Treatment using Kampo medicine (Keigai-rengyo-to, Seijo-bofu-to, or Senkyu-chacho-san) for Mayaro virus infection

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Mayaro virus (MAYV) is an emerging alphavirus first identified in Trinidad and now found mainly in the Amazon basin of Brazil, Peru, Bolivia, and Venezuela. Occasional imported cases in Europe and North America raise concern that MAYV could spread similarly to chikungunya or Zika. The virus circulates in a sylvatic cycle involving Haemagogus mosquitoes and non‑human primates, but experimental evidence indicates that Aedes aegypti and Aedes albopictus could act as competent urban vectors. Clinically, infection causes acute fever, myalgia, rash, and prominent arthralgia, with chronic or relapsing joint symptoms frequently lasting months or years. Diagnosis relies on RT‑PCR in early infection or serology later, requiring differentiation from dengue, chikungunya, and Zika. No specific antiviral exists: ribavirin is ineffective, and favipiravir works only when given before or at infection onset. Management is supportive, and several vaccine platforms remain experimental. Phytochemicals such as Epigallocatechin gallate, quercetin, naringin, naringenin, epicatechin, proanthocyanidin, and rosmarinic acid show in vitro or in silico anti‑MAYV activity. These compounds are present in Japanese Kampo medicines, which may warrant further investigation in formal preclinical and clinical studies.