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Kazemi SM, Kelisani ZG, Avella I, Lüddecke T. The need for a refined scorpion antivenom for Iran. Toxicon 2024; 248:108033. [PMID: 39038663 DOI: 10.1016/j.toxicon.2024.108033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/16/2024] [Accepted: 07/16/2024] [Indexed: 07/24/2024]
Abstract
Scorpion sting is a medical burden globally but especially frequent hotspots of scorpion biodiversity. In Iran, one of those hotspot countries, many fatalities occur in the South as well as the Southwest and are thought to be caused by Hemiscorpius lepturus. Accordingly, those are used for antivenom production. However, recent surveys revealed that indeed a different species Hemiscorpius acanthocercus is responsible for most accidents in the South, while H. lepturus is primarily causing the fatalities in the Southwest and thus Iranian scorpion antivenom needs to be refined in that respect. Such a refined antivenom would need to cover both species of Hemiscorpius. In response, the Iranian Ministry of Health requested the adjustment of the production line from local antivenom suppliers but until today no action has been taken.
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Affiliation(s)
- Seyed Mahdi Kazemi
- Zagros Herpetological Institute, 37156-88415, P. O. No 12, Somayyeh 14 Avenue, Qom, Iran
| | - Zohreh Gholam Kelisani
- Department of Counseling Feizoleslam Non-Profit Institute of Higher Education, Institute Khomeini Shahr, Isfahan, Iran
| | - Ignazio Avella
- Animal Venomics Lab, Fraunhofer Institute for Molecular Biology and Applied Ecology, Ohlebergsweg 12, 35392, Gießen, Germany; Institute for Insect Biotechnology, Justus Liebig University of Gießen, Heinrich-Buff Ring 26-32, 35392, Gießen, Germany; LOEWE Centre for Translational Biodiversity Genomics, Senckenberganlage 25, 60325, Frankfurt, Germany
| | - Tim Lüddecke
- LOEWE Centre for Translational Biodiversity Genomics, Senckenberganlage 25, 60325, Frankfurt, Germany; Animal Venomics Lab, Fraunhofer Institute for Molecular Biology and Applied Ecology, Ohlebergsweg 12, 35392, Gießen, Germany.
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Cortés-Fossati F, Méndez M. Comparative medical importance of spider bites in Spain over 1997-2020: a retrospective study based on hospital cases coded using ICD. JOURNAL OF MEDICAL ENTOMOLOGY 2024; 61:891-899. [PMID: 38598337 DOI: 10.1093/jme/tjae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/04/2024] [Accepted: 04/02/2024] [Indexed: 04/12/2024]
Abstract
Envenomation by terrestrial toxic animals is considered a serious risk to human health worldwide. Snakes, hymenopterans, spiders, and scorpions have mainly attracted the attention of medical literature. However, the relative importance of spiders has been studied only in a few countries. Here, we present the first retrospective study on the incidence of spider bites requiring hospital care in Spain, compared to bites or stings from snakes, hymenopterans, and scorpions. Using ICD9MC and ICD10 databases from the World Health Organization's International Classification of Diseases for the period 1997-2020, we quantified the cases of envenomation by spiders, compared to those by other terrestrial toxic animals, the demographic data of envenomation cases, the relative severity of spider bites, and the geographic distribution of envenomation cases. Overall, the incidence of acute intoxication by terrestrial toxic animals in Spain was ca. 1.23 cases per million inhabitants. In decreasing order of importance, cases were due to snakes, hymenopterans, spiders, scorpions, and myriapods. Fatal cases were extremely rare, caused mainly by hymenopterans. No fatalities were caused by spiders, scorpions, and myriapods. A greater incidence of snake bites occurred in northern Spain, but no geographical trends were found for spider bites or scorpion stings. Severe poisoning or life-threatening cases due to bites or stings from toxic terrestrial animals in Spain seems to be very low, especially for spiders, compared to other countries in the world. In general, spiders do not present a risk to human health and should not be considered a major driver of morbidity.
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Affiliation(s)
- Fernando Cortés-Fossati
- Evolutionary Ecology Group, Area of Biodiversity and Conservation, Universidad Rey Juan Carlos, c/ Tulipán s/n., E-28933 Móstoles, Madrid, Spain
| | - Marcos Méndez
- Evolutionary Ecology Group, Area of Biodiversity and Conservation, Universidad Rey Juan Carlos, c/ Tulipán s/n., E-28933 Móstoles, Madrid, Spain
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Baleela RMH, Mohammad A, Saeed SAK. The role of social media in public health awareness during times of war in Sudan: snakebites and scorpion stings. BMC Public Health 2024; 24:1752. [PMID: 38956503 PMCID: PMC11218301 DOI: 10.1186/s12889-024-19156-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 06/14/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Snakebite envenomation (SBE) and scorpion sting envenomation (SSE) are significant neglected tropical diseases that primarily affect impoverished communities in rural areas of developing nations. A lack of understanding about snake and scorpion species and their distribution exacerbates the disabilities and fatalities caused by SBE and SSE. In Sudan, particularly in regions affected by ongoing conflicts where healthcare resources are scarce, social media platforms offer a cost-effective approach to addressing public health challenges. Our aim in this study is to highlight the benefits of using social media for data collection and health promotion in such environments. METHODS We present a cost-effective communication and data collection strategy implemented at the Toxic Organisms Research Centre (TORC) of the University of Khartoum, focusing on a Facebook group, "Scorpions and Snakes of Sudan", as our primary social media platform. Additionally, we discuss the lessons learned and the initial impact of this strategy on enhancing population health literacy. RESULTS The group community is composed of ~ 5000 members from 14 countries. During the period from January 2023 to January 2024, we received 417 enquiries about snakes and scorpions belonging to 11 families and composed of 55 species. In addition, 53 other enquiries covered a range of organisms and their tracks (e.g., spiders, skinks, chameleons, foxes, sun spiders, centipedes, lizards, moth larvae, and insect tracks). The first photographic evidence of Malpolon monspessulanus in Sudan was via the group activities. The rare species Telescopus gezirae, the Blue Nile cat snake, is also documented via the group member's queries. Recognizing the evolving nature of social media use in public health, we also address the current limitations and evidence gaps that need to be addressed to effectively translate best practices into policy. CONCLUSION In conclusion, utilizing Facebook as an institutional platform to share scientific information in simple Arabic language underscores the proactive roles that citizens, scientists, and public health stakeholders can play in leveraging social media for eHealth, eAwareness, and public health initiatives. This approach highlights the potential for collaborative efforts, particularly during crises, to maximize the benefits of social media in advancing public health.
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Affiliation(s)
- Rania M H Baleela
- Toxic Organisms Research Centre, Faculty of Science, University of Khartoum, Khartoum, Sudan.
- Department of Zoology, Faculty of Science, University of Khartoum, Khartoum, Sudan.
| | | | - Sara A K Saeed
- Toxic Organisms Research Centre, Faculty of Science, University of Khartoum, Khartoum, Sudan
- Natural History Museum, Faculty of Science, University of Khartoum, Khartoum, Sudan
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Araújo KAMD, Torres-Rêgo M, Gurgel-Medeiros T, Silva-Júnior AAD, Leite RDS, Daniele-Silva A, Fernandes-Pedrosa MDF. Epidemiological study in Brazil: Scorpion sting cases in Natal, Rio Grande do Norte. Heliyon 2024; 10:e24190. [PMID: 38293345 PMCID: PMC10826653 DOI: 10.1016/j.heliyon.2024.e24190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/16/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Scorpion sting accidents are a public health problem in the state of Rio Grande do Norte, Brazil. The increasing and high incidence of cases in urban areas reveals the importance of studies to determine the epidemiological profile and the spatial distribution of these accidents. This is a retrospective study that describes and analyzes the cases of scorpion stings in the city of Natal, Rio Grande do Norte, Northeast Brazil, from 2007 to 2018. Data from the Information System database of Notifiable Diseases (SINAN) were obtained from the Secretary of Health of Rio Grande do Norte. 31,368 accidents due to scorpion stings were reported, more frequently in urban areas of Natal, whose Human Development Index is low. The cases occurred predominantly in hot and humid regions, mainly affecting women aged between 30 and 60 years. Most individuals sought medical attention within 3 h of the incident. The severity and mortality of the injured individuals varied according to the area of occurrence, age of the patient, and the local and systemic symptoms presented. Pain, numbness, and edema were the most frequent local symptoms, and systemic symptoms were frequently described as headache, hyperthermia and sweating. Therefore, scorpionism in the city of Natal is an environmental and public health problem, with a significant growth trend (p < 0.05). Through the data collected on the spatial distribution and risks, this approach allows the creation of effective control strategies to prevent accidents.
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Affiliation(s)
- Kaliany Adja Medeiros de Araújo
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), College of Pharmacy, Federal University of Rio Grande do Norte, General Gustavo Cordeiro de Farias Avenue, S/N, Petrópolis, Natal, 59012-570, Brazil
| | - Manoela Torres-Rêgo
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), College of Pharmacy, Federal University of Rio Grande do Norte, General Gustavo Cordeiro de Farias Avenue, S/N, Petrópolis, Natal, 59012-570, Brazil
- Graduate Program of Chemistry, Chemistry Institute, Federal University of Rio Grande do Norte, Senador Salgado Filho Avenue, 3000, Lagoa Nova, Natal, 59072-970, Brazil
| | - Thaynara Gurgel-Medeiros
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), College of Pharmacy, Federal University of Rio Grande do Norte, General Gustavo Cordeiro de Farias Avenue, S/N, Petrópolis, Natal, 59012-570, Brazil
| | - Arnóbio Antônio da Silva-Júnior
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), College of Pharmacy, Federal University of Rio Grande do Norte, General Gustavo Cordeiro de Farias Avenue, S/N, Petrópolis, Natal, 59012-570, Brazil
| | - Renner de Souza Leite
- Graduate Program of Physiological Sciences Federal University of Campina Grande, Olho D’água da Bica, S/N, Cuité, Paraíba, 59072-970, Brazil
| | - Alessandra Daniele-Silva
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), College of Pharmacy, Federal University of Rio Grande do Norte, General Gustavo Cordeiro de Farias Avenue, S/N, Petrópolis, Natal, 59012-570, Brazil
| | - Matheus de Freitas Fernandes-Pedrosa
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), College of Pharmacy, Federal University of Rio Grande do Norte, General Gustavo Cordeiro de Farias Avenue, S/N, Petrópolis, Natal, 59012-570, Brazil
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Takehara CA, Lamas JLT, Gasparino RC, Fusco SDFB. Moderate or severe scorpion sting: identification of risk factors. Rev Esc Enferm USP 2023; 57:e20230022. [PMID: 37902581 PMCID: PMC10615126 DOI: 10.1590/1980-220x-reeusp-2023-0022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/20/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE To characterize scorpion accidents at the Information and Toxicological Assistance Center (CIATox) in Campinas, to analyze risk factors related to the moderate and severe classification, and to determine the age group at greatest risk for this classification. METHOD Cross-sectional and retrospective study, with patients assisted in person at CIATox, who had a scorpion accident, from January 2015 to December 2019. Descriptive and inferential analysis was conducted. For the age variable, a ROC curve was constructed to determine cutoff points in relation to the severity classification. Poisson regression models were adjusted considering severity classification as the dependent variable. RESULTS A total of 754 cases with a mean age of 36.05 years, mostly female and non-occupational accidents that occurred in the urban area, was analyzed. The most frequent scorpion was the Tityus serrulatus. The risk factors found for greater severity were age group up to 22 years and previous care in other health services. CONCLUSION The age range up to 22 years old should be used as a predictive factor of severity in the clinical evaluation of patients stung by scorpions to carry out adequate management of cases.
