Epidemiological study of bee stings in the state of Paraiba, Northeastern Brazil, from 2015 to 2019

INTRODUCTION: In Brazil, envenomation by bee sting is a public health problem due to its incidence in all regions of the country, as well as the severity of cases. Despite the medical and sanitary importance, the literature on this topic in Brazil is scarce, in the Northeast region. OBJECTIVE: To describe the epidemiological characteristics of bee stings in Paraíba, in the Northeast region of Brazil, from 2015 to 2019. METHODS: The current study is a descriptive and retrospective epidemiological investigation conducted through the recovery of secondary data made available by the database from the Ministry of Health Notification Information System. RESULTS: A total of 1,151 cases were analyzed, and they were reported during all the months of the period of the study and were more frequent in the regions Agreste and Sertão of the Paraíba. The victims were men aged 20 to 59 years. Most individuals received medical assistance within 3 hours of the incident. The cases were classified as mild and progressed to cure. CONCLUSION: In Paraíba, bee stings have increased in recent years, especially in regions with a semi-arid climate. In addition, this study provides data that may be used in the development of educational health actions to promote the prevention and control of bee stings in this region.

Epidemiology of envenomation by Africanized honeybees in the state of Rio Grande do Norte, Northeastern Brazil / Epidemiologia dos envenenamentos por abelhas africanizadas no Estado do Rio Grande do Norte, Nordeste do Brasil

ABSTRACT: Introduction: In the American continent, accidents caused by honeybees are a public health problem due to the high incidence and severity of the cases. Despite its medical importance, there are few epidemiological studies on this topic in Brazil, especially referring to the Northeastern states. The present study aims to describe the epidemiological features of honeybee envenomation cases in the state of the Rio Grande do Norte, Northeastern Brazil, from 2007 to 2014. Methods: Data were collected from the Notifiable Diseases Information System database of the Health Department of Rio Grande do Norte. Results: We analyzed a total of 2,168 cases. Cases occurred in all months of the years studied, reaching higher frequencies from June to October. Most incidents happened in urban areas and involved men, with victims aged between 20 and 39 years. Victims were mainly stung on the head and hand, and they received medical care predominantly within 3 hours after the injury. Local manifestations were more frequent than systemic ones. Clinically, most cases were mild and progressed to cure. Conclusion: The high number of honeybee sting cases shows that Rio Grande do Norte may be an important risk area for such injury.

RESUMO: Introdução: No continente americano, os acidentes causados por abelhas são um problema de saúde pública devido à alta incidência e severidade dos casos. Apesar de sua importância médica, há poucos estudos epidemiológicos sobre esse tema no Brasil, especialmente referentes aos estados do Nordeste. O presente estudo tem como objetivo descrever as características epidemiológicas dos casos de envenenamento por abelhas no estado do Rio Grande do Norte, no Nordeste do Brasil, de 2007 a 2014. Metodologia: Os dados foram coletados da base de dados do Sistema de Informação de Agravos de Notificação da Secretaria Estadual de Saúde do Rio Grande do Norte. Resultados: Um total de 2.168 casos foram analisados. Os casos mostraram distribuição em todos os meses dos anos estudados, com maior frequência de junho a outubro. A maioria dos casos ocorreu em áreas urbanas e envolveu homens, com vítimas entre 20 e 39 anos de idade. As vítimas foram principalmente picadas na cabeça e na mão, e receberam assistência médica predominantemente dentro de 3 horas após serem picadas. As manifestações locais eram mais frequentes do que as sistêmicas. Clinicamente, a maioria dos casos foi leve e progrediu para cura. Conclusão: O alto número casos de picadas de abelhas mostra que o Rio Grande do Norte pode ser uma importante área de risco para tal incidente.

Clinical and epidemiological aspects of scorpion stings in the northeast region of Brazil / Aspectos clínicos e epidemiológicos dos acidentes escorpiônicos na região do nordeste do Brasil

Scorpion stings are a serious public health issue in tropical and subtropical countries. This is a descriptive and retrospective study of the clinical-epidemiological characteristics of scorpion sting cases registered in the Health System in the city of Campina Grande, Paraíba state, from 2007 to 2012. Data was collected from the Injury Notification Information System data banks of the Ministry of Health. A total of 2,283 records, provided by the Third Health Sector of Campina Grande, were analyzed. Data revealed that the majority of the victims are female aged between 20 and 29 years, and the highest incidence of stings was in the urban area. Victims were mostly stung on the feet and hand. Serotherapy was not administered in most cases. The majority of the victims received medical assistance within 1 to 3 hours after the sting. The most prevalent clinical manifestations were pain, edema and paresthesias. Most cases were classified as mild, though seven deaths were reported. The high incidence rate suggests that this town may be an endemic area of scorpion stings, supporting the need to develop strategies to control and prevent scorpion stings.

Os acidentes escorpiônicos constituem um grave problema de saúde pública em países tropicais e subtropicais. Este estudo retrospectivo analisou as notificações dos acidentes escorpiônicos registrados no Sistema de Saúde do município de Campina Grande, no estado da Paraíba, de 2007 a 2012. As informações foram coletadas do banco de dados do Sistema de Informação de Agravos de Notificação do Ministério da Saúde. Foram analisadas 2283 fichas de notificação. Os dados revelaram que a maioria dos acidentados é do sexo feminino, com idade entre 20 e 29 anos. Os acidentes foram mais frequentes em área urbana, sendo os pés e as mãos os locais anatômicos do corpo mais atingidos pelas picadas. A soroterapia não foi administrada na maioria dos acidentados e as vítimas prevalentemente recorreram aos sistemas de saúde dentro do período de 1 a 3 horas após o acidente. As manifestações clínicas mais frequentes foram dor, edema e parestesias. A maioria dos acidentes foi classificada como leve, porém foram registrados 7 casos de óbito. A elevada taxa de incidência de acidentes escorpiônicos sugere que esse município pode ser uma área endêmica de escorpiões, justificando a necessidade da elaboração de estratégias de controle e prevenção de acidentes por estes animais.

