Aspectos epidemiológicos dos acidentes por animais peçonhentos no Nordeste brasileiro / Epidemiological aspects of accidents by poisony animals in Northeast Brazil / Aspectos epidemiológicos de accidentes por animales venenosos en el Noreste de Brasil

Objetivo: Descrever os aspectos epidemiológicos dos acidentes por animais peçonhentos no Nordeste do Brasil. Método: estudo descritivo, retrospectivo, construído a partir de dados secundários disponíveis no portal do Departamento de Informática do Sistema Único de Saúde do Brasil referente aos casos de acidentes com animais peçonhentos no período de 2015 a 2019. Resultados: percebeu-se que entre 2015 e 2019 houve um crescimento percentual médio de 74,25% nos casos, sendo registrados cerca de 4 mil acidentes com animais peçonhentos por mês. Quanto aos aspectos sociodemográficos, predominou o sexo feminino (51,35%), pardos (62,51%), com faixa etária de 20-59 anos (57,5%). Além disso, nos aspectos clínicos dos acidentes, nota-se a maior ocorrência de acidentes com escorpiões (72,70%). Conclusão: vê-se a importância em analisar aspectos epidemiológicos a fim de subsidiar ações de promoção, proteção e gestão em saúde

Objective: to analyze the epidemiological aspects of accidents by venomous animals in Northeastern Brazil. Method: descriptive, retrospective study, constructed from secondary data available on the website of the Department of Informatics of the Brazilian Unified Health System regarding cases of accidents with venomous animals in the period from 2015 to 2019. Results: it was noticed that between 2015 and 2019 there was an average percentage increase of 74.25% in cases, with approximately 4 thousand accidents involving venomous animals per month. As for the sociodemographic aspects, there was a predominance of females (51.35%), browns (62.51%), aged 20-59 years (57.5%). In addition, in the clinical aspects of accidents, there is a higher occurrence of accidents with scorpions (72.70%). Conclusion: we see the importance of analyzing epidemiological aspects in order to support health promotion, protection and management actions

Objetivo: analizar los aspectos epidemiológicos de los accidentes por animales venenosos en el noreste de Brasil. Método: estudio descriptivo, retrospectivo, construido a partir de datos secundarios disponibles en el sitio web del Departamento de Informática del Sistema Único de Salud de Brasil sobre los casos de accidentes con animales venenosos en el período de 2015 a 2019. Resultados: se notó que entre 2015 y 2019 fue un aumento porcentual promedio de 74,25% en los casos, con aproximadamente 4 mil accidentes con animales venenosos por mes. En cuanto a los aspectos sociodemográficos, hubo predominio del sexo femenino (51,35%), marrones (62,51%), de 20 a 59 años (57,5%). Además, en los aspectos clínicos de los accidentes, hay una mayor ocurrencia de accidentes con escorpiones (72,70%). Conclusión: vemos la importancia de analizar los aspectos epidemiológicos para apoyar las acciones de promoción, protección y gestión de la salud

Preventing Vector-Borne Transmission of Zika Virus Infection During Pregnancy, Puerto Rico, USA, 2016-20171.

We examined pregnant women's use of personal protective measures to prevent mosquito bites during the 2016-2017 Zika outbreak in Puerto Rico. Healthcare provider counseling on recommended measures was associated with increased use of insect repellent among pregnant women but not with wearing protective clothing.

