Universidade Federal do Amazonas - UFAM, Instituto de Ciências Biológicas, Programa de Pós-Graduação em Zoologia, Av. General Rodrigo Octavio, 1200, Coroado I, 69067-005, Manaus, Amazonas, Brazil.
Universidade do Estado do Amazonas - UEA, Escola Superior de Ciências da Saúde, Programa de Pós-Graduação em Medicina Tropical, Av. Carvalho Leal, 1777, Cachoeirinha, 69065-001, Manaus, Amazonas, Brazil; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado - FMT-HVD, Diretoria de Ensino e Pesquisa, Av. Pedro Teixeira, w/n, Dom Pedro, 69040-000, Manaus, Amazonas, Brazil.
Toxicon. 2020 Feb;175:7-18. doi: 10.1016/j.toxicon.2019.11.011. Epub 2019 Nov 27.
Coral snakes constitute a relatively diverse and little known group of venomous snakes. So far, data for this kind of snakebite in the Amazon region are based only on case reports. This study takes advantage of novel data from the Brazilian Health Ministry database from 2010 to 2015 and presents a review of the cases reported in the literature regarding the Amazonian biome both from Brazil and nearby countries. Thirty-four cases reported in the database were used in the study, representing 0.05% of the snakebites in Brazilian Amazonia for that period. The incidence rate was 0.123 cases/100,000 inhabitants/year. The most affected group is that of working age men, suggesting occupational risk. Most of bites were on lower limbs. Pain, edema and paresthesia were the most common symptoms. Systemic symptoms not usually associated with coral snakes envenomings, such as coagulopathy and thrombocytopenia, have been reported in Amazonia. Five patients received less antivenom than indicated by the Health Ministry. Based on these results, we recommend the execution of educational programs to avoid such accidents and to teach both the general public and health professionals the correct treatment for the bites. We also suggest that the covering of Intensive Care Units in the region needs to be improved to avoid deaths.
珊瑚蛇是一组相对多样但鲜为人知的毒蛇。到目前为止，关于亚马逊地区此类蛇咬伤的数据仅基于病例报告。本研究利用了巴西卫生部数据库 2010 年至 2015 年的新数据，并回顾了来自巴西和附近国家的关于亚马逊生物群落的文献报道中的病例。数据库中报告了 34 例病例，占该时期巴西亚马逊地区蛇咬伤的 0.05%。发病率为 0.123 例/100,000 居民/年。受影响最大的群体是处于工作年龄的男性，表明存在职业风险。大多数咬伤发生在下肢。疼痛、水肿和感觉异常是最常见的症状。在亚马逊地区报告了一些与珊瑚蛇中毒不相关的全身症状，如凝血功能障碍和血小板减少症。有 5 名患者接受的抗蛇毒血清少于卫生部建议的剂量。基于这些结果，我们建议执行教育计划以避免此类事故，并向公众和卫生专业人员传授正确的咬伤治疗方法。我们还建议改善该地区重症监护病房的覆盖范围，以避免死亡。