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Brady MF, Kumar P, Currier C, Ruha AM. Treatment of Scorpion Envenomations in the Middle East: Understanding the Stinging Controversy. Wilderness Environ Med 2023; 34:258-260. [PMID: 36872164 DOI: 10.1016/j.wem.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/13/2022] [Accepted: 01/04/2023] [Indexed: 03/06/2023]
Affiliation(s)
- Mark F Brady
- Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, RI
| | - Prasanna Kumar
- Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, RI
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Chiaravalloti-Neto F, Lorenz C, Lacerda AB, de Azevedo TS, Cândido DM, Eloy LJ, Wen FH, Blangiardo M, Pirani M. Spatiotemporal bayesian modelling of scorpionism and its risk factors in the state of São Paulo, Brazil. PLoS Negl Trop Dis 2023; 17:e0011435. [PMID: 37339128 PMCID: PMC10313024 DOI: 10.1371/journal.pntd.0011435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 06/30/2023] [Accepted: 06/05/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Scorpion stings in Brazil represent a major public health problem due to their incidence and their potential ability to lead to severe and often fatal clinical outcomes. A better understanding of scorpionism determinants is essential for a precise comprehension of accident dynamics and to guide public policy. Our study is the first to model the spatio-temporal variability of scorpionism across municipalities in São Paulo (SP) and to investigate its relationship with demographic, socioeconomic, environmental, and climatic variables. METHODOLOGY This ecological study analyzed secondary data on scorpion envenomation in SP from 2008 to 2021, using the Integrated Nested Laplace Approximation (INLA) to perform Bayesian inference for detection of areas and periods with the most suitable conditions for scorpionism. PRINCIPAL FINDINGS From the spring of 2008 to 2021, the relative risk (RR) increased eight times in SP, from 0.47 (95%CI 0.43-0.51) to 3.57 (95%CI 3.36-3.78), although there has been an apparent stabilization since 2019. The western, northern, and northwestern parts of SP showed higher risks; overall, there was a 13% decrease in scorpionism during winters. Among the covariates considered, an increase of one standard deviation in the Gini index, which captures income inequality, was associated with a 11% increase in scorpion envenomation. Maximum temperatures were also associated with scorpionism, with risks doubling for temperatures above 36°C. Relative humidity displayed a nonlinear association, with a 50% increase in risk for 30-32% humidity and reached a minimum of 0.63 RR for 75-76% humidity. CONCLUSIONS Higher temperatures, lower humidity, and social inequalities were associated with a higher risk of scorpionism in SP municipalities. By capturing local and temporal relationships across space and time, authorities can design more effective strategies that adhere to local and temporal considerations.
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Affiliation(s)
| | - Camila Lorenz
- School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Luciano José Eloy
- Epidemiological Surveillance Center “Prof. Alexandre Vranjac”, São Paulo, Brazil
| | | | - Marta Blangiardo
- MRC Centre for Environment & Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Monica Pirani
- MRC Centre for Environment & Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
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Hilal I, Khourcha S, Safi A, Hmyene A, Asnawi S, Othman I, Stöcklin R, Oukkache N. Comparative Proteomic Analysis of the Venoms from the Most Dangerous Scorpions in Morocco: Androctonus mauritanicus and Buthus occitanus. Life (Basel) 2023; 13:life13051133. [PMID: 37240778 DOI: 10.3390/life13051133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/27/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
Morocco is known to harbor two of the world's most dangerous scorpion species: the black Androctonus mauritanicus (Am) and the yellow Buthus occitanus (Bo), responsible for 83% and 14% of severe envenomation cases, respectively. Scorpion venom is a mixture of biological molecules of variable structures and activities, most of which are proteins of low molecular weights referred to as toxins. In addition to toxins, scorpion venoms also contain biogenic amines, polyamines, and enzymes. With the aim of investigating the composition of the Am and Bo venoms, we conducted an analysis of the venoms by mass spectrometry (ESI-MS) after separation by reversed-phase HPLC chromatography. Results from a total of 19 fractions obtained for the Am venom versus 22 fractions for the Bo venom allowed the identification of approximately 410 and 252 molecular masses, respectively. In both venoms, the most abundant toxins were found to range between 2-5 kDa and 6-8 kDa. This proteomic analysis not only allowed the drawing of an extensive mass fingerprint of the Androctonus mauritanicus and Buthus occitanus venoms but also provided a better insight into the nature of their toxins.
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Affiliation(s)
- Ines Hilal
- Laboratory of Venoms and Toxins, Pasteur Institute of Morocco, Casablanca 20360, Morocco
- Laboratory of Biochemistry, Environment and Food Technology, Faculty of Sciences and Techniques of Mohammedia, Mohammedia 20650, Morocco
| | - Soukaina Khourcha
- Laboratory of Venoms and Toxins, Pasteur Institute of Morocco, Casablanca 20360, Morocco
- Laboratory of Biochemistry, Environment and Food Technology, Faculty of Sciences and Techniques of Mohammedia, Mohammedia 20650, Morocco
| | - Amal Safi
- Laboratory of Biochemistry, Environment and Food Technology, Faculty of Sciences and Techniques of Mohammedia, Mohammedia 20650, Morocco
| | - Abdelaziz Hmyene
- Laboratory of Biochemistry, Environment and Food Technology, Faculty of Sciences and Techniques of Mohammedia, Mohammedia 20650, Morocco
| | - Syafiq Asnawi
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia
| | - Iekhsan Othman
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia
| | - Reto Stöcklin
- Atheris Laboratories, Case Postale 314, CH-1233 Bernex, Geneva, Switzerland
| | - Naoual Oukkache
- Laboratory of Venoms and Toxins, Pasteur Institute of Morocco, Casablanca 20360, Morocco
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Acunha T, Rocha BA, Nardini V, Barbosa F, Faccioli LH. Lipidomic profiling of the Brazilian yellow scorpion venom: new insights into inflammatory responses following Tityus serrulatus envenomation. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2023; 86:283-295. [PMID: 36895096 DOI: 10.1080/15287394.2023.2188896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Due to the high prevalence and clinical relevance, scorpionism is a critical public health issue in several Brazilian regions. Tityus serrulatus, commonly known as the Brazilian yellow scorpion, is the most venomous genus found in Brazilian fauna and associated with severe clinical manifestations such as localized pain, hypertension, sweating, tachycardia and complex hyperinflammatory responses. In general, T. serrulatus venom contains a complex mixture of active compounds, including proteins, peptides, and amino acids. Although knowledge of the protein fractions of scorpion venom is available, venom lipid components are not yet comprehensively known. The aim of the present study was to determine and characterize the lipid constituents/profile of the T. serratus venom utilizing liquid chromatography coupled with high-resolution mass spectrometry. Lipid species (164 in total) belonging to 3 different lipid categories, glycerophospholipids, sphingolipids, and glycerolipids, were identified. A further search on MetaCore/MetaDrug platform, which is based upon a manually curated database of molecular interactions, molecular pathways, gene-disease associations, chemical metabolism, and toxicity information, exhibited several metabolic pathways for 24 of previously identified lipid species, including activation of nuclear factor kappa B and oxidative stress pathways. Further several bioactive compounds, such as plasmalogens, lyso-platelet-activating factors, and sphingomyelins, associated with systemic responses triggered by T. serrulatus envenomation were detected. Finally, lipidomic data presented provide advanced and valuable information to better comprehend the mechanisms underlying the complex pathophysiology induced by T. serrulatus envenomation.
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Affiliation(s)
| | | | | | - Fernando Barbosa
- Departamento de Análise Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Lúcia Helena Faccioli
- Departamento de Análise Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Trinidad-Porfirio BE, Morales-Pérez A, Nava-Aguilera E, Flores-Moreno M, Morales-Nava L, García-Leyva J, Silva-Domínguez R, Cortés-Guzmán AJ, Fernández-Salas I, Andersson N. Occurrence of scorpion sting and associated factors in a highly marginalized municipality in Guerrero, Mexico: A cross-sectional study. PLoS Negl Trop Dis 2023; 17:e0011271. [PMID: 37126488 PMCID: PMC10150966 DOI: 10.1371/journal.pntd.0011271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/24/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Scorpion sting is a neglected public health problem, despite a global estimate of 1.2 million scorpion stings and some 3,250 deaths annually. METHODS This cross-sectional study estimates the occurrence of scorpion stings and identifies associated factors in seven communities in the highly marginalized municipality of Chilapa, in the Mexican state of Guerrero. After informed consent, 1,144 households provided information on 4,985 residents. The questionnaire collated sociodemographic data, characteristics of the dwelling, efforts to avoid scorpion stings, and individual information of scorpion stings suffered in the last year. Cluster-adjusted (acl), bivariate and multivariate analysis relied on the Mantel-Haenszel procedure. RESULTS The overall period prevalence of scorpion stings in the year prior to the study was 4.4% (218/4985), 5.4% in men (126/2320), and 3.5% in women (92/2665), p<0.01. The majority occurred at home 68.3% (149/218), followed by agricultural fields 26.6% (58/218), street 2.8% (6/218), and work 2.3% (5/218). Factors associated with scorpion sting were carrying firewood (OR 2.1; CI95%acl 1.40-3.09), keeping free-range hens around of the home (OR 1.9; CI95%acl 1.19-2.85), residing in a rural area (OR 1.7; CI95%acl 1.04-2.78), being male (OR 1.6; CI95%acl 1.18-2.28), and helping with housework (OR 1.6; CI95%acl 1.04-2.40). CONCLUSION This study confirms scorpion bites are a public health problem in these marginalized communities in Guerrero State, with risk factors related to living conditions and the work process at home and in the fields. Almost all risk factors identified could be reduced with low-cost interventions implemented by the communities themselves.
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Affiliation(s)
| | - Arcadio Morales-Pérez
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Elizabeth Nava-Aguilera
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Miguel Flores-Moreno
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Liliana Morales-Nava
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Jaime García-Leyva
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Rufino Silva-Domínguez
- Departamento de Epidemiología y Medicina Preventiva, Secretaría de Salud Guerrero, Chilpancingo, Guerrero, México
| | - Antonio Juan Cortés-Guzmán
- Departamento de Epidemiología y Medicina Preventiva, Secretaría de Salud Guerrero, Chilpancingo, Guerrero, México
| | - Ildefonso Fernández-Salas
- Laboratorio de Entomología Médica, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León, México
| | - Neil Andersson
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
- Department of Family Medicine, McGill University, Montreal, Canada
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Brites-Neto J, Dell Ducas V, Figueiredo FS. Spatial Analysis in Areas with High Occurrence of Accidents Caused by Tityus serrulatus and Tityus bahiensis (Scorpiones: Buthidae) in Brazil. Wilderness Environ Med 2023; 34:63-71. [PMID: 36543614 DOI: 10.1016/j.wem.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION In Brazil, scorpion stings are recorded in high numbers with an increasing epidemiological situation in most municipalities. In the present study, data between 1998 and 2018 in Americana, São Paulo, were analyzed. METHODS In total, 4122 records on scorpion stings were georeferenced using a Garmin eTREX 30X global positioning system device, with WGS84 datum projection and Universal Transverse Mercator zone 23S. Multiple Poisson regression was used to explore the relationship between the incidence rates of stings and urban planning areas (UPAs). Eight quantitative variables were used to establish the environmental and anthropic characterization of UPAs associated or not associated with scorpionism. A spatial analysis was performed for geoprocessing maps of Americana using spatial statistics tools (optimized hotspot analysis and kernel density function) from cartographic clusters in the ArcMap software, version 10.5. RESULTS The optimized hotspot analysis tool identified spatial clusters with high values of the incidence of scorpion stings in the surroundings of all UPAs in the municipality. The estimation of the kernel function of event intensity showed a wide distribution of stings across the area of the entire municipal territory, with UPA-02 and UPA-06 exhibiting the highest occurrence of scorpion stings. Six significant hotspots were established as highest-event-density areas (with occurrences of 160-270) and were contiguous to 4 environmental protection areas, located in more peripheral regions, and to 2 municipal cemeteries, which were located in urban central areas. CONCLUSIONS This analysis showed that the risk of scorpion stings in different Americana's UPAs has increased occurrence and incidence intensity.
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Turgut K, Yavuz E, Gülaçtı U, Aydın İ, Sönmez C, Aktaş N, Arslan E. Comparison of Intravenous Paracetamol, Dexketoprofen Trometamol, or Topical Lidocaine Use for Pain Relief in Scorpion Stings: A Placebo-Controlled, Randomized Study. Wilderness Environ Med 2022; 33:379-385. [PMID: 36229383 DOI: 10.1016/j.wem.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/31/2022] [Accepted: 08/08/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION After a scorpion sting, patients commonly present to hospitals with pain. Our study sought to compare the analgesic efficacy of IV paracetamol, IV dexketoprofen trometamol, topical lidocaine, and placebo in patients reporting pain after presenting with a history of scorpion sting. METHODS This double-blind, randomized, placebo-controlled study was conducted in the emergency department of a tertiary hospital. Adult patients who presented with the complaint of pain after a scorpion sting and did not have systemic findings were randomly assigned to 1 of the following 4 groups: IV paracetamol, IV dexketoprofen trometamol, topical lidocaine, and placebo. The visual analog scale scores were measured at the time of presentation to the emergency department and at 30 and 60 min to determine the pain intensity. RESULTS The study included 106 patients, of whom 30 were in the paracetamol group, 26 in the dexketoprofen trometamol group, 25 in the topical lidocaine group, and 25 in the placebo group. We did not find a different analgesic effect among the groups in the first 30 min (P=0.185). IV paracetamol, dexketoprofen trometamol, and topical lidocaine did not show different analgesic effects in the first 60 min (P>0.05). IV paracetamol and dexketoprofen trometamol were found to provide a more effective analgesia than the placebo at 60 min (P<0.05). The analgesic effects of topical lidocaine and placebo did not differ (P=0.330). CONCLUSIONS IV paracetamol and IV dexketoprofen trometamol provided analgesia in the first 60 min, similar to topical lidocaine but superior to placebo.