Informe especial: Análisis comparativo de las denuncias de accidentes por mordeduras de animales de compañía en el contexto del ASPO por Covid-19 / Special report: Comparative analysis of reports of accidents caused by bites of pet animals in the context of ASPO by Covid-19

El aislamiento social, preventivo y obligatorio (ASPO) es una medida excepcional que el Gobierno Nacional adopta en un contexto crítico. Con el fin de proteger la salud pública frente a la propagación de la Covid-19, se dispuso que todas las personas que habitan, o se encuentren temporalmente, en las jurisdicciones donde rige esta normativa deberán permanecer en sus domicilios habituales, sólo pudiendo realizar desplazamientos mínimos e indispensables para aprovisionarse de artículos de limpieza, medicamentos y alimentos (Decreto Nacional 297/2020). En la Ciudad de Autónoma de Buenos Aires (CABA) rige desde el 20 de marzo el ASPO, y se ha ido flexibilizando a lo largo del tiempo. En este contexto se modificaron conductas, actividades e incluso asistencia a los centros de salud para consultas no relacionadas con Covid-19. En este informe pretendemos dar cuenta de la situación en relación a la denuncia de accidentes por mordeduras de animales de compañía. (AU)

Consenso: niños y mascotas / Consensus: children and pets

La relación de un niño con un animal doméstico, bajo circunstancias debidamente controladas, es beneficiosa para ambos. Las mascotas establecen vínculos de apego con los niños y la relación resulta positiva en aspectos afectivos, en refuerzo de la personalidad y promoción de autoestima, y en desarrollo cognitivo.Sin embargo, existen riesgos en la convivencia de niños y mascotas: mordeduras, lesiones diversas, transmisión de enfermedades. Los factores de riesgo pueden ser inherentes a los niños (edades, conductas inoportunas, falta de supervisión), al medioambiente (hogares pequeños, espacios inadecuados) o a los perros (razas no recomendables, conductas agresivas).En este consenso, se insiste en pautas para una tenencia responsable y una convivencia segura. Se recomiendan perros y gatos como mascotas, y se desaconsejan especies exóticas y animales no tradicionales. Se brindan pautas de tratamiento de mordeduras y se esbozan las principales zoonosis de las que pueden ser transmisores los animales de compañía.

The relationship of a child with a pet, under duly controlled circumstances, is beneficial for both. Pets establish emotional attachments to children, and the relationship turns out positive in terms of affective aspects, in reinforcement of the child ́s personality and promoting self-esteem, and in cognitive development, among many other advantages.Nevertheless, there are real risks in the coexistence of kids and pets: trauma, bites, several injuries and also disease transmission. Risk factors of injuries can be inherent in children (age, improper behavior, lack of supervision), in the environment (small houses, inadequate spaces), or in dogs (big or not recommended breeds, aggressive behaviors).This consensus insists on some guidelines for a responsible tenure and safe coexistence. Dogs and cats are recommended as pets, discouraging exotic species and non-traditional animals. Guidelines for bites treatment are provided and the main zoonoses of which pets can be carriers and transmitters are outlined

Blackflies in the ointment: O. volvulus vector biting can be significantly reduced by the skin-application of mineral oil during human landing catches.

BACKGROUND: Standard human landing catches (sHLCs) have historically been a key component of Onchocerca volvulus transmission monitoring, but expose health-workers to potentially hazardous vector bites. Novel human-bait-free trapping methods have been developed, but do not always work where they are needed and may not generate O. volvulus surveillance data that is directly comparable with historic data. METHODOLOGY: Simuliid sHLCs and mineral-oil protected HLCs (mopHLCs) were performed in a rural village of Amazonas state, Brazil. A four-hour direct comparisons of sHLCs and mopHLCs was carried-out using six vector collectors, each of whom used one leg for a sHLC and one for a mopHLC. Two-person collection teams then exclusively performed either mopHLCs or sHLCs for a further set of 12 four-hour collections. Following the completion of all collections, simuliid-bite mark estimates were made from legs used exclusively in sHLCs and legs used exclusively in mopHLCs. PRINCIPAL FINDINGS: All of the 1669 captured simuliids were identified as the O. volvulus vector Simulium oyapockense. Overall, mopHLC simuliids captured per hour (S/H) rates were lower than those obtained with sHLC trapping (15.5 S/H versus 20 S/H). Direct comparisons of simuliid capture rates found that vector-collectors captured simuliids significantly more efficiently ([Formula: see text]: 20.5 S/H) with mopHLC trapping than with sHLC trapping ([Formula: see text]: 16.4 S/H): P-value = 0.002. MopHLCs performed in isolation were, however, observed to capture vectors less efficiently ([Formula: see text]: 13.4 S/H) than sHLCs performed under similar conditions ([Formula: see text]: 19.98 S/H). All six vector collectors had significantly higher simuliid capture per counted bite mark (SC/CBM) rates using mopHLCs than they were observe to have using sHLCs ([Formula: see text]: 21 SC/CBM versus [Formula: see text]: 1 SC/CBM; p-value = 0.03125). CONCLUSIONS: Vector collectors captured significantly more simuliids per counted bite mark with mopHLCs than with sHLCs. Further investigations into the utility of mopHLCs for onchocerciasis xenomonitoring and beyond are merited.