Snakebite cases in the municipalities of the State of Paraiba, Brazil

Introduction This study investigated the epidemiological and clinical profile of snakebite cases reported from 2007 to 2012 in the municipalities of the Curimataú region, State of Paraíba, in northeastern Brazil. Methods Data were collected from the Health Department of the State of Paraíba using the Injury Notification Information System data banks of the Health Ministry. Results A total of 304 snakebite cases were studied. The cases occurred most frequently from April to June. The genera Bothrops, Crotalus, and Micrurus were responsible for 74.6%, 6.2%, and 1.3% of cases, respectively. Snakebite cases predominated in males living in rural areas and between 10 and 19 years old. The highest incidence of bites occurred on the feet. The majority of the victims received medical assistance within 1 to 3h after being bitten. With regard to severity, 48% of the cases were classified as mild, 26% as moderate, and 2.6% as severe. Successful cures predominated, and no deaths were reported. The average antivenom ampoule dose used for the treatment in some snakebite cases was lower than that recommended by the Health Ministry. Conclusions Although our results show that Paraíba has a good level of medical care, there are serious deficiencies in recording snakebite information. These data indicate the need to improve the recording process for snakebite cases. Further training for health professionals seems to be necessary to optimize their skills in treating snakebite victims. .

Epidemiology of snakebite accidents in the municipalities of the state of Paraíba, Brazil / Epidemiologia dos acidentes ofídicos ocorridos nos municípios do Estado da Paraíba, Brasil

Acidentes por animais peçonhentos representam um importante, embora negligenciado, problema de saúde pública mundial. Neste sentido, foi realizado um estudo descritivo dos acidentes ofídicos atendidos e registrados, entre 2007 e 2010, nas unidades de saúde dos municípios do Cariri, Estado da Paraíba, Nordeste do Brasil. As informações foram coletadas do banco de dados do Sistema de Informação de Agravos de Notificação do Ministério da Saúde. Um total de 351 registros de vítimas de ataques por serpentes peçonhentas foram analisados. As vítimas foram predominantemente trabalhadores rurais do sexo masculino com mais de 50 anos. As maiores incidências de acidentes ofídicos ocorreram em áreas rurais, entre abril e junho de 2007 e 2010. As serpentes do gênero Bothrops foram responsáveis pela maioria dos casos, e as vítimas foram, em sua maioria, picado nos pés. A maioria das vítimas recebeu assistência médica no prazo de 1h a 3h após a picada. As manifestações clínicas mais comuns foram dor, edema e equimoses, classificadas como leve ou moderada. Duas mortes foram relatadas. Os resultados deste estudo podem contribuir para identificar as condições que aumentam o risco dos acidentes ofídicos na Região Nordeste.

Accidents involving venomous animals represent an important, albeit neglected, public health issue worldwide. A descriptive study was made of snakebite cases attended and recorded between 2007 and 2010 in the health units of the municipalities of Cariri, State of Paraíba, northeastern Brazil. Data was collected from the Injury Notification Information System data banks of the Health Ministry and a total of 351 records of snakebite victims were reviewed. Victims were predominantly male farm workers over 50. The highest incidence of snakebites occurred in rural areas, between April and June of 2007 and 2010. Snakes of the genus Bothrops were responsible for most cases, and victims were mostly bitten on the feet. The majority of the victims received medical assistance within 1 to 3 hours after being bitten. The most common clinical manifestations were pain, edema and ecchymosis, which were mainly classified as mild or moderate. Two deaths were reported. It was concluded that there is a significant impact of seasonality in snakebites, the prevalence of attacks caused by Bothrops, affecting the lower limbs of adult male farmers in rural areas. The findings of this study may contribute to identify the conditions that increase the risk of snake attacks in the northeastern region.

Histological analysis of the damage to toad bladders caused by a myotoxic Lysine-49 phospholipase A2 from Agkistrodon contortrix laticinctus snake venom

Agkistrodon contortrix laticinctus myotoxin (ACLMT) is a myotoxic Lys49 phospholipase A2 isolated from the venom of the broad-banded copperhead, A. c. laticinctus. We have previously shown that ACLMT affects water transport in toad bladders, but little in known about the mechanisms involved in the action of this toxin on membrane permeability. In this study, we examined the morphological alterations caused by ACLMT in toad bladder epithelium. The bladders were exposed to the toxin (20 nM) for 30 min at 23o C using Bentley’s technique. Longitudinal and cross sections were obtained from paraffin-embedded bladders and stained with hematoxylin-eosin prior to analysis by light microscopy. Exposure to the toxin resulted in disorganization of the epithelial cell layer and damage to the smooth muscle bundles. The smooth muscle cells were swollen, with hypercontracted myofi laments and clear areas among the fibers. These findings suggest that ACLMT affects the structural integrity of the epithelium, and that the pathological changes induced by this toxin in smooth muscle cells may be caused by an increase in the cytosolic calcium concentration. These results contribute to our understanding of the mechanisms involved in the action of snake venom Lys49 PLA2 myotoxins in biological tissues.