Table 4. Epidemiological aspects of scorpionism in the Brazilian Amazon region.
| Scorpion species/Animal description | Region | Number of cases/Period/Time of day and year | Gender/Age of the victims (years) | Sting location | Time between the accident and the medical assistance | Main signs and symptoms | Clinical manifestations | Treatment administered | Ref. |
|---|---|---|---|---|---|---|---|---|---|
| T. obscurus and T. silvestris | Belém (Pará, Brazil) (1°26′S 48°29′W) | 61 Jan. to Dec.1996 | 54.1% female Age range 0-7 (21.4%) 7-55 (65.3%) ˃ 55 (13.3%) | Upper limbs - hand (40.9%); neck (3.3%); elbow (1.6%) Lower limbs - foot (31.2%); thigh (14.7%) | - |
Local symptoms - pain (83.9%), edema (47.5%),
hiperemia (36%), paresthesia (6.6%) Systemic symptoms - vomiting (13%), tachycardia (3.2%), nausea (3.2%), somnolence (3.2%), paleness (3.2%), shock (1.6%), sweating (1.6%) |
Mild (86.9%) Moderate (11.4%), Severe (1.7%) | Specific antivenom serum (26.2%) | [110] |
| T. obscurus (8.3%) Designation - “lacrau” (a synonym in Portuguese for the word scorpion) (87.5%); scorpion (4.2%), did not know (8.3%). Description - black (5.6%), black and large (59.7%), yellow (1.4%), and did not know inform (33.3%). Took the animal (8.3%). | Municipal Hospital of Santarém - Santarém (2°25′48″S 54°43′12″W) (94.4%), Belterra (02°38′09″S 54°56′13″W) (4.2%), Prainha (1°48′0″S 53°28′48″W) (1.4%) (Pará, Brazil) | 72 Feb. 2000 to Feb. 2001 Morning (40.3%) Afternoon (41.6%) 19-6 h (18.1%) The highest incidences occurred in Mar. (18.1%), Aug. (18.1%) and Apr. (11.1%) | 83.3% male Age range (median 33.6 ± 18.3 years) 2-14 (13%) 84.1%) > 65 (2.8%) | Upper limbs (51.5%) - hands (41.1%) Lower limbs (43.1%) - foot (38.9%) Other body parts (5.4%). | Time ranged from 30 min to 14 h, with an average of 4.6 ± 3.2 h. |
Local symptoms (91.7%) - paresthesia (79.2%),
pain (52.8%), edema (26.4%). Neurological signs (97.2%) - myoclonia (93%), electric shock sensation (88.9%); dysmetria (86.1%), dysarthria (80.6%), ataxia (70.8%) |
Moderate (76.4%), with no serious cases | Specific antivenom serum was not administered in 32.7% of the moderate cases (unavailable). Antiscorpionic serum (63.6%) and antiaracnidic serum (3.7%), with an average of 3.5 ± 0.8 ampoules. Patients discharged cured - within 24 hours (98.6%), in 3 days (1.4%). | [49] |
| T. obscurus Specimens were taken by the patients and identified. | Eastern and western areas of the state of Pará (Brazil) | 48 Jan. 2008 to July 2011 | Eastern: 50% male Western: 64.3% male Age range Eastern: < 5 (2.9%) 11.8%) > 15 (85.3%) Western: < 5 (7.1%) 6-14 (7.1%) > 15 (85.8%) | Eastern: upper limbs (70.6%); lower limbs (23.5%); other parts (5.9%) Western: upper limbs (57.2%); lower limbs (35.7%); other parts (7.1%) | Eastern: < 1 h (64.7%) 2-3 h (14.7%) > 3 h (20.6%) Western: < 1 h (57.1%) 2-3 h (14.3%) > 3 h (28.6%) |
Eastern: Local symptoms - pain (88.2%),
radiating pain (5.9%), paresthesia (47.1%); systemic
manifestations - sweating (5.9%), somnolence (2.9%) Western: local symptoms - pain (100%), radiating pain (64.3%), paresthesia (85.7%); systemic manifestations - sweating (35.7%), somnolence (28.6%), tremors (35.7%), agitation (28.6%), electric shock sensation (50%), myoclonus (64.3%), dysarthria (42.8%) |
Eastern: Level 1 (76.5%) Level 2 (17.6%) Dry sting (5.9%) Western: Level 1 (35.7%) Level 2 (64.3%) | Eastern: Painkillers (76.5%) Antivenom (17.6%) Western: Painkillers (35.7%) Antivenom (64.3%) | [9] |
| - | State of Amazonas - highest incidence in Apuí (7°11′49″S 59°53′27″W) and Rio Preto da Eva (2°41′56″S 59°42′0″W)) | 2,120 (56.6% from rural areas; 38.7% work-related accidents; 72.4% farmer/fisher) Jan. 2007 to Dec. 2014 | 63.9% male 0-10 (14.8%) 11-20 (18.6%) 21-30 (19.7%) 31-40 (18.1%) 41-50 (14.8%) 51-60 (8.2%) > 61 (5.7%) | Upper limbs (47.9%); lower limbs (46.5%), body (3.3%), head (2.3%) | < 3 h (69.6%) 4-6 h (17.1%) 7-12 h (6.9%) 13-24 h (3.4%) > 24 h (2.8%) | - | Mild (68.6%) Moderate (26.8%), Severe (4.6%) Death (0.3%) | - | [36] |
| - | State of Pará (Brazil) | 13,453 2007 to 2014 | 65.8% male Age ranged from 1 to > 60 years old 1-14 (20.2%) 15-19 (9.5%) 20-39 (38.6%) 40-59 (23.9%) >60 (7.8%) | - | 0-1 h (37.6%) 1-3 h (30.4%) 3-6 h (17.2%) 6-12 h (8.2%) > 12 h (6.6%) | - | Mild (55.8%) Moderate (39.1%) Severe (51%) | - | [124] |
| - | Cruzeiro do Sul (Acre, Brazil) (7°37′51″S 72°40′12″W) | 164 2012 to 2017 | 68.2% male Age range 0-10 (13.5%) 11-20 (10.1%) 21-30 (15.2) 31-40 (25.4%) 41-50 (10.1%) 51-60 (6.4%) ˃ 60 (18.6%) | Upper limbs - forearm (1.3%), upper arm (1.3%), hand (55.7%); Lower limbs - foot (35.3%), lower leg (4.0%), thigh (0.6%) | 0-1 h (45.1%) 1-3 h (27.0%) 3-6 h (15.2%) 6-12 h (6.9%) 12-24 h (2.0%) ˃24 h (3.4%) |
Local symptoms (100%) - pain (81.7%), edema (66.8%); Systemic manifestations (5.4%) - neuroparalytics (4.7%); Vomiting/diarrhea (2.0%) |
Mild (67.3%) Moderate (25%) Severe (7.6%) | Serum therapy (68.9%) | [117] |
| T. obscurus Black | Santarém (Pará, Brazil) (2°25′48″S 54°43′12″W) | 28 2013 to 2014 | 60.7% male Age range 1 - 10 (7.1%) 11 - 20 (7.1%) 21 - 30 (32.1%) 31 - 40 (14.3%) 41 - 50 (17.9%) 51 - 60 (7.1%) 61 - 70 (14.3%) | Upper limbs - hand; lower limbs foot | - | Neurological manifestations - electric shock sensation, ataxia, dysarthria, dysmetria | - | No antivenom available (1%), antivenom administered 10 hours after the accident (1%) | [38] |
-: no information. Ref.: reference.