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Affiliation(s)
- Kasım Turgut
- Department of Emergency Medicine, Research and Training Hospital, Adiyaman University, Adiyaman, Turkey
| | - Erdal Yavuz
- Department of Emergency Medicine, Research and Training Hospital, Adiyaman University, Adiyaman, Turkey.
| | - Umut Gülaçtı
- Department of Emergency Medicine, Research and Training Hospital, Adiyaman University, Adiyaman, Turkey
| | - İrfan Aydın
- Department of Emergency Medicine, Research and Training Hospital, Adiyaman University, Adiyaman, Turkey
| | - Cihat Sönmez
- Department of Emergency Medicine, Research and Training Hospital, Adiyaman University, Adiyaman, Turkey
| | - Nurettin Aktaş
- Department of Emergency Medicine, Research and Training Hospital, Adiyaman University, Adiyaman, Turkey
| | - Ebru Arslan
- Department of Emergency Medicine, Research and Training Hospital, Adiyaman University, Adiyaman, Turkey
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Elmourid A, Elhidan MA, Boussaa S, Bhiri M, Touloun O. Epidemiological and faunistic characterization of scorpionism in the Beni Mellal-Khenifra region, Central Morocco. Toxicon 2022; 218:70-75. [PMID: 36087714 DOI: 10.1016/j.toxicon.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/30/2022] [Accepted: 09/02/2022] [Indexed: 11/24/2022]
Abstract
Scorpionism is a serious public health problem in several parts of the world including Morocco, where is considered as the first cause of intoxication. The Beni Mellal-Khenifra region is one of the most affected regions by this health problem. The aim of this study is to describe the epidemiological and faunistic characteristics of scorpionism in this area. A retrospective epidemiological study was conducted based on the data of 16,388 cases of scorpion stings recorded between 2016 and 2020. In the laboratory, the collected scorpions were determined morphologically based on the valid taxonomic keys. Statistical and descriptive analyses were performed using Excel 2016. Statistical significance was determined by P-value < 0.05. The study comprised 16,388 stung patients. The scorpion stings incidence was 123.58 cases/100,000 population/year and was significantly higher at Azilal province (217.69 cases/100,000 population/year). We found a positive correlation between the scorpion stings incidence and the percentage of the rural population (r = 0.72) and between the scorpion stings incidence and the number of harmful species found in each province (r = 0.69). The general lethality rate was on average of 0.30% with a higher rate in Fquih Ben Salah province (0.63%) followed by Azilal province (0.32%). Children have the highest lethality than adults (p < 0.05). In the study area, eight species were identified, belonging to the families Buthidae and Scorpionidae, including dangerous species. Scorpionism is a real health problem in the Beni Mellal-Khenifra region, which is a rich and diverse area of scorpion fauna. Our findings can be useful for better understanding the problem of scorpionism in this region in order to better control it.
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Affiliation(s)
- Abdessamad Elmourid
- Polyvalent Team in Research and Development (LPVRD), Department of Biology & Geology, Polydisciplinary Faculty, University, Sultan My Slimane, Beni Mellal, 23030, Morocco.
| | | | - Samia Boussaa
- ISPITS-Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
| | - Mourad Bhiri
- Regional Directorate of Health and Social Protection of the Beni Mellal-Khenifra Region, Morocco
| | - Oulaid Touloun
- Polyvalent Team in Research and Development (LPVRD), Department of Biology & Geology, Polydisciplinary Faculty, University, Sultan My Slimane, Beni Mellal, 23030, Morocco
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14
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Lourenço WR. Back to Tityus serrulatus Lutz & Mello, 1922 (Scorpiones: Buthidae): new comments about an old species. J Venom Anim Toxins Incl Trop Dis 2022; 28:e20220016. [PMID: 35910487 PMCID: PMC9281443 DOI: 10.1590/1678-9199-jvatitd-2022-0016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/15/2022] [Indexed: 11/26/2022] Open
Abstract
A synopsis on the historical, geographical and ecological aspects related to the most conspicuous scorpion species of the genus Tityus known from Brazil is proposed. Tityus serrulatus Lutz & Mello, 1922 was described precisely one century ago, nevertheless many questions related to its ecological adaptations and geographical expansion remain without a precise response. This species, well known for its infamous reputation of noxious species, is also known for its capacity to reproduce asexually, by parthenogenesis. Although the individuals of a given population are considered clones, a new hypothesis could suggest the occurrence of mutations within isolated individuals, leading to distinct subpopulations that could present better phenotypic performances in ecological habitats distinct from those of the original area of distribution of the species.
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Affiliation(s)
- Wilson R Lourenço
- Muséum national d'Histoire naturelle, Sorbonne Universités, Institut de Systématique, Evolution, Biodiversité (ISYEB), UMR7205-CNRS, MNHN, UPMC, EPHE, CP 53, 57 rue Cuvier, 75005 Paris, France
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15
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Lacerda AB, Lorenz C, Azevedo TS, Cândido DM, Wen FH, Eloy LJ, Chiaravalloti-Neto F. Detection of areas vulnerable to scorpionism and its association with environmental factors in São Paulo, Brazil. Acta Trop 2022; 230:106390. [PMID: 35245492 DOI: 10.1016/j.actatropica.2022.106390] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/28/2022] [Accepted: 02/28/2022] [Indexed: 11/01/2022]
Abstract
Accidents caused by scorpions are considered a neglected condition and represent a major health problem in most tropical countries, especially for children and elderly people. In Brazil, scorpionism is recurrent in the southeast region, mainly in the state of São Paulo, due to the progressive increase in scorpions found in urban habitats. Thus, our study aimed to provide better insights into the geographic and epidemiological characteristics of scorpion envenomation in São Paulo state and identify the environmental factors that are associated with these accidents. This is an ecological and retrospective study with secondary data on scorpion accidents in the state of São Paulo from 2008 to 2018 obtained from the Notifiable Disease Information System. The SatScan software was used to identify the higher- and lower-risk spatiotemporal clusters. A total of 145,464 scorpion sting cases were recorded in the state of São Paulo, between 2008 and 2018; there was a four-fold increase in the incidence rate. Accidents occurred more frequently in the spring season, wherein higher-risk clusters were in the north and northwest regions of the state. High temperatures, low precipitation, and poor natural vegetation are associated with higher risk areas. Our study mapped vulnerable areas for scorpion accidents that can aid in the design of efficient public health policies, which should be intensified during the spring season.
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16
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Ghezellou P, Jakob K, Atashi J, Ghassempour A, Spengler B. Mass-Spectrometry-Based Lipidome and Proteome Profiling of Hottentotta saulcyi (Scorpiones: Buthidae) Venom. Toxins (Basel) 2022; 14:toxins14060370. [PMID: 35737031 PMCID: PMC9228814 DOI: 10.3390/toxins14060370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 12/10/2022] Open
Abstract
Scorpion venom is a complex secretory mixture of components with potential biological and physiological properties that attracted many researchers due to promising applications from clinical and pharmacological perspectives. In this study, we investigated the venom of the Iranian scorpion Hottentotta saulcyi (Simon, 1880) by applying mass-spectrometry-based proteomic and lipidomic approaches to assess the diversity of components present in the venom. The data revealed that the venom’s proteome composition is largely dominated by Na+- and K+-channel-impairing toxic peptides, following the enzymatic and non-enzymatic protein families, e.g., angiotensin-converting enzyme, serine protease, metalloprotease, hyaluronidase, carboxypeptidase, and cysteine-rich secretory peptide. Furthermore, lipids comprise ~1.2% of the dry weight of the crude venom. Phospholipids, ether-phospholipids, oxidized-phospholipids, triacylglycerol, cardiolipins, very-long-chain sphingomyelins, and ceramides were the most intensely detected lipid species in the scorpion venom, may acting either independently or synergistically during the envenomation alongside proteins and peptides. The results provide detailed information on the chemical makeup of the venom, helping to improve our understanding of biological molecules present in it, leading to a better insight of the medical significance of the venom, and improving the medical care of patients suffering from scorpion accidents in the relevant regions such as Iran, Iraq, Turkey, and Afghanistan.
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Affiliation(s)
- Parviz Ghezellou
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University Giessen, 35392 Giessen, Germany;
- Correspondence: (P.G.); (B.S.)
| | - Kevin Jakob
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University Giessen, 35392 Giessen, Germany;
| | - Javad Atashi
- Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, Tehran 1983969411, Iran; (J.A.); (A.G.)
| | - Alireza Ghassempour
- Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, Tehran 1983969411, Iran; (J.A.); (A.G.)
| | - Bernhard Spengler
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University Giessen, 35392 Giessen, Germany;
- Correspondence: (P.G.); (B.S.)
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17
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Lacerda AB, Lorenz C, De Azevedo TS, Cândido DM, Wen FH, Eloy LJ, Bersusa AAS, Chiaravalloti Neto F. Scorpion envenomation in the state of São Paulo, Brazil: Spatiotemporal analysis of a growing public health concern. PLoS One 2022; 17:e0266138. [PMID: 35395017 PMCID: PMC8992990 DOI: 10.1371/journal.pone.0266138] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/14/2022] [Indexed: 11/19/2022] Open
Abstract
Scorpion envenomation is a significant public health concern in São Paulo, Brazil, and its incidence and mortality have increased in recent decades. The present study analyzed documented scorpion envenomation notifications from 2008 to 2018 throughout the 645 municipalities of São Paulo. Annual incidence and mortality rates were calculated and stratified according to sex and age. The local empirical Bayesian method and Getis-Ord Gi* statistic were used to represent standardized incidence rates in the municipalities and to identify high- and low-risk agglomerates. The incidence rate of scorpion envenomation quintupled between 2008 and 2018. Overall, the risk was higher for man, and increased with age. Deaths due to envenomation, however, were concentrated almost entirely in children 0–9 years of age. Incidence maps showed that the risk of envenomation increased in almost all regions and municipalities of São Paulo throughout the study period. The highest incidence rates were found in the western, northwestern and northern regions of the state, in contrast to the São Paulo metropolitan area and southern and coastal regions. Hot spots were identified in the Presidente Prudente, Barretos, São José do Rio Preto, and Araçatuba regional health districts, which over time formed a single high-risk cluster. In spatial terms, however, deaths were randomly distributed. In this study, we identified areas and populations at risk of scorpion envenomation and associated–fatalities, which can be used to support decision-making by health services to reduce human contact with these arachnids and avoid fatalities, especially in children.
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Affiliation(s)
- Alec Brian Lacerda
- Faculdade de Saúde Pública–Universidade De São Paulo, São Paulo, Brazil
- * E-mail:
| | - Camila Lorenz
- Faculdade de Saúde Pública–Universidade De São Paulo, São Paulo, Brazil
| | - Thiago Salomão De Azevedo
- Faculdade de Saúde Pública–Universidade De São Paulo, São Paulo, Brazil
- Secretaria de Saúde do Município de Santa Bárbara d’Oeste–SP, Santa Bárbara d’Oeste, Brazil
| | | | | | - Luciano José Eloy
- Centro de Vigilância Epidemiológica “Prof. Alexandre Vranjac”, São Paulo, Brazil
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18
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Forde A, Jacobsen A, Dugon MM, Healy K. Scorpion Species with Smaller Body Sizes and Narrower Chelae Have the Highest Venom Potency. Toxins (Basel) 2022; 14:219. [PMID: 35324715 PMCID: PMC8951363 DOI: 10.3390/toxins14030219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023] Open
Abstract
Scorpionism is a global health concern, with an estimation of over one million annual envenomation cases. Despite this, little is known regarding the drivers of scorpion venom potency. One widely held view is that smaller scorpions with less-developed chelae possess the most potent venoms. While this perception is often used as a guide for medical intervention, it has yet to be tested in a formal comparative framework. Here, we use a phylogenetic comparative analysis of 36 scorpion species to test whether scorpion venom potency, as measured using LD50, is related to scorpion body size and morphology. We found a positive relationship between LD50 and scorpion total length, supporting the perception that smaller scorpions possess more potent venoms. We also found that, independent of body size, scorpion species with long narrow chelae have higher venom potencies compared to species with more robust chelae. These results not only support the general perception of scorpion morphology and potency, but also the presence of an ecology trade-off with scorpions either selected for well-developed chelae or more potent venoms. Testing the patterns of venom variations in scorpions aids both our ecological understanding and our ability to address the global health burden of scorpionism.
