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Accidents with animals of medical interest in brazil 2016

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Accidents with Animals

of Medical Interest in Brazil

Published in: Health & Medicine
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Accidents with animals of medical interest in brazil 2016

  1. 1. Alexandre Naime Barbosa MD, PhD Infectious Diseases Professor Winter School on Tropical Diseases Botucatu School of Medicine - UNESP 2016 - Botucatu - SP - Brazil
  2. 2. O material que se segue faz parte do projeto didático do Prof. Dr. Alexandre Naime Barbosa Objetivos 1. Ensino: Treinamento de Estudantes e Profissionais da Área de Saúde; 2. Extensão: Facilitar o Contato da População em Geral com Conceitos Científicos; 3. Científico: Fomentar a Discussão Científica e Compartilhar Material Didático. Autoria e Cessão 1. Conteúdo: Os dados contidos estão referenciados, em respeito ao autor original; 2. Uso: Está permitido o uso do material, desde que citada a fonte; 3. Contato: fale com o autor e conheça o seu projeto didático em:
  3. 3. The following material is part of the educational project produced by Prof. Dr. Alexandre Naime Barbosa Objectives 1. Education: Training for Students & Health Professionals 2. Community: Provide and Translate Scientific Information to the Population; 3. Scientific: Encourage the Scientific Discussion and Share Teaching Materials. Authorship and Assignment 1. Content: The following data are referenced in respect to the original author; 2. Use: It is allowed to use the material, if the source is mentioned; 3. Contact: Talk to Dr. Barbosa and keep in touch with his project in:
  4. 4. 1. The Brazilian Biodiversity 2. Amazon Biome 3. Pantanal Biome 4. Atlantic Forest Biome 5. Marine Biome 6. Conclusions
  5. 5. • Land area: 5th in the World, 3rd in Americas • Climate: from equatorial to temperate • Environment: from rainforests to deserts • Ecosystems: highly diversified • Perfect scenario for a huge biodiversity Wikipedia, 2013
  6. 6. • Brazil: 1st country in biodiversity • Mammals: 689; Fish: over 3,000 • Birds: 1,832; Reptiles: 744 • Invertebrates: over 200,000 • Wildlife distribution: Biomes Brazil Environment Ministry, 2011
  7. 7. • Biomes: six main regions • Amazon: The biggest and most bio-diverse • Pantanal: World's largest wetland area • Atlantic Forest: A biodiversity hotspot • Atlantic Ocean: Marine biodiversity • Others: Caatinga, Savannah and Lowlands Embrapa, 2012
  8. 8. • Rainforest in the Amazon River Basin • Equatorial Climate, hot and wet (rain) • Venom: Snakes, Fish, Frogs and Invertebrates • Trauma: Mammals, Reptiles, Fish and Invertebrates WWF, 2014
  9. 9. Some Venomous and Poisonous Animals 1. Snakes: Bothrops sp.; Lachesis sp. 2. Fish: Stingrays, Catfishes 3. Frogs: Dendrobatidae Family 4. Invertebrates: Spiders, Scorpions, Bees, Ants, etc. Haddad Jr et al. JVAT, 2013
  10. 10. Venomous Snake: Bothrops sp. (Jararaca, Jararacuçu, Urutu) - 90% of Snakes Bites; over 60 species - 70 centimeters to 2 meters - Throughout Brazil - Nocturnal, prefers wet places Anacassia Lima, 2012
  11. 11. Venomous Snake: Bothrops sp. (Jararaca, Jararacuçu, Urutu) - Proteolytic, Coagulant and Hemorrhagic - Local edema, pain and necrosis - Coagulopathy, bleeding and renal failure - Fatality rate (Tx): 0,31 %, AV available Anacassia Lima, 2012
  12. 12. Venomous Snake: Lachesis sp. (Surucucu) - 1,5 % of Snakes Bites; 3 species - 2 to 4 meters - Amazon and Atlantic Forest - Prefers dense forests Anacassia Lima, 2012
