune system’s fight against the infecting virus.

I contend that we should be thinking seriously about these matters.

If the link between the Zika virus and microcephaly is established, and the evidence seems to be pointing that way, and if the virus becomes endemic in the Americas — as it very well may do — then we may have to start to screen all pregnant women for the Zika virus.

We already screen all pregnant women for syphilis and HIV and treatment is always given to any woman who has a positive test result for syphilis or for HIV.

A scenario is already forming in my mind where we have women at their initial visit to the doctor having a blood test for the Zika virus and, if they are positive, getting a shot of gamma globulin to protect them against the complications of the infection. Gamma globulin injections may be useful in the elderly and those who suffer from serous chronic illness, etc, as well.

If the link between Guillain-Barre syndrome and the Zika virus is established we may really have to use the gamma globulin to help these patients.

Asking the questions

I would like to ask these questions: If the Zika virus was discovered in Africa, why were no cases of microcephaly reported from that continent? After all, the Zika virus has been isolated in 1947 in Africa.

And what about Easter Island and the other Pacific islands? Why are there no cases of microcephaly reported? Has something changed in this virus? Can it be that the Zika virus is acting with some other factor to cause the microcephaly? And how long will it be before we have a vaccine against this virus?

If the Zika virus becomes established in this region we will be facing a public health nightmare and now is the time that we should start to think about these things. We cannot even begin to think about the danger that the Zika virus will pose to our tourist industry if and when it comes here. Who would want to come to Jamaica with that looming? The economic impact of this infection on Jamaica will need to be explored.

Again, we have a wonderful opportunity to put Jamaica on the map and to lead the way in developing gamma globulin against this disease and clinical trials using known antiviral drugs to combat Zika infections.

Dr Neil Persadsingh is a skin specialist in private practice. Send comments to the Observer or neilsin13@hotmail.com.