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Affiliation(s)
- Alannah Forde
- Venom Systems & Proteomics Lab, School of Natural Sciences, Ryan Institute, National University of Ireland Galway, H91 TK33 Galway, Ireland; (A.F.); (A.J.); (M.M.D.)
| | - Adam Jacobsen
- Venom Systems & Proteomics Lab, School of Natural Sciences, Ryan Institute, National University of Ireland Galway, H91 TK33 Galway, Ireland; (A.F.); (A.J.); (M.M.D.)
| | - Michel M. Dugon
- Venom Systems & Proteomics Lab, School of Natural Sciences, Ryan Institute, National University of Ireland Galway, H91 TK33 Galway, Ireland; (A.F.); (A.J.); (M.M.D.)
| | - Kevin Healy
- Macroecology Lab, School of Natural Sciences, Ryan Institute, National University of Ireland Galway, H91 TK33 Galway, Ireland
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19
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Kerdoun MA. Epidemiological aspects of scorpion stings in Algeria: A monocentric retrospective study. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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20
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OUP accepted manuscript. Syst Biol 2022; 71:1281-1289. [DOI: 10.1093/sysbio/syac021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/01/2022] [Accepted: 03/05/2022] [Indexed: 11/14/2022] Open
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21
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Diochot S. Pain-related toxins in scorpion and spider venoms: a face to face with ion channels. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20210026. [PMID: 34925480 PMCID: PMC8667759 DOI: 10.1590/1678-9199-jvatitd-2021-0026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/10/2021] [Indexed: 12/12/2022] Open
Abstract
Pain is a common symptom induced during envenomation by spiders and scorpions.
Toxins isolated from their venom have become essential tools for studying the
functioning and physiopathological role of ion channels, as they modulate their
activity. In particular, toxins that induce pain relief effects can serve as a
molecular basis for the development of future analgesics in humans. This review
provides a summary of the different scorpion and spider toxins that directly
interact with pain-related ion channels, with inhibitory or stimulatory effects.
Some of these toxins were shown to affect pain modalities in different animal
models providing information on the role played by these channels in the pain
process. The close interaction of certain gating-modifier toxins with membrane
phospholipids close to ion channels is examined along with molecular approaches
to improve selectivity, affinity or bioavailability in vivo for
therapeutic purposes.
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Affiliation(s)
- Sylvie Diochot
- Institut de Pharmacologie Moléculaire et Cellulaire (IPMC), Centre National de la Recherche Scientifique (CNRS) UMR 7275 et Université Côte d'Azur (UCA), 06560 Valbonne, France. Institut de Pharmacologie Moléculaire et Cellulaire Centre National de la Recherche Scientifique Université Côte d'Azur Valbonne France
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22
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Barbosa MDOR, de Paulo MEFDV, Nencioni ALA. Scorpion Envenomation of Lactating Rats Decreases the Seizure Threshold in Offspring. Toxins (Basel) 2021; 13:853. [PMID: 34941691 PMCID: PMC8707262 DOI: 10.3390/toxins13120853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
Few data are available in the literature describing the long-term effects of envenoming in the perinatal period. In this study, the relationship between envenoming of lactating rats and possible behavioral changes in the mother and in her offspring were investigated. Lactating Wistar rats received a single dose of T. serrulatus crude venom on postnatal days 2 (V2), 10 (V10) or 16 (V16), and had their maternal behavior evaluated. The seizure threshold was evaluated in adulthood offspring. A decrease in maternal care during envenoming was observed in V2 and V10 groups. The retrieval behavior was absent in the V2 group, and a lower seizure threshold in the adult offspring of all groups was observed. During envenoming, mothers stayed away from their offspring for a relatively long time. Maternal deprivation during the early postnatal period is one of the most potent stressors for pups and could be responsible, at least in part, for the decrease in the convulsive threshold of the offspring since stress is pointed to as a risk factor for epileptogenesis. Furthermore, the scorpionic accident generates an intense immune response, and inflammation in neonates increases the susceptibility to seizures in adulthood. Therefore, maternal envenoming during lactation can have adverse effects on offspring in adulthood.
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Affiliation(s)
| | | | - Ana Leonor Abrahão Nencioni
- Laboratory of Pharmacology, Butantan Institute, Av. Dr. Vital Brazil 1500, São Paulo 05503-900, Brazil; (M.d.O.R.B.); (M.E.F.d.V.d.P.)
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23
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Das B, Saviola AJ, Mukherjee AK. Biochemical and Proteomic Characterization, and Pharmacological Insights of Indian Red Scorpion Venom Toxins. Front Pharmacol 2021; 12:710680. [PMID: 34650430 PMCID: PMC8505525 DOI: 10.3389/fphar.2021.710680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/16/2021] [Indexed: 12/16/2022] Open
Abstract
The Indian red scorpion (Mesobuthus tamulus) is one of the world's deadliest scorpions, with stings representing a life-threatening medical emergency. This species is distributed throughout the Indian sub-continent, including eastern Pakistan, eastern Nepal, and Sri Lanka. In India, Indian red scorpions are broadly distributed in western Maharashtra, Saurashtra, Kerala, Andhra Pradesh, Tamil Nadu, and Karnataka; however, fatal envenomations have been recorded primarily in the Konkan region of Maharashtra. The Indian red scorpion venom proteome comprises 110 proteins belonging to 13 venom protein families. The significant pharmacological activity is predominantly caused by the low molecular mass non-enzymatic Na+ and K+ ion channel toxins. Other minor toxins comprise 15.6% of the total venom proteome. Indian red scorpion stings induce the release of catecholamine, which leads to pathophysiological abnormalities in the victim. A strong correlation has been observed between venom proteome composition and local (swelling, redness, heat, and regional lymph node involvement) and systemic (tachycardia, mydriasis, hyperglycemia, hypertension, toxic myocarditis, cardiac failure, and pulmonary edema) manifestations. Immediate administration of antivenom is the preferred treatment for Indian red scorpion stings. However, scorpion-specific antivenoms have exhibited poor immunorecognition and neutralization of the low molecular mass toxins. The proteomic analysis also suggests that Indian red scorpion venom is a rich source of pharmacologically active molecules that may be envisaged as drug prototypes. The following review summarizes the progress made towards understanding the venom proteome of the Indian red scorpion and addresses the current understanding of the pathophysiology associated with its sting.
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Affiliation(s)
- Bhabana Das
- Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur, India
| | - Anthony J. Saviola
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ashis K. Mukherjee
- Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur, India
- Institute of Advanced Study in Science and Technology, Guwahati, India
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Martins JG, Santos GC, Procópio REDL, Arantes EC, Bordon KDCF. Scorpion species of medical importance in the Brazilian Amazon: a review to identify knowledge gaps. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20210012. [PMID: 34589120 PMCID: PMC8452272 DOI: 10.1590/1678-9199-jvatitd-2021-0012] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/09/2021] [Indexed: 12/24/2022] Open
Abstract
Scorpionism is a relevant medical condition in Brazil. It is responsible for most accidents involving venomous animals in the country, which leads to severe symptoms that can evolve to death. In recent years, an increase of almost 50% in the incidence of scorpionism has been observed in the Northern Region, where the highest severity of envenoming has been notified since the beginning of the 21st century. This review aims to provide an in-depth assessment of public data and reports on symptoms and epidemiology of envenoming, ecological aspects of scorpions, and characterization of venoms and toxins to access the gaps that need to be filled in the knowledge of the scorpion species of medical importance from the Brazilian Amazon. A systematic search using the string words "Amazon" and "scorpion" was performed on 11 databases. No restriction on date, language or status of the publication was applied. Reports not related to the Brazilian Amazon were excluded. Therefore, 88 studies remained. It is shown that populations of scorpions of medical importance, even of the same species, may present significant toxic variations peculiar to some regions in the Brazilian Amazon, and commercial scorpion antivenoms were not able to shorten the intensity and duration of neurological manifestations in patients stung by T. silvestris, T. apiacas or T. obscurus. It is also highlighted that the toxins responsible for triggering these alterations have not been elucidated yet and this is a fruitful field for the development of more efficient antivenoms. Furthermore, the geographic distribution of scorpions of the genus Tityus in the Brazilian Amazon was revised and updated. The cumulative and detailed information provided in this review may help physicians and scientists interested in scorpionism in the Brazilian Amazon.
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Affiliation(s)
- Jonas Gama Martins
- Graduate Program in Genetics, Conservation and Evolutionary Biology
(PPG GCBEv), National Institute for Amazon Research (INPA), Manaus, AM,
Brazil
| | - Gabrielle Cristina Santos
- Department of BioMolecular Sciences, School of Pharmaceutical
Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP,
Brazil
| | - Rudi Emerson de Lima Procópio
- Graduate Program in Biotechnology and Natural Resources of Amazon,
University of the State of Amazonas (UEA), Manaus, AM, Brazil
| | - Eliane Candiani Arantes
- Department of BioMolecular Sciences, School of Pharmaceutical
Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP,
Brazil
| | - Karla de Castro Figueiredo Bordon
- Department of BioMolecular Sciences, School of Pharmaceutical
Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP,
Brazil
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25
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Simone Y, van der Meijden A. Armed stem to stinger: a review of the ecological roles of scorpion weapons. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20210002. [PMID: 34527038 PMCID: PMC8425188 DOI: 10.1590/1678-9199-jvatitd-2021-0002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/18/2021] [Indexed: 12/24/2022] Open
Abstract
Scorpions possess two systems of weapons: the pincers (chelae) and the stinger (telson). These are placed on anatomically and developmentally well separated parts of the body, that is, the oral appendages and at the end of the body axis. The otherwise conserved body plan of scorpions varies most in the shape and relative dimensions of these two weapon systems, both across species and in some cases between the sexes. We review the literature on the ecological function of these two weapon systems in each of three contexts of usage: (i) predation, (ii) defense and (iii) sexual contests. In the latter context, we will also discuss their usage in mating. We first provide a comparative background for each of these contexts of usage by giving examples of other weapon systems from across the animal kingdom. Then, we discuss the pertinent aspects of the anatomy of the weapon systems, particularly those aspects relevant to their functioning in their ecological roles. The literature on the functioning and ecological role of both the chelae and the telson is discussed in detail, again organized by context of usage. Particular emphasis is given on the differences in morphology or usage between species or higher taxonomic groups, or between genders, as such cases are most insightful to understand the roles of each of the two distinct weapon systems of the scorpions and their evolutionary interactions. We aimed to synthesize the literature while minimizing conjecture, but also to point out gaps in the literature and potential future research opportunities.
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Affiliation(s)
- Yuri Simone
- CIBIO Research Centre in Biodiversity and Genetic Resources, InBIO, Porto, Portugal
| | - Arie van der Meijden
- CIBIO Research Centre in Biodiversity and Genetic Resources, InBIO, Porto, Portugal
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Alhamoud MA, Al Fehaid MS, Alhamoud MA, Alkhalifah AA, Alzoayed MH, Menezes RG. Scorpion Stings in Saudi Arabia: An Overview. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021273. [PMID: 34487071 PMCID: PMC8477104 DOI: 10.23750/abm.v92i4.11550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/14/2021] [Indexed: 11/23/2022]
Abstract
Background and aim of the work: Scorpion sting envenomation is an important cause of morbidity and mortality among incidents caused by envenomations, especially in children and elderly, worldwide. In Saudi Arabia, it is an important issue as the climate and the desert terrain are ideal for scorpions’ habitat. The aim of this review is to emphasize on the importance of scorpion stings in Saudi Arabia and provide updates regarding scorpion types and epidemiological aspects of scorpion stings in Saudi Arabia. Methods: Aliterature review of articles on scorpions and scorpion stings in Saudi Arabia. Results: In Saudi Arabia, at least 28 species of scorpions are identified. An estimated 14,500 scorpion stings are annually documented in various regions of Saudi Arabia. Most of the cases of scorpion envenomation recover completely with treatment in Saudi Arabia. People who live in the desert terrain, such as nomads or shepherds, are the population at highest risk for scorpion stings. The highest incidence of scorpion stings is reported during the summer season. Conclusion: Scorpions are found to inhabit all the regions of the country. The incidence of scorpion stings in Saudi Arabia seems to be significant. However, the mortality rate is low in Saudi Arabia. There are insufficient studies regarding this topic, and as such, it is clear that there is a lack of information regarding autopsy findings of scorpion sting deaths in Saudi Arabia. (www.actabiomedica.it)
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Affiliation(s)
- Mustafa A Alhamoud
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Mohammad S Al Fehaid
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Mohammed A Alhamoud
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Ahmed A Alkhalifah
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Mohammed H Alzoayed
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Ritesh G Menezes
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
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Almeida ACC, Carvalho FM, Mise YF. Risk factors for fatal scorpion envenoming among Brazilian children: a case-control study. Trans R Soc Trop Med Hyg 2021; 115:975-983. [PMID: 34352889 DOI: 10.1093/trstmh/trab120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/15/2021] [Accepted: 07/20/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Scorpion envenoming is relatively frequent in tropical and subtropical regions and potentially fatal. We aimed to identify risk factors for fatal scorpion envenoming among Brazilian children. METHODS A case-control study investigated all fatal cases of scorpion envenoming among children up to 10 y old, reported to the Brazilian Diseases Surveillance System between 1 January 2007 and 18 July 2016. Controls were randomly sampled from children who survived the envenoming over this period. Data were analysed using logistic regression. RESULTS Of the 254 cases and 1083 controls investigated, the identified risk factors were age ≤5 y, occurred in a rural area, time-to-treatment ≥3 h, treatment with scorpion antivenom (SAV) but either excessive or insufficient number of vials, treatment with antivenom that was neither SAV nor anti-spider and no antivenom administered compared with the standard recommended treatment. Treatment effectiveness at preventing fatal scorpion envenoming was 77.0% when time-to-treatment was <3 h and 75% in children 9-10 y of age. SAV was 63% effective at preventing death when administered early at the recommended dosage. CONCLUSIONS Fatal scorpion envenoming was associated with younger age, incident occurring in a rural area, late treatment and inadequate antivenom treatment. SAV was effective at preventing death when administered early.