  13. 13. Venomous Snake: Lachesis sp. (Surucucu) - Proteolytic, Coagulant, Hemorrhagic and Neurotoxic - Coagulopathy, bleeding and vagal hyperactivity - Local edema, pain and necrosis - Fatality rate (Tx): 0,95%, AV available Anacassia Lima, 2012
  14. 14. Venomous Fish: Freshwater Stingrays (Arraia de Água Doce) - Severe pain, local edema and erythema - Cutaneous necrosis and secondary infection - Lytic properties not fully studied - Supportive therapy (hot water) Haddad Jr et al. JVAT, 2013
  15. 15. Poisonous Frog: Dendrobatidae Family (Sapos/Rãs) - Not venomous, but poisonous (skin) - Toxicity through the consumption of small insects - Produce one of the most lethal toxins - Exposure: intentional, in rituals The Sapo Diaries, 2013
  16. 16. Some Trauma Injuries by Animals 1. Mammals: Panthera onca, Tapirus terrestris, Myrmecophaga tridactyla 2. Fish: Vandellia cirrhosa, Electrophorus electricus 3. Reptiles: Eunectes sp., Black Caiman 4. Invertebrates: Blatella germanica Voz do Acre Journal, 2012
  17. 17. Trauma Mammal: Panthera onca (Jaguar, Onça Pintada) - Mainly in the Amazon and Pantanal - Recently new cases in Brazil - Ecotourism and Fishing tourism - “Onça-seeing” tourism Campos Neto et al. WEM 2011
  18. 18. Trauma Mammal: Panthera onca (Jaguar, Onça Pintada) Predatory Attack 1: Non Fatal - Fishermen boat, 17y/o man - cranial-encephalic trauma - brain and bone tissue loss, memory deficit Campos Neto et al. WEM 2011
  19. 19. Trauma Mammal: Panthera onca (Jaguar, Onça Pintada) Predatory Attack 2: Fatal - Fisherman tent, 21y/o man - cervical transection of the spinal cord - cervical and brain tissue and bone loss Campos Neto et al. WEM 2011
  20. 20. Trauma Mammal: Myrmecophaga tridactyla (Anteater or Tamanduá) - Tamanduá: 2 meters, 40 kg - Rare accidents - 47y/o male hunter attacked by defense - Death due to wounds in femural artery Haddad et al. WEM 2014
  21. 21. Trauma Fish: Vandellia cirrhosa (Candiru) - Small parasitic freshwater catfish, 12 cm - Attracted by urine, enter through the urethra - Umbrella-like spines, only removed after surgery - Symptoms: pain and urethra bleeding FUNASA
  22. 22. Trauma Fish: Electrophorus electricus (Poraquê) - Big freshwater knifefish, 2 - 3 meters - Powerful electric shocks of up to 600 volts - Shocks used hunting and self-defense - 4,2% of all aquatic animals accident in a fishermen cohort GarroneNeto et al. CSP 2005
  23. 23. Trauma Reptile: Eunectes sp. (Anaconda, Sucuri) - One of the biggest snakes; 2 to 10 meters - Non venomous - Several reports of attacks to humans - Only accidental attacks The NYC, 2010 Google
  24. 24. Trauma Reptile: Black Caiman (Jacaré-açu) - Not common, accidental - 11y/o girl bathing on a river was attacked - Many wounds and femur fracture - Death due to drowning Haddad Jr et al. WEM, 2011
  25. 25. Ueida et al. IJD 2013 Trauma Invertebrate: Blatella germanica (Cockroach, barata) - Cockroach bites in massive infestation - Poor sanitary conditions, indigenous people - Secondary infections, allergy - Cockroach can enter the ear, nose or mouth
  26. 26. • Wetland in the Paraguay River Basin • Tropical Climate, dry or rainy season • Venom: Snakes, Fish and Invertebrates • Trauma: Mammals, Reptiles, Fish and Invertebrates IBAMA, 2013
  27. 27. Some Venomous Animals 1. Snakes: Bothrops sp. 2. Fish: Stingrays, Freshwater Catfish 3. Invertebrates: Spiders, Scorpions, Bees, etc. Haddad Jr et al. RSBMT, 2012
  28. 28. Venomous Fish: Freshwater Catfish P. Maculatus (mandijuba) and P. corruscans (surubim) - Venomous stingers - Pain, inflammation and bleeding - Ulcer can be a complication Haddad Jr et al. RSBMT, 2012
  29. 29. Some Trauma Animals 1. Mammals: Panthera onca, Tapirus terrestris, etc. 2. Fish: Serrasalmus sp. 3. Reptiles: Eunectes sp, Caiman sp. Haddad Jr et al. RSBMT, 2012
