Selfmedication with sauco blanco: a potential risk of post-chikungunha acute poisoning

Abstract

The chikungunya virus (CHIKV), a growing threat in the Americas over the past two decades, leaves a devastating burden beyond the acute phase. Its hallmark is debilitating joint pain that, in 30-50% of patients, persists for months or years, in many cases progressing to erosive arthritis similar to rheumatoid arthritis. In the absence of a specific curative treatment and desperate for relief, patients frequently resort to self-medication with medicinal plants, such as elderberry (Sambucus nigra L.).

This practice, however, conceals an alarming danger. Although motivated by the search for relief, consuming elderberry infusions carries a significant risk of acute poisoning. Key parts of the plant (leaves, seeds, berries, and bark) contain sambunigrin, a glycoside that can release cyanide in toxic quantities if the dose is exceeded. Furthermore, its berries contain compounds with cardiotoxic potential. Scientific evidence regarding safe maximum doses is scarce, making self-medication a dangerous game, especially for children, the elderly, and people with cardiovascular conditions.

Therefore, this article, in the authors' view, is an urgent call to action. A national prevention strategy is needed to educate the public about the serious risks of herbal self-medication in the context of chikungunya and to guide them toward safe, medically supervised management. The search for relief should not become a path to further poisoning.