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Affiliation(s)
- Ana Caroline C Almeida
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Salvador, 40110-040, Brazil
| | - Fernando M Carvalho
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Largo do Terreiro de Jesus, s/n Centro Histórico, Salvador, 40026-010, Brazil
| | - Yukari F Mise
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Salvador, 40110-040, Brazil
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Almeida ACCD, Mise YF, Carvalho FM, Silva RMLD. Ecological association between socioeconomic, occupational and sanitation factors and the occurrence of scorpionism in Brazil, 2007-2019. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2021; 30:e2021009. [PMID: 34854465 DOI: 10.1590/s1679-49742021000400021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/20/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze ecological association between socioeconomic, occupational and sanitation characteristics and scorpionism in Brazil. METHODS This was an ecological study with data on scorpion sting accidents reported on the Notifiable Health Conditions Information System (2007-2019). Negative binomial regression was used to estimate incidence rate ratios (IRR) and confidence intervals (95%CI). RESULTS In the study period there were 1,079,333 scorpion sting accidents, with a cumulative incidence rate of 41.5/100,000 inhabitants. In the adjusted analysis, there was association with the municipal percentages of: women (IRR=1.65 - 95%CI 1.18;2.30) and men (IRR=0.90 - 95%CI 0.88;0.91) working in the construction industry, women (IRR=1.21 - 95%CI 1.18;1.25) and men (IRR=0.73 - 95%CI 0.69;0.77) working in domestic service, women (IRR=1.03 - 95%CI 1.02;1.04) and men (IRR=0.93 - 95%CI 0.92;0.93) working in farming, households with refuse collection (IRR=0.99 - 95%CI 0.98;0.99) and households with refuse left nearby (IRR=1.02 - 95%CI 1.01;1.02), expected years of schooling (IRR=0.88 - 95%CI 0.83;0.92), and unemployment rate (IRR=1.07 - 95%CI 1.05;1.09). CONCLUSION Scorpionism was associated with precarious infrastructure/sanitation, job availability, education and female occupation.
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Affiliation(s)
| | - Yukari Figueroa Mise
- Universidade Federal da Bahia, Instituto de Saúde Coletiva, Salvador, BA, Brasil
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Çelik E, Çağlar A, Çelik SF. Clinical Effects and Predictive Factors Affecting the Clinical Severity of Scorpion Envenomations in Western Turkey. J Trop Pediatr 2021; 67:6313145. [PMID: 34213542 DOI: 10.1093/tropej/fmab053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Scorpion envenomation is a common medical emergency in many countries, including Turkey. Severe systemic symptoms occur more easily in children and mortality rates are higher. The aim of this study is to describe the clinical effects and predictive factors affecting the clinical severity of scorpion envenomations in Western Turkey. METHODS Two hundred one children (138 mild cases, 34 moderate, and 29 severe) with scorpion envenomation aged between 1 month and -17 years were included in the study. The patients' demographic and laboratory characteristics were compared among clinical severity subgroups. RESULTS The patients' median age was 7 (4-11) years. The median age of the severe group was significantly lower than that of the mild and moderate groups (p < 0.001). Seventeen patients (8.5%) developed myocarditis, while no pulmonary edema was observed in any case. Leukocyte, neutrophil and platelet (PLT) counts, and plateletcrit (PCT) and glucose levels increased significantly with the severity of envenomation (p < 0.001). PLT counts and PCT levels exhibited positive correlation with leukocyte and neutrophil counts (p < 0.001, r = 0.781, r = 0.638, r = 0.772, and r = 0.629, respectively). Supraventricular tachycardia developed in 1 (5.9%) patient, and dilated cardiomyopathy in another (5.9%). No mortality occurred in any case. CONCLUSION Increased PLT counts and PCT levels may be helpful in evaluating clinical severity in patients with scorpion sting envenomation. The possibility of myocarditis development in children should be remembered and cardiac enzymes should be checked, even if patients are asymptomatic and cardiac enzymes are normal on admission.
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Affiliation(s)
- Elif Çelik
- Department of Pediatrics, Faculty of Medicine, Adnan Menderes University, Aydın 09010, Turkey
| | - Aykut Çağlar
- Department of Pediatric Emergency Care, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Serkan Fazlı Çelik
- Department of Pediatric Cardiology, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
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Ferraz CR, Manchope MF, Andrade KC, Saraiva-Santos T, Franciosi A, Zaninelli TH, Bagatim-Souza J, Borghi SM, Cândido DM, Knysak I, Casagrande R, Kwasniewski FH, Verri WA. Peripheral mechanisms involved in Tityus bahiensis venom-induced pain. Toxicon 2021; 200:3-12. [PMID: 34153310 DOI: 10.1016/j.toxicon.2021.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
Scorpionism is a public health burden in Brazil. Tityus bahiensis is responsible for most accidents in the Southeastern region of Brazil. Here, the hyperalgesic mechanisms of Tityus bahiensis venom were investigated, focusing on the role of pro-inflammatory cytokines (tumor necrosis factor alpha [TNF-α] and interleukin 1 beta [IL-1β]) and activation of the transcription factor NFκB. Intraplantar (i.pl.) administration of Tityus bahiensis venom (0.2, 0.6, 1.2 and 2.4 μg/20 μL i.pl.) induced mechanical hyperalgesia and thermal hyperalgesia. The 2.4 μg dose of Tityus bahiensis venom induced overt pain-like behavior and increased myeloperoxidase (MPO) and N-acetyl-beta-D-glucosaminidase (NAG) activities, TNF-α and IL-1β levels in the paw tissue. Systemic pre-treatment with etanercept (soluble TNF-α receptor; 10 mg/kg), IL-1ra (IL-1 receptor antagonist; 30 mg/kg) and pyrrolidine dithiocarbamate (PDTC, nuclear factor kappa B [NFκB] inhibitor; 100 mg/kg) inhibited Tityus bahiensis venom-induced mechanical and thermal hyperalgesia, MPO and NAG activity and overt pain-like behavior. These data demonstrate the involvement of TNF-α and IL-1β signaling as well as NFκB activation in Tityus bahiensis venom-induced mechanical and thermal hyperalgesia, overt pain-like behavior, and MPO activity and NAG activity, indicating thus, that targeting these mechanisms might contribute to reducing the pain in this scorpionism.
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Affiliation(s)
- Camila R Ferraz
- Laboratory of Pain, Inflammation, Neuropathy, and Cancer, Department of Pathology, Londrina State University, Londrina, Paraná, Brazil
| | - Marília F Manchope
- Laboratory of Pain, Inflammation, Neuropathy, and Cancer, Department of Pathology, Londrina State University, Londrina, Paraná, Brazil
| | - Ketlem C Andrade
- Laboratory of Pain, Inflammation, Neuropathy, and Cancer, Department of Pathology, Londrina State University, Londrina, Paraná, Brazil
| | - Telma Saraiva-Santos
- Laboratory of Pain, Inflammation, Neuropathy, and Cancer, Department of Pathology, Londrina State University, Londrina, Paraná, Brazil
| | - Anelise Franciosi
- Laboratory of Pain, Inflammation, Neuropathy, and Cancer, Department of Pathology, Londrina State University, Londrina, Paraná, Brazil
| | - Tiago H Zaninelli
- Laboratory of Pain, Inflammation, Neuropathy, and Cancer, Department of Pathology, Londrina State University, Londrina, Paraná, Brazil
| | - Julia Bagatim-Souza
- Laboratory of Pain, Inflammation, Neuropathy, and Cancer, Department of Pathology, Londrina State University, Londrina, Paraná, Brazil
| | - Sergio M Borghi
- Laboratory of Pain, Inflammation, Neuropathy, and Cancer, Department of Pathology, Londrina State University, Londrina, Paraná, Brazil; Center for Research in Health Sciences, University of Northern Paraná, Londrina, Paraná, Brazil
| | - Denise M Cândido
- Arthropod Laboratory, Butantan Institute, São Paulo, São Paulo, Brazil
| | - Irene Knysak
- Arthropod Laboratory, Butantan Institute, São Paulo, São Paulo, Brazil
| | - Rubia Casagrande
- Department of Pharmaceutical Sciences, Centre of Health Sciences, Londrina State University, Londrina, Paraná, Brazil
| | - Fábio H Kwasniewski
- Department of Pathology, Londrina State University, Londrina, Paraná, Brazil.
| | - Waldiceu A Verri
- Laboratory of Pain, Inflammation, Neuropathy, and Cancer, Department of Pathology, Londrina State University, Londrina, Paraná, Brazil; Department of Pathology, Londrina State University, Londrina, Paraná, Brazil.
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Gutiérrez JM, Zanette L, Vigilato MAN, Pompei JCA, Martins D, Fan HW. Appraisal of antivenom production in public laboratories in Latin America during the first semester of 2020: The impact of COVID-19. PLoS Negl Trop Dis 2021; 15:e0009469. [PMID: 34138853 PMCID: PMC8211283 DOI: 10.1371/journal.pntd.0009469] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
- * E-mail:
| | - Larissa Zanette
- Centro Panamericano de Fiebre Aftosa, Organización Panamericana de la Salud, Rio de Janeiro, Brazil
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Ryan RYM, Seymour J, Loukas A, Lopez JA, Ikonomopoulou MP, Miles JJ. Immunological Responses to Envenomation. Front Immunol 2021; 12:661082. [PMID: 34040609 PMCID: PMC8141633 DOI: 10.3389/fimmu.2021.661082] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/01/2021] [Indexed: 01/05/2023] Open
Abstract
Venoms are complex mixtures of toxic compounds delivered by bite or sting. In humans, the consequences of envenomation range from self-limiting to lethal. Critical host defence against envenomation comprises innate and adaptive immune strategies targeted towards venom detection, neutralisation, detoxification, and symptom resolution. In some instances, venoms mediate immune dysregulation that contributes to symptom severity. This review details the involvement of immune cell subtypes and mediators, particularly of the dermis, in host resistance and venom-induced immunopathology. We further discuss established venom-associated immunopathology, including allergy and systemic inflammation, and investigate Irukandji syndrome as a potential systemic inflammatory response. Finally, this review characterises venom-derived compounds as a source of immune modulating drugs for treatment of disease.
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Affiliation(s)
- Rachael Y. M. Ryan
- Division of Tropical Health and Medicine, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health & Medicine, James Cook University, Cairns, QLD, Australia
- School of Environment and Sciences, Griffith University, Nathan, QLD, Australia
| | - Jamie Seymour
- Division of Tropical Health and Medicine, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health & Medicine, James Cook University, Cairns, QLD, Australia
| | - Alex Loukas
- Division of Tropical Health and Medicine, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health & Medicine, James Cook University, Cairns, QLD, Australia
| | - J. Alejandro Lopez
- School of Environment and Sciences, Griffith University, Nathan, QLD, Australia
- QIMR Berghofer Medical Research Institute, The University of Queensland, Herston, QLD, Australia
| | - Maria P. Ikonomopoulou
- Translational Venomics Group, Madrid Institute for Advanced Studies (IMDEA) in Food, CEI UAM+CSIC, Madrid, Spain
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - John J. Miles
- Division of Tropical Health and Medicine, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health & Medicine, James Cook University, Cairns, QLD, Australia
- Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, Cairns, QLD, Australia
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Godoy DA, Badenes R, Seifi S, Salehi S, Seifi A. Neurological and Systemic Manifestations of Severe Scorpion Envenomation. Cureus 2021; 13:e14715. [PMID: 34055554 PMCID: PMC8158070 DOI: 10.7759/cureus.14715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Scorpion envenomation is a life-threatening toxicological emergency and considered as a major public health problem, especially in endemic regions (India, Africa, Latin America); it is generally characterized by low resources and tropical or subtropical weather. Scorpion envenomation is especially fatal in the first hours, usually due to respiratory and/or cardiovascular collapse. The neurologic manifestations, triggered by multiple neurotoxic mechanisms, are varied and complex and mostly reported in children. The aim of this review is to clarify the epidemiologic characteristics and clinical manifestations as well as diagnosis and management of neurologic complications following scorpion envenomation. The management of patients with severe clinical forms is based on early recognition of the sting, antivenom serum administration, and cardiorespiratory and systemic support.
