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Affiliation
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Laboratório de Imunologia, Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. |
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Abstract
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Scorpionism is a neglected public health problem in Brazil, which is growing in importance owing to an increasing number of envenomations and deaths, mainly in urban centers. According to the country’s public health system, the number of confirmed scorpion sting deaths has risen in the past eleven years, from 61 in 2007 to 90 in 2017, with cases of scorpion stings rising from 37,370 to 124,982 in this period. In the last 5 years (2013 to 2017) about 83% of deaths occurred within 48 hours of being stung.
The fatality rate in victims under the age of 10 and over 75 years is 0.32% and 0.13%, respectively, whereas it is usually less than 0.09% in the remaining age groups. However, in those aged between 1 and 5 years the fatality rate is 0.40%.
In Brazil, there are about 160 species of scorpions, but stings of medical importance are caused by the genus Tityus, which has, among other characteristics, the presence of a subaculear tubercle under the sting. Of these, four Tityus species (T. serrulatus, T. bahiensis, T. stigmurus, and T. obscurus) are of medical concern, the most important being the yellow scorpion, Tityus serrulatus.
The accelerated urbanization observed in Brazil in the last decades, without the adequate creation of basic infrastructure (such as water, light, sewage treatment, and regular collection of garbage), has provided conditions for the proliferation of opportunistic and invasive scorpions, such as T. serrulatus and T. stigmurus. These two species are parthenogenetic, which means the female can breed without being fertilized by males. Both are adapted to profoundly modified environments, which is the case with several cities of Brazil where the human population increased rapidly, and show great flexibility in adapting to human dwellings. This situation is characteristic of certain regions of Brazil, Mexico, and North Africa.
The sting of Tityus serrulatus is responsible for most of the severe cases and deaths ...
Language: en |