Epidemiology of ophidian and arachnid accidents in Hospital Municipal Lourenço Jorge between 2011 and 2014

Área: Hospitalar

TIAGO GAUDIE LEY MEOHAS

Lucas Delepostes Lins
Maraísa Valente de Almeida Costa
Michel Fernandes Batista dos Santos
Rafael Prudêncio de Lemos
Felipe Sahb Furtado

Introduction: Accidents caused by venomous animals are currently a major health issue in Brazil, making 360.500 people look for health care between 2000 and 2013. Even with the compulsory reporting system, there is a huge under notification of the cases. In addition, there are difficulties in classifying the gender of the animal involved and severity, turning the correct serum therapy almost impossible. Given its location surrounded by Mata Atlântica Forest, as many others E.R.s with a Toxinology service on the southeast Brazilian seashore, it seemed relevant to create an epidemiologic and clinical profile on such episodes. Materials and methods: A cross-sectional study was carried out using 350 patient files from January 2011 to December 2014. The following variables were analyzed: cases per year, sex of the patients, the animal involved, the affected body part, the patients’ clinical picture and the number and type of serum used. Results: Bothrops were involved in most cases (63.5%), followed by arachnids (30%) and other snakes (2.5%). Men were involved in twice as many cases as women. Both lower and upper limbs had similar involvement (46% to 44%). However, snakebites predominated in the lower limbs (73,4%), unlike accidents with arachnids, that were slightly more frequent in the upper limbs (51,8%). Local symptoms were found in 96% of the patients and only 5% of all 350 of them had systemic symptoms. Regarding the severity, 96% were classified as mild and 4% as moderate. There were no serious cases on this study. Conclusion: Bothrops predominance in this study can be explained by its adaptability, specially Bothrops jararaca. Almost all of the accidents occurred in urban areas, specially near small wastelands in the west side of the city. All the patients’ compartment syndrome in this study were secondary to the Bothrops jararaca bite. There were only 2 accidents with Micrurus but none of the patients showed symptoms, recent studies show that this difficulty in inoculating the toxin is due these snakes’ dental arch (proteroglyph) and a reduced opening jaw angle. A strong relationship between high pluviometric indexes (usually from September to April) and snake and scorpion accidents was noticed, but there was no relation between them and spider accidents. Even with a high demographic index Latrodectus, there was only 1 reported accident with these species, this shows how pacific the species is and a non-predilection to be invasive in urban areas.