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Affiliation(s)
- Daniel A Godoy
- Neurointensive Care Unit/Neuro Critical Care, Hospital Carlos Malbran, Sanatorio Pasteur, Catamarca, ARG
| | - Rafael Badenes
- Department of Anesthesiology and Surgery, University Clinic Hospital, Valencia, ESP
| | - Sepehr Seifi
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, USA
| | - Shanay Salehi
- School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, USA
| | - Ali Seifi
- Department of Neurosurgery, University of Texas Health Science Center at San Antonio, San Antonio, USA
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Mortality caused by venomous animals in Venezuela (2000-2009): A new epidemiological pattern. ACTA ACUST UNITED AC 2021; 41:29-40. [PMID: 33761187 PMCID: PMC8055589 DOI: 10.7705/biomedica.5561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Indexed: 11/24/2022]
Abstract
Introducción Los accidentes causados por animales venenosos ocurren con mucha frecuencia en comunidades pobres con acceso limitado a los servicios de salud. Se les consideran enfermedades desatendidas y son una de las causas importantes de morbimortalidad en varias naciones del mundo, incluida Venezuela. Objetivo Evaluar la mortalidad por contacto traumático con animales venenosos (serie X20-X29) en Venezuela en el periodo de 2000 a 2009. Materiales y métodos Los datos se obtuvieron de los anuarios de mortalidad del Ministerio de Salud. Resultados Se registraron 759 decesos, la mayoría de ellos en el 2009. La primera causa fue la mordedura de serpientes (n=323; 42,6%), seguida por la picadura de himenópteros (n=170; 22,4%), la mordedura de centípedos (n=106; 14,0%) y la picadura de escorpiones (n=76; 10,0%). La mediana de la tasa de mortalidad general para el periodo fue de 0,285 fallecidos por 100.000 habitantes, en tanto que, por grupo específico, fue de 0,120 para ofidios, de 0,065 para himenópteros, de 0,035 para centípedos y de 0,025 para escorpiones. Conclusión Al comparar estos datos con los antecedentes históricos, se evidenció la modificación del patrón de mortalidad en el país caracterizada por un aumento significativo de los decesos por centípedos, tercera causa de muerte, lo que reubica la picadura de escorpiones como la cuarta causa de mortalidad.
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Amado TF, Moura TA, Riul P, Lira AFDA, Badillo-Montaño R, Martinez PA. Vulnerable areas to accidents with scorpions in Brazil. Trop Med Int Health 2021; 26:591-601. [PMID: 33560566 DOI: 10.1111/tmi.13561] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify areas that present a higher risk of exposure to accidents with scorpions in Brazil. METHODS We used techniques of spatial prioritisation to determine the most vulnerable localities to envenomation by four scorpion species. Our prioritisation integrated ecological niche models with health investment, antivenin availability, access to health care facilities and metrics of human impact data. RESULTS The ecological niche models indicated that three scorpion species (Tityus bahiensis, Tityus serrulatus, and Tityus stigmurus) are more associated with human population density, while T. obscurus demonstrated a strong association with temperature variations during the year. Spatial prioritisation indicated that the areas with higher risk exposure to accidents with scorpions are in northern and northeastern Brazil. Alternatively, more isolated but densely populated areas in the southeastern and central regions also emerged as a priority. CONCLUSION Mapping areas where humans are more likely to interact with scorpions can assist in the design of efficient public health policies.
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Affiliation(s)
- Talita Ferreira Amado
- Laboratório de Pesquisas Integrativas em Biodiversidade, Universidade Federal de Sergipe, São Cristóvão, Brazil.,Biodiversity and Macroecology Lab, Universidad Rey Juan Carlos, Madrid, Spain
| | - Thais Andrade Moura
- Laboratório de Pesquisas Integrativas em Biodiversidade, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | - Pablo Riul
- Departamento de Sistemática e Ecologia, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - André Felipe de Araujo Lira
- Programa de Pós-Graduação em Ciência Animal Tropical, Universidade Federal Rural de Pernambuco, Recife, Brazil
| | - Raúl Badillo-Montaño
- Red de Estudios Moleculares Avanzados, Instituto de Ecologia A, C, Xalapa-Enríquez, Mexico
| | - Pablo Ariel Martinez
- Laboratório de Pesquisas Integrativas em Biodiversidade, Universidade Federal de Sergipe, São Cristóvão, Brazil
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Amr ZS, Abu Baker MA, Al-Saraireh M, Warrell DA. Scorpions and scorpion sting envenoming (scorpionism) in the Arab Countries of the Middle East. Toxicon 2020; 191:83-103. [PMID: 33387549 DOI: 10.1016/j.toxicon.2020.12.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/16/2020] [Accepted: 12/27/2020] [Indexed: 01/27/2023]
Abstract
The twelve Arab countries of the Middle East are inhabited by 117 species of scorpions of varying medical importance within six families. Scorpion stings are a very common occurrence throughout the region. Twenty-two scorpion species are considered to be dangerously venomous, causing potentially life threatening stings. Accessible literature in English and Arabic on scorpions, scorpion stings and available antivenoms was reviewed to document the scorpion fauna and scorpion stings in each country. Saudi Arabia, Iraq and Jordan report the highest numbers of stings and envenomings. Clinically, the most important toxins in Old World scorpion venoms are α-toxins that target voltage-gated sodium (Nav) channels at neurotoxin binding site 3, causing sympathetic excitation and the endogenous release of catecholamines that is responsible for transient, but life-threatening myocardial damage. Most victims of scorpion stings suffer severe local pain, but a few, especially children, develop systemic envenoming which, in the case of most Middle Eastern buthid species, such as Androctonus and Leiurus species, is dominated by the cardiovascular and respiratory consequences of hypercatecholinaemic myocarditis. Other syndromes include paralysis (Parabuthus leiosoma), coagulopathy (Nebo hierichonticus and Hemiscorpius species), and local tissue damage, haemolysis and acute kidney injury (H. lepturus). Early antivenom treatment is recommended but its value remains controversial. However, intensive care, with the ancillary use of vasoactive drugs such as prazosin and dobutamine, has proved effective.
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Affiliation(s)
- Zuhair S Amr
- Biology Department, Jordan University for Science and Technology, Irbid, Jordan.
| | | | | | - David A Warrell
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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Vaucel J, Mutricy R, Hoarau M, Pujo JM, Elenga N, Labadie M, Kallel H. Pediatric scorpionism in northern Amazonia: a 16-year study on epidemiological, environmental and clinical aspects. J Venom Anim Toxins Incl Trop Dis 2020; 26:e202000038. [PMID: 32973890 PMCID: PMC7485965 DOI: 10.1590/1678-9199-jvatitd-2020-0038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: The Amazon basin is one of the seven major geographical areas where
scorpionism is recorded. In French Guiana, 90 stings per 100,000 inhabitants
are registered per year. As the severity of cases is higher in children,
descriptive studies are needed to have a better understanding of this
pathology. The aim of the present study is to describe pediatric scorpionism
in French Guiana. Methods: We conducted a monocentric descriptive retrospective study on scorpion
stings in all pediatric patients admitted to Cayenne General Hospital from
January 1, 2002 to December 31, 2018. Results: In this survey, 132 patients were included. Of them, 63% were male. Patients
with general signs of envenomation were younger and lighter (p = 0.04). The
picture was “one sting” (95.3%) by a “big” (47.6%), “black” (60%) and “small
pincer” (58%) scorpion on the extremity of the body (84%). Stings occurred
mainly during the day, while patients changed clothes. There was no
envenomation during night. The monthly evaluation highlights that the number
of stings and percentage of general signs of envenomation were closely
connected to a composite variable including the variation of the level of
rivers (p = 0.005). Cardiac symptoms were recorded in 82% of cases with
general signs of envenomation. The presence of pulmonary; ear, nose, and
throat (ENT); or gastrointestinal symptoms are related to major envenomation
(p = 0.001, p = 0.01, and p = 0.02 respectively). Leukocytosis and glycemia
increased according to the envenomation grade whereas serum potassium and
alkaline reserve decreased. Forty-six patients needed hospitalization and
seven of them required intensive care. No patient died nor presented
sequelae at discharge from the hospital. Conclusion: Pediatric scorpionism in French Guiana is closely associated with child
activities and climatic conditions. Severe envenomation presented most of
the time with cardiac, pulmonary, and gastrointestinal symptoms.
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Affiliation(s)
- Jules Vaucel
- Poison Control Center (Centre Antipoison) Nouvelle Aquitaine, Centre Hospitalier et Universitaire Pellegrin, Bordeaux 33076, Aquitaine, France.,Emergency Department, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
| | - Remi Mutricy
- Emergency Department, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
| | - Maëlle Hoarau
- Emergency Department, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
| | - Jean-Marc Pujo
- Emergency Department, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
| | - Narcisse Elenga
- Emergency Pediatric Department, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
| | - Magali Labadie
- Poison Control Center (Centre Antipoison) Nouvelle Aquitaine, Centre Hospitalier et Universitaire Pellegrin, Bordeaux 33076, Aquitaine, France
| | - Hatem Kallel
- Intensive Care Unit, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
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Feola A, Perrone MA, Piscopo A, Casella F, Della Pietra B, Di Mizio G. Autopsy Findings in Case of Fatal Scorpion Sting: A Systematic Review of the Literature. Healthcare (Basel) 2020; 8:E325. [PMID: 32899951 PMCID: PMC7551928 DOI: 10.3390/healthcare8030325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 01/18/2023] Open
Abstract
Scorpion sting is a public health issue in several countries, particularly in America, the Middle East, India and Africa. The estimated annual global incidence of scorpion envenomings is about 1.5 million, resulting in 2600 deaths. Scorpions are Arthropoda characterized by a tail ending in a terminal bulbous (telson) containing paired venom glands and the stinger. There are 19 known families of scorpions and more than 2200 species, of which about 50 from the families of Buthidae, Hemiscorpiidae and Scorpionidae are harmful to humans. Scorpion venom is a complex structure composed of neurotoxic proteins, salts, acidic proteins and organic compounds, thereby having neurologic, cardiovascular, hematologic and renal side effects, in addition to local effects such as redness, pain, burning and swelling. When the sting is fatal, the mechanism of death is often related to cardiotoxicity with terminal pulmonary edema. However, the cholinergic excess or the neuromuscular excitation can provoke respiratory failure. Sometimes, death is due to an anaphylactic reaction to the envenoming. The purpose of this literature review is to evaluate the autopsy findings in scorpion sting-related deaths in order to better understand the pathophysiological mechanisms underlying them, thus helping pathologists in defining the correct diagnosis.
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Affiliation(s)
- Alessandro Feola
- Department Experimental Medicine, University of Campania, 80138 Naples, Italy;
| | | | - Amalia Piscopo
- Forensic Medicine, Department of Law, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.P.); (G.D.M.)
| | - Filomena Casella
- Unit of Legal Medicine, AORN “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy;
| | - Bruno Della Pietra
- Department Experimental Medicine, University of Campania, 80138 Naples, Italy;
| | - Giulio Di Mizio
- Forensic Medicine, Department of Law, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.P.); (G.D.M.)
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Collaço RDC, Hyslop S, Rocha T, Dorce VAC, Rowan EG, Antunes E. Neurotoxicity of Tityus bahiensis (brown scorpion) venom in sympathetic vas deferens preparations and neuronal cells. Arch Toxicol 2020; 94:3315-3327. [PMID: 32548756 PMCID: PMC7415753 DOI: 10.1007/s00204-020-02799-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/28/2020] [Indexed: 01/04/2023]
Abstract
Systemic scorpion envenomation is characterized by massive neurotransmitter release from peripheral nerves mediated primarily by scorpion venoms neurotoxins. Tityus bahiensis is one of the medically most important species in Brazil, but its venom pharmacology, especially regarding to peripheral nervous system, is poorly understood. Here, we evaluated the T. bahiensis venom activity on autonomic (sympathetic) neurotransmission by using a variety of approaches, including vas deferens twitch-tension recordings, electrophysiological measurements (resting membrane potentials, spontaneous excitatory junctional potentials and whole-cell patch-clamp), calcium imaging and histomorphological analysis. Low concentrations of venom (≤ 3 μg/mL) facilitated the electrically stimulated vas deferens contractions without affecting postsynaptic receptors or damaging the smooth muscle cells. Transient TTX-sensitive sustained contractions and resting membrane depolarization were mediated mainly by massive spontaneous ATP release. High venom concentrations (≥ 10 μg/mL) blocked the muscle contractions and induced membrane depolarization. In neuronal cells (ND7-23wt), the venom increased the peak sodium current, modified the current-voltage relationship by left-shifting the Nav-channel activation curve, thereby facilitating the opening of these channels. The venom also caused a time-dependent increase in neuronal calcium influx. These results indicate that the sympathetic hyperstimulation observed in systemic envenomation is presynaptically driven, probably through the interaction of α- and β-toxins with neuronal sodium channels.