  30. 30. Trauma Fish: Serrasalmus sp. (Piranha) - No report of massive attack to humans - Generally 1 single bite per person - Outbreaks related to bathing - Circular wound, laceration of tissues Haddad Jr et al. WEM 2003
  31. 31. Trauma Reptiles: Caiman sp. (Jacaré do Pantanal) - Very rare, accidental - Fisherman 61y/o, only bite on hand - Pain, blending, edema and secondary infection - Trauma and hand fracture Campos Neto et al. DT 2013
  32. 32. • Tropical Forest in the Atlantic Coast • Tropical and Subtropical Climate • Venom: Snakes, Fish and Invertebrates • Trauma: Mammals, Fish and Invertebrates IBAMA 2013
  33. 33. Some Venomous Animals 1. Snakes: Bothrops sp.; Crotalus sp.; Micrurus sp 2. Fish: Stingrays, Freshwater Catfish 3. Invertebrates: Spiders, Scorpions, Bees, etc. Butantan Institute
  34. 34. Venomous Snakes: Crotalus sp. (Cascavel) - 7,7 % of Snakes Bites; 32 species (1Br) - 50 centimeters to 1,5 meters - Atlantic Forest, Cerrado, Caatinga - Prefers rocky and dry places Anacassia Lima, 2012
  35. 35. Venomous Snakes: Crotalus sp. (Cascavel) - Coagulant, Miotoxic and Neurotoxic - Bleeding, dark urine and myalgia - Ptosis, myasthenic face and renal failure - Fatality rate (Tx): 1,85%, AV available CEVAP, 2011
  36. 36. Venomous Snakes: Micrurus sp (Coral) - 0,4 % of Snakes Bites; 65 species - 90 centimeters to 1,5 meters - Thoughout Brazil - Reclusive behavior, beneath the ground M. M. Moura, 2012
  37. 37. Venomous Snakes: Micrurus sp (Coral) - Neurotoxic only, but very potent - Acute progressive myasthenic syndrome - Paralysis of respiratory muscles, death - Fatality rate: 0,36%; AV available Anacassia Lima, 2012
  38. 38. Venomous Invertebrates: Spiders Phoneutria sp. (Armadeira) - Agressive, 17 centimeters - Neurotoxic venom, but in low dose - Painful, dangerous to children, AV available Funasa, 2009
  39. 39. Venomous Invertebrates: Spiders Loxosceles sp. (Aranha marrom) - Not agressive, 4 centimeters - Necrotic venom - Without acute symptoms, AV available Funasa, 2009
  40. 40. Venomous Invertebrates: Scorpions Tityus serrulatus (yellow) and T. bahiensis (brown) - Local pain and inflammation - Potential Neurotoxic Venom - Dangerous to children, AV available Funasa, 2009
  41. 41. Venomous Invertebrates: Caterpillar Lonomia sp. - Local pain and inflammation - Hemorrhagic syndrome and Renal Failure - Rare but possible deaths, AV available SMS Curitiba, 2012
  42. 42. Venomous Invertebrates: Bees Apis Mellifera (Africanized honey bees) - 9,000 accidents/y, 26 deaths (2011) - Complex venom, and allergic reaction - No specific antivenom, supportive therapy CEVAP, 2011
  43. 43. Some Trauma Animals 1. Mammals: Tapirus terrestris, Porcupines, etc. 2. Fish: Serrasalmus sp, etc. Google
  44. 44. Trauma Mammals: Tapirus terrestris (Anta) - Tapir: 2 meters, 200 kg - Rare accidents - 55y/o male farmer bitten three times - Death due to bite in the cervical region Haddad Jr et al. WEM, 2005
  45. 45. Trauma Mammals: Porcupines (Ouriços-cacheiros) - Porcupines: small rodent - Rare accidents, non aggressive behavior - 34y/o male tourist tried to capture - After spines removed, the pain stopped Haddad Jr et al. JVAT 2010
  46. 46. • Extension: 9.198 km • Climate: from equatorial to temperate • Venom: Fish and Invertebrates • Trauma: Fish and Invertebrates Google
  47. 47. Some Venomous Animals 1. Fish: Stingrays, Marine Catfish and Scorpionfish. 2. Invertebrates: Sponges, Man-of-war, Jellyfish, Octopus and Sea Urchin Google
  48. 48. Venomous Fish: Scorpionfish Scorpaena sp. (Mangangá) - Venomous stings in fin - Strong and long pain - Necrosis can be a complication Brasil Reef