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Affiliation(s)
- Rita de Cássia Collaço
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.
| | - Stephen Hyslop
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Thalita Rocha
- São Francisco University (USF), Bragança Paulista, SP, Brazil
| | - Valquiria A C Dorce
- Laboratory of Pharmacology, Division for Scientific Development, Butantan Institute, São Paulo, SP, Brazil
| | - Edward G Rowan
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Edson Antunes
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
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Evans ERJ, McIntyre L, Northfield TD, Daly NL, Wilson DT. Small Molecules in the Venom of the Scorpion Hormurus waigiensis. Biomedicines 2020; 8:E259. [PMID: 32751897 PMCID: PMC7459668 DOI: 10.3390/biomedicines8080259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 12/15/2022] Open
Abstract
Despite scorpion stings posing a significant public health issue in particular regions of the world, certain aspects of scorpion venom chemistry remain poorly described. Although there has been extensive research into the identity and activity of scorpion venom peptides, non-peptide small molecules present in the venom have received comparatively little attention. Small molecules can have important functions within venoms; for example, in some spider species the main toxic components of the venom are acylpolyamines. Other molecules can have auxiliary effects that facilitate envenomation, such as purines with hypotensive properties utilised by snakes. In this study, we investigated some non-peptide small molecule constituents of Hormurus waigiensis venom using LC/MS, reversed-phase HPLC, and NMR spectroscopy. We identified adenosine, adenosine monophosphate (AMP), and citric acid within the venom, with low quantities of the amino acids glutamic acid and aspartic acid also being present. Purine nucleosides such as adenosine play important auxiliary functions in snake venoms when injected alongside other venom toxins, and they may have a similar role within H. waigiensis venom. Further research on these and other small molecules in scorpion venoms may elucidate their roles in prey capture and predator defence, and gaining a greater understanding of how scorpion venom components act in combination could allow for the development of improved first aid.
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Affiliation(s)
- Edward R. J. Evans
- Centre for Molecular Therapeutics, AITHM, James Cook University, Cairns, QLD 4878, Australia; (E.R.J.E.); (N.L.D.)
| | - Lachlan McIntyre
- Independent Researcher, P.O. Box 78, Bamaga, QLD 4876, Australia;
| | - Tobin D. Northfield
- Department of Entomology, Tree Fruit Research and Extension Center, Washington State University, Wenatchee, WA 98801, USA;
| | - Norelle L. Daly
- Centre for Molecular Therapeutics, AITHM, James Cook University, Cairns, QLD 4878, Australia; (E.R.J.E.); (N.L.D.)
| | - David T. Wilson
- Centre for Molecular Therapeutics, AITHM, James Cook University, Cairns, QLD 4878, Australia; (E.R.J.E.); (N.L.D.)
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Furtado AA, Daniele-Silva A, Silva-Júnior AAD, Fernandes-Pedrosa MDF. Biology, venom composition, and scorpionism induced by brazilian scorpion Tityus stigmurus (Thorell, 1876) (Scorpiones: Buthidae): A mini-review. Toxicon 2020; 185:36-45. [PMID: 32585220 DOI: 10.1016/j.toxicon.2020.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/13/2020] [Accepted: 06/17/2020] [Indexed: 12/20/2022]
Abstract
Scorpionism is a serious public health problem in various regions of the world. In Brazil, a high number of accidents by scorpions have been reported. From 2014 to 2018, about 547,000 cases were recorded, resulting in 466 deaths. The scorpion Tityus stigmurus is the predominant species in the northeast of Brazil, being responsible for most scorpionism cases in this region. With the aid of the transcriptomic approach of the venom gland of this species, components as neurotoxins, antimicrobials, metal chelating peptides and hypotensins, have been identified and characterized in silico, showing different biologic activity in vitro. In addition, the neuronal, pancreatic, renal, and enzymatic effects have been demonstrated for the crude T. stigmurus venom. Therefore, the T. stigmurus scorpion venom constitutes a rich arsenal of bioactive molecules with high potential for therapeutic and biotechnological application.
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Affiliation(s)
- Allanny Alves Furtado
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Department of Pharmaceutical Sciences, College of Pharmacy, Federal University of Rio Grande do Norte, Rua General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal, 59012-570, Brazil.
| | - Alessandra Daniele-Silva
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Department of Pharmaceutical Sciences, College of Pharmacy, Federal University of Rio Grande do Norte, Rua General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal, 59012-570, Brazil.
| | - Arnóbio Antônio da Silva-Júnior
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Department of Pharmaceutical Sciences, College of Pharmacy, Federal University of Rio Grande do Norte, Rua General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal, 59012-570, Brazil.
| | - Matheus de Freitas Fernandes-Pedrosa
- Laboratory of Technology and Pharmaceutical Biotechnology (Tecbiofar), Department of Pharmaceutical Sciences, College of Pharmacy, Federal University of Rio Grande do Norte, Rua General Gustavo Cordeiro de Farias, S/N, Petrópolis, Natal, 59012-570, Brazil.
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dos Santos AB, de Albuquerque CMR. Behavioural changes in Tityus stigmurus (Thorell, 1876) (SCORPIONES: BUTHIDAE) exposed to a pyrethroid insecticide. J ETHOL 2020. [DOI: 10.1007/s10164-020-00651-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Taniele-Silva J, Martins LG, de Sousa MB, de Souza LM, Cardoso RMB, Velasco SRU, Ramos GDS, de Miranda CT, Moura AÁ, Anderson L, Bassi ÊJ. Retrospective clinical and epidemiological analysis of scorpionism at a referral hospital for the treatment of accidents by venomous animals in Alagoas State, Northeast Brazil, 2007-2017. Rev Inst Med Trop Sao Paulo 2020; 62:e26. [PMID: 32401958 PMCID: PMC7232956 DOI: 10.1590/s1678-9946202062026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/23/2020] [Indexed: 12/02/2022] Open
Abstract
Scorpionism has a high incidence rate in Brazil. It is considered a serious public health problem mainly in tropical and subtropical regions around the world. The number of scorpion accidents have increased over the years and the highest frequencies have been reported mainly in the Brazilian Northeast region. Therefore, in this study we report a retrospective clinical and epidemiological analysis of scorpion stings from 2007 to 2017 in Alagoas State, Northeast Brazil, at a referral hospital for assistance and treatment of accidents by venomous animals. During the analyzed period, the referral hospital treated 27,988 cases, and an increase in the number of cases has taken place over the years. The highest frequency of scorpion stings was observed in females, and the age range most affected was from 20 to 29 years old. The most stung body site was the foot, followed by finger, toe or hand. Regarding the severity, most severe cases were reported in children up to 4 years old (69.4%) and 50% of the total cases treated with serotherapy corresponded to patients in this age range. Interestingly, it was also found that the occurrence of systemic manifestations and the severity of the cases were significantly associated with pediatric patients. In this way, this study highlights the scorpionism as an environmental public health problem in Alagoas State, Northeast Brazil, as well as the need to intensify the epidemiological surveillance and educational campaigns to prevent and control scorpion accidents throughout the year.
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Affiliation(s)
- Jamile Taniele-Silva
- Universidade Federal de Alagoas, Instituto de Ciências Biológicas e da Saúde, Laboratório de Pesquisas em Virologia e Imunologia, Grupo de Pesquisa em Regulação da Resposta Imune, Maceió, Alagoas, Brazil
| | - Lycia Gama Martins
- Universidade Federal de Alagoas, Instituto de Ciências Biológicas e da Saúde, Laboratório de Pesquisas em Virologia e Imunologia, Grupo de Pesquisa em Regulação da Resposta Imune, Maceió, Alagoas, Brazil
- Universidade Federal de Alagoas, Faculdade de Medicina, Maceió, Alagoas, Brazil
- Universidade Estadual de Ciências da Saúde de Alagoas, Hospital Escola Dr. Hélvio Auto, Maceió, Alagoas, Brazil
| | | | | | | | | | - Geymerson dos Santos Ramos
- Universidade Federal de Alagoas, Instituto de Computação, Laboratório de Computação Científica e Análise Numérica, Maceió, Alagoas, Brazil
| | | | - Adriana Ávila Moura
- Universidade Federal de Alagoas, Faculdade de Medicina, Maceió, Alagoas, Brazil
- Universidade Estadual de Ciências da Saúde de Alagoas, Hospital Escola Dr. Hélvio Auto, Maceió, Alagoas, Brazil
| | - Letícia Anderson
- Universidade Federal de Alagoas, Instituto de Ciências Biológicas e da Saúde, Laboratório de Pesquisas em Virologia e Imunologia, Grupo de Pesquisa em Regulação da Resposta Imune, Maceió, Alagoas, Brazil
- Centro Universitário CESMAC, Maceió, Alagoas, Brazil
| | - Ênio José Bassi
- Universidade Federal de Alagoas, Instituto de Ciências Biológicas e da Saúde, Laboratório de Pesquisas em Virologia e Imunologia, Grupo de Pesquisa em Regulação da Resposta Imune, Maceió, Alagoas, Brazil
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Niermann CN, Tate TG, Suto AL, Barajas R, White HA, Guswiler OD, Secor SM, Rowe AH, Rowe MP. Defensive Venoms: Is Pain Sufficient for Predator Deterrence? Toxins (Basel) 2020; 12:toxins12040260. [PMID: 32316477 PMCID: PMC7232307 DOI: 10.3390/toxins12040260] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 03/26/2020] [Accepted: 04/03/2020] [Indexed: 12/19/2022] Open
Abstract
Pain, though unpleasant, is adaptive in calling an animal’s attention to potential tissue damage. A long list of animals representing diverse taxa possess venom-mediated, pain-inducing bites or stings that work by co-opting the pain-sensing pathways of potential enemies. Typically, such venoms include toxins that cause tissue damage or disrupt neuronal activity, rendering painful stings honest indicators of harm. But could pain alone be sufficient for deterring a hungry predator? Some venomologists have argued “no”; predators, in the absence of injury, would “see through” the bluff of a painful but otherwise benign sting or bite. Because most algogenic venoms are also toxic (although not vice versa), it has been difficult to disentangle the relative contributions of each component to predator deterrence. Southern grasshopper mice (Onychomys torridus) are voracious predators of arthropods, feeding on a diversity of scorpion species whose stings vary in painfulness, including painful Arizona bark scorpions (Centruroides sculpturatus) and essentially painless stripe-tailed scorpions (Paravaejovis spinigerus). Moreover, southern grasshopper mice have evolved resistance to the lethal toxins in bark scorpion venom, rendering a sting from these scorpions painful but harmless. Results from a series of laboratory experiments demonstrate that painful stings matter. Grasshopper mice preferred to prey on stripe-tailed scorpions rather than bark scorpions when both species could sting; the preference disappeared when each species had their stingers blocked. A painful sting therefore appears necessary for a scorpion to deter a hungry grasshopper mouse, but it may not always be sufficient: after first attacking and consuming a painless stripe-tailed scorpion, many grasshopper mice went on to attack, kill, and eat a bark scorpion even when the scorpion was capable of stinging. Defensive venoms that result in tissue damage or neurological dysfunction may, thus, be required to condition greater aversion than venoms causing pain alone.
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Affiliation(s)
- Crystal N. Niermann
- Department of Biology, Sam Houston State University, Huntsville, TX 77340, USA; (C.N.N.); (T.G.T.)
| | - Travis G. Tate
- Department of Biology, Sam Houston State University, Huntsville, TX 77340, USA; (C.N.N.); (T.G.T.)
| | - Amber L. Suto
- Department of Integrative Biology, Michigan State University, East Lansing, MI 48824, USA; (A.L.S.); (O.D.G.)
| | - Rolando Barajas
- Neuroscience Program, Michigan State University, East Lansing, MI 48824, USA; (R.B.); (H.A.W.)
| | - Hope A. White
- Neuroscience Program, Michigan State University, East Lansing, MI 48824, USA; (R.B.); (H.A.W.)
| | - Olivia D. Guswiler
- Department of Integrative Biology, Michigan State University, East Lansing, MI 48824, USA; (A.L.S.); (O.D.G.)
| | - Stephen M. Secor
- Department of Biological Sciences, University of Alabama, Tuscaloosa, AL 35487, USA;
| | - Ashlee H. Rowe
- Department of Biology, University of Oklahoma, Norman, OK 73019, USA;
| | - Matthew P. Rowe
- Department of Biology, University of Oklahoma, Norman, OK 73019, USA;
- Correspondence: ; Tel.: +1-405-325-6539
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Das B, Patra A, Mukherjee AK. Correlation of Venom Toxinome Composition of Indian Red Scorpion ( Mesobuthus tamulus) with Clinical Manifestations of Scorpion Stings: Failure of Commercial Antivenom to Immune-Recognize the Abundance of Low Molecular Mass Toxins of This Venom. J Proteome Res 2020; 19:1847-1856. [PMID: 32125869 DOI: 10.1021/acs.jproteome.0c00120] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Indian red scorpion (Mesobuthus tamulus), with its life-threatening sting, is the world's most dangerous species of scorpion. The toxinome composition of M. tamulus venom was determined by tandem mass spectrometry (MS) analysis of venom protein bands separated by SDS-PAGE. A total of 110 venom toxins were identified from searching the MS data against the Buthidae family (taxid: 6855) of toxin entries in nonredundant protein databases. The Na+ and K+ ion channel toxins taken together are the most abundant toxins (76.7%) giving rise to the neurotoxic nature of this venom. The other minor toxin classes in the M. tamulus venom proteome are serine protease-like protein (2.9%), serine protease inhibitor (2.2%), antimicrobial peptide (2.3%), hyaluronidase (2.2%), makatoxin (2.1%), lipolysis potentiating peptides (1.2%), neurotoxin affecting Cl- channel (1%), parabutoporin (0.6%), Ca2+ channel toxins (0.8%), bradykinin potentiating peptides (0.2%), HMG CoA reductase inhibitor (0.1%), and other toxins with unknown pharmacological activity (7.7%). Several of these toxins have been shown to be promising drug candidates. M. tamulus venom does not show enzymatic activity (phospholipase A2, l-amino acid oxidase, adenosine tri-, di-, and monophosphatase, hyaluronidase, metalloproteinase, and fibrinogenolytic), in vitro hemolytic activity, interference with blood coagulation, or platelet modulation properties. The clinical manifestations post M. tamulus sting have been described in the literature and are well correlated with its venom proteome composition. An abundance of low molecular mass toxins (3-15 kDa) are responsible for exerting the major pharmacological effects of M. tamulus venom, though they are poorly immune-recognized by commercial scorpion antivenom. This is a major concern for the development of effective antivenom therapy against scorpion stings.