  49. 49. Venomous Invertebrates: Sponges Tedania, Neofibularia and Microciona - Irritating slime and spikes - Allergic symptoms Haddad, 2013
  50. 50. Venomous Invertebrates: Man-of-war Physalia physalis, Caravela - Small distal spicules - Toxic and an allergic action - Severe pain (like burning) - Systemic repercussion Haddad, 2013 Google
  51. 51. Venomous Invertebrates: Jellyfish Medusa, Água Viva - Small distal spicules - Toxic and an allergic action - Severe pain (like burning) - Systemic repercussion Haddad, 2013 Google
  52. 52. Some Trauma Animals 1. Fish: Moray eels (Muraenidae), Sharks, etc. 2. Invertebrates: Sea Urchin, Crabs, etc. Haddad, 2015Google
  53. 53. Trauma Invertebrates: Sea Urchin Ouriço do Mar - Spine penetration and breaking - Pain and Inflammation - Granuloma and Secondary Infection - Most common injury Haddad, 2013
  54. 54. • 1927-2015: 143 attacks (official data) • Systematic report: only after 1992 • Main concentration in the Northeast Region • Metropolitan area of Recife is the most affected • Main species: Bull, Tiger, Sand Tiger and Great White
  55. 55. • 1927-1992: only 6 attacks in Pernambuco (official data) • Systematic report: only after 1992 • 1992-2015: 60 attacks (until July 2015) • Metropolitan area of Recife is the most affected • Main species: Bull (cabeça chata) and Tiger (tigre) Pernambuco State CEMIT, 2013
  56. 56. • Shark Attacks in beaches - Boa Viagem and Piedade: 69.4% - Urban and crowded beaches CEMIT, 2013 Google
  57. 57. • Deaths between 1992-2015: - 24 deaths from 60 attacks reported - Mortality rate: 40% - Deaths by Exposure Category: Bathers = 83.3% - 2012-2015 (until August): 5 attacks (4 fatal), 4 males, all bathers - Cause of death: massive trauma injuries CEMIT, 2013 Google
  58. 58. • The most recent death, case report: - 07/21/2013, Monday, 1:20 p.m. - Boa Viagem beach, tourists in the water - Two girls were taken by sea current to a deeper area - Lifeguard was called due to drowning risk - Trying to swim, an 18 y/o female was bitten by a shark Globo TV, 2013 OESP, 2013
  59. 59. • The most recent death, case report: - Rescued from the water and taken to the hospital, 2 episodes of CRA - Hypovolemic sock, BP: 0x0, unconscious - Trauma lesion on the left leg - Extensive blood, musculature and bone loss - Amputation of the leg and all supportive therapies were performed - Death after 10 hours of the attack OESP, 2013 Restauração Hospital Archive
  60. 60. • Why are these attacks so frequent? General Reasons - Same habitat: high population densities of sharks and humans - Public warnings are constantly ignored, mainly by tourists - Sea sports and other activities are increasing (e.g. surf) - Splashing of arms and legs can attract sharks - An occasional attack can be considered normal
  61. 61. • Why are these attacks so frequent? Specific Reasons - High frequency of aggressive shark species OESP, 2013
  62. 62. • Why are these attacks so frequent? Specific Reasons - Topography: a deep channel, 100 meters of the shore OESP, 2013
  63. 63. • Why are these attacks so frequent? Specific Reasons 1. Changes in the Suape bay, a natural nursery of aquatic life, in order to build the port (1980) could have dislodged the sharks. 2. Sharks usually follow the ships 3. Waste and blood from a slaughterhouse were thrown into a close river.OESP, 2013
  64. 64. Biodiversity: Brazilian Coins
  65. 65. • In a continental country, huge biodiversity • Many animal can be dangerous to humans • Disturbs to the ecological balance = Accidents • Research and learn with animals biology and behavior • Fight against predatory exploration of the wildlife
  66. 66. Obrigado pela Atenção!

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