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Affiliation(s)
- Bhabana Das
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur 784028, Assam, India
| | - Aparup Patra
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur 784028, Assam, India
| | - Ashis Kumar Mukherjee
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur 784028, Assam, India
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Valdez-Velázquez LL, Cid-Uribe J, Romero-Gutierrez MT, Olamendi-Portugal T, Jimenez-Vargas JM, Possani LD. Transcriptomic and proteomic analyses of the venom and venom glands of Centruroides hirsutipalpus, a dangerous scorpion from Mexico. Toxicon 2020; 179:21-32. [PMID: 32126222 DOI: 10.1016/j.toxicon.2020.02.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/31/2020] [Accepted: 02/26/2020] [Indexed: 01/01/2023]
Abstract
Centruroides hirsutipalpus (Scorpiones: Buthidae) is related to the "striped scorpion" group inhabiting the western Pacific region of Mexico. Human accidents caused by this species are medically important due to the great number of people stung and the severity of the resulting intoxication. This communication reports an extensive venom characterization using high-throughput proteomic and Illumina transcriptomic sequencing performed with RNA purified from its venom glands. 2,553,529 reads were assembled into 44,579 transcripts. From these transcripts, 23,880 were successfully annoted using Trinotate. Using specialized databases and by performing bioinformatic searches, it was possible to identify 147 putative venom protein transcripts. These include α- and β-type sodium channel toxins (NaScTx), potassium channel toxins (KScTx) (α-, β-, δ-, γ- and λ-types), enzymes (metalloproteases, hyaluronidases, phospholipases, serine proteases, and monooxygenases), protease inhibitors, host defense peptides (HDPs) such as defensins, non-disulfide bridge peptides (NDBPs), anionic peptides, superfamily CAP proteins, insulin growth factor-binding proteins (IGFBPs), orphan peptides, and other venom components (La1 peptides). De novo tandem mass spectrometric sequencing of digested venom identificatied 50 peptides. The venom of C. hirsutipalpus contains the highest reported number (77) of transcripts encoding NaScTxs, which are the components responsible for human fatalities.
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Affiliation(s)
| | - Jimena Cid-Uribe
- Instituto de Biotecnología, Universidad Nacional Autónoma de México, Avenida Universidad, 2001, Colonia Chamilpa, Cuernavaca, Morelos, 62210, Mexico
| | - María Teresa Romero-Gutierrez
- Departamento de Ciencias Computacionales, Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara, Boulevard Marcelino García Barragán 1421, Guadalajara, Jalisco, 44430, Mexico
| | - Timoteo Olamendi-Portugal
- Instituto de Biotecnología, Universidad Nacional Autónoma de México, Avenida Universidad, 2001, Colonia Chamilpa, Cuernavaca, Morelos, 62210, Mexico
| | | | - Lourival D Possani
- Instituto de Biotecnología, Universidad Nacional Autónoma de México, Avenida Universidad, 2001, Colonia Chamilpa, Cuernavaca, Morelos, 62210, Mexico.
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Santana CR, Oliveira MG. Avaliação do uso de soros antivenenos na emergência de um hospital público regional de Vitória da Conquista (BA), Brasil. CIENCIA & SAUDE COLETIVA 2020; 25:869-878. [DOI: 10.1590/1413-81232020253.16362018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 06/27/2018] [Indexed: 01/10/2023] Open
Abstract
Resumo O presente estudo tem como objetivo caracterizar o perfil epidemiológico de vítimas de acidentes escorpiônicos e ofídicos e avaliar a adequação das prescrições de soros antivenenos. Estudo transversal cujas fontes de dados foram as fichas de notificação de acidentes por animais peçonhentos do Sistema de Informação de Agravos de Notificação no município de Vitória da Conquista (BA), Brasil. Foram incluídas as informações de acidentes escorpiônicos ou ofídicos no período entre julho de 2016 e junho de 2017 atendidos no município. Os dados obtidos e as variáveis de interesse foram analisadas de acordo com as perguntas deste estudo. No período observado foram atendidas 293 vítimas de acidentes por animais peçonhentos. Destas, 149 (50,9%) foram homens e 114 (38,9%) possuíam entre 20 a 59 anos. Foram 235 (80,9%) casos de escorpionismo e 58 (19,1%) de ofidismo. Destes, 203 (69,3%) foram classificados como leves e em 200 (68,5%) casos foi prescrita soroterapia para estes pacientes. Quanto à adequação das prescrições, 172 (59,7%) foram julgadas inadequadas e destas, o uso de número de ampolas acima do indicado foi a mais frequente. A prescrição inapropriada de soros antivenenos ocorreu em aproximadamente em 60% dos casos avaliados. Apesar disso, a maioria dos acidentes foi classificada como leve, em homens jovens.
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Echeverry P JS, Correa Salgado RA. A retrospective study of scorpionism in 11 domestic dogs and a cat in the urban area of Manizales, Colombia. Toxicon 2019; 170:94-98. [PMID: 31563524 DOI: 10.1016/j.toxicon.2019.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 09/20/2019] [Accepted: 09/25/2019] [Indexed: 11/18/2022]
Abstract
The present study analyzes cases of scorpionism in 11 dogs and a cat that were registered at a veterinary clinic in the city of Manizales, between 2009 and 2018. All eight cases where expert identification of the arthropod was possible, involved Centruroides gracilis (Latreille, 1804). None of the stings were lethal, though two cases were classified as severe envenomation and five moderate. The primary sign was local pain, in addition to lameness in all 10 cases that involved one of the limbs (83,3%, 10 of 12 cases). The other two cases had injuries involving the face. The established treatment was symptomatic with clinical and patient monitoring. Antivenom could not be used due to its high cost and scarcity. However, even the severest cases improved satisfactorily, and all patients were discharged without complication.
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Affiliation(s)
- Juan S Echeverry P
- Universidad de Caldas, Colombia; Centro de Especialistas Veterinarios Mascotas, Manizales, Colombia.
| | - Ricardo A Correa Salgado
- Universidad de Caldas, Colombia; Centro de Especialistas Veterinarios Mascotas, Manizales, Colombia.
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Galíndez-Cerón JD, Jorge RJB, Chavez-Acosta MH, Jorge ARC, Alves NTQ, Prata MMG, Rodrigues FADP, Havt A, Sampaio TL, Martins AMC, Guerrero-Vargas JA, Monteiro HSA, Beltrán-Vidal JT. Renal Alterations Induced by the Venom of Colombian Scorpion Centruroides Margaritatus. Curr Top Med Chem 2019; 19:2049-2057. [PMID: 31364515 DOI: 10.2174/1568026619666190731143523] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/21/2019] [Accepted: 06/05/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Scorpion venom causes renal injury and affects vascular ion-channels function. Centruroides margaritatus scorpion is found in Colombia and is frequently the cause of envenomation accidents; however, its renal impact has never been investigated. OBJECTIVE To evaluate the effects of C. margaritatus venom (CmV) on renal parameters using isolated rat kidney and renal cell culture models. METHODS Wistar rats (n = 5, weighing 240-300 g) were first perfused with Krebs-Henseleit solution containing 6 g 100 mL-1 bovine serum albumin. After 30 minutes, the kidneys were perfused with CmV to a final concentration of 10 μgmL-1; evaluation was performed by measuring Perfusion Pressure (PP), Renal Vascular Resistance (RVR), Urinary Flow (UF), Glomerular Filtration Rate (GFR), and percentage of electrolyte tubular transport. Moreover, kidney histological analyses and cell cytotoxicity in renal tubule epithelial cells (MDCK) and proximal tubular cells (LLC-MK2) were assessed. RESULTS CmV increased PP and RVR 60 min after perfusion. On the other hand, UF, GFR, and the percentages of sodium, potassium and chloride tubular transport decreased after experimental envenomation. UF dropped after 120 min, while GFR and percentage of electrolyte tubular transport diminished after 60, 90 and 120 min. CmV was not toxic to MDCK cell line but reduced the viability of LLC-MK2 cells at concentrations ranging from 6.25 to 200 μgmL-1. Histological analyses disclosed hydropic degeneration, edema, and protein deposits. Flow cytometry disclosed that cell death occurred predominantly by necrosis. CONCLUSION Our results suggest that C. margaritatus venom can trigger renal impairment, mainly in the proximal kidney tubule.
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Affiliation(s)
- J D Galíndez-Cerón
- Departamento de Biología, Facultad de Ciencias Naturales, Exactas y de la Educación, Grupo de Investigaciones Herpetológicas y Toxinológicas, Universidad del Cauca, Popayán, Colombia
| | - R J B Jorge
- Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - M H Chavez-Acosta
- Departamento de Biología, Facultad de Ciencias Naturales, Exactas y de la Educación, Grupo de Investigaciones Herpetológicas y Toxinológicas, Universidad del Cauca, Popayán, Colombia
| | - A R C Jorge
- Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - N T Q Alves
- Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - M M G Prata
- Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - F A de Paulo Rodrigues
- Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - A Havt
- Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - T L Sampaio
- Departamento de Análises Clínicas e Toxicológicas, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - A M C Martins
- Departamento de Análises Clínicas e Toxicológicas, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - J A Guerrero-Vargas
- Departamento de Biología, Facultad de Ciencias Naturales, Exactas y de la Educación, Grupo de Investigaciones Herpetológicas y Toxinológicas, Universidad del Cauca, Popayán, Colombia
| | - H S A Monteiro
- Departamento de Fisiologia e Farmacologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - J T Beltrán-Vidal
- Departamento de Biología, Facultad de Ciencias Naturales, Exactas y de la Educación, Grupo de Investigaciones Herpetológicas y Toxinológicas, Universidad del Cauca, Popayán, Colombia
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Evaluation of Scorpion Envenomation by Tityus trivittatus in Adults: An Analysis of Variables Related to Severity of Clinical Presentation. Wilderness Environ Med 2019; 30:274-280. [PMID: 31351826 DOI: 10.1016/j.wem.2019.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 05/20/2019] [Accepted: 05/23/2019] [Indexed: 11/23/2022]
Abstract
INTRODUCTION In Argentina, the scorpion species Tityus trivittatus has been the species most commonly associated with serious injury and death. METHODS We performed a retrospective study of cases of T trivittatus envenomation that presented to the emergency department at an infectious disease hospital in Cordoba, Argentina, between December 2014 and February 2015. All cases were taxonomically confirmed using criteria established in the Argentine Ministry of Health national guidelines. The primary outcome was classification of clinical presentation (mild/moderate/severe). Classification of clinical presentation was performed in a post hoc fashion using the national guidelines and compared to the classification of clinical presentation given to patients at the time of diagnosis in the emergency department. RESULTS We included 450 individuals with T trivittatus envenomation. The median age of was 36 y (interquartile range 25-52), and 57% were female. In the emergency department, only 5 patients (<1%) were diagnosed as moderate cases and received antivenom; all other cases were diagnosed as mild. Conversely, in our post hoc classification of clinical presentations, 280 patients had mild presentations, 170 had moderate presentations, and no patients had severe presentations. In our cohort, there were no deaths, no inpatient hospital admissions, and no requirements for continuous cardiac monitoring. We found that age >50 y, (odds ratio [OR] 2.5, P<0.001), time from sting to presentation >120 min (OR 2.6, P=0.02), and pre-existing hypertension (OR=3.9, P<0.001) were all independently associated with worse post hoc classification severity. CONCLUSIONS Our study exposed factors associated with moderate presentations of scorpion envenomation and proposes the option of conservative treatment for affected adults.
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