Venomous Bites, Stings, and Poisoning: An Update.

This article discusses the epidemiology, prevention, clinical features, and treatment of venomous bites by snakes, lizards, and spiders; stings by fish, jellyfish, echinoderms, insects, and scorpions; and poisoning by ingestion of fish, turtles, and shellfish. Invertebrate stings cause fatalities by anaphylaxis, secondary to acquired hypersensitivity (Hymenoptera, such as bees, wasps, and ants; and jellyfish), and by direct envenoming (scorpions, spiders, jellyfish, and echinoderms). Simple preventive techniques, such as wearing protective clothing, using a flashlight at night, and excluding venomous animals from sleeping quarters, are of paramount importance to reduce the risk of venomous bites and stings.

Rabies vaccine initiation and adherence among animal-bite patients in Haiti, 2015.

BACKGROUND: Approximately 59,000 people die from rabies worldwide annually. Haiti is one of the last remaining countries in the Western Hemisphere with endemic canine rabies. Canine-mediated rabies deaths are preventable with post-exposure prophylaxis (PEP): wound treatment, immunoglobulin, and vaccination. In countries where PEP is available, variability in healthcare seeking behaviors and lack of adherence to recommended treatment guidelines could also contribute to these deaths. Yet, few studies have addressed these issues. METHODS: We examined animal-bite reporting and assessed adherence to treatment guidelines at nine healthcare facilities in Haiti. We analyzed individual-level, de-identified patient data (demographic characteristics, geographic location, healthcare facility type, vaccine administration, and bite injury information) using descriptive analyses and logistic regression to examine factors associated with receiving PEP. FINDINGS: During the 6 month study period, we found 2.5 times more animal-bite case-patients than reported by the national surveillance system (690 versus 274). Of the 690 animal-bite patients identified, 498 (72%) sought care at six PEP providing facilities. Of the case-patients that sought care, 110 (22%) received at least one rabies vaccine. Of the 110 patients, 60 (55%) received all five doses. Delays were observed for three events: when patients presented to a facility after an animal-bite (3.0 days, range: 0-34 days), when patients received their fourth dose (16.1 days, range: 13-52 days), and when patients received their fifth dose (29 days, range: 26-52). When comparing vaccination status and patient characteristics, we found a significant association for bite location (p < .001), severity rank score (p < .001), geographic location (p < .001), and healthcare facility type (p = .002) with vaccination. CONCLUSION: High levels of underreporting identified here are of concern since vaccine distribution may, in part, be based on the number of animal-bite cases reported. Given that the Haitian government provides PEP to the population for free and we found animal-bite victims are seeking care in a timely manner─ reducing rabies deaths is an achievable goal.

Análisis de las lesiones ocasionadas por mordeduras de animales de compañía en la Ciudad de Buenos Aires: Año 2017 / Analysis of the injuries caused by pets´s bites in the City of Buenos Aires: Year 2017

Las lesiones ocasionadas por mordeduras de animales de compañía constituyen un problema de importancia para la salud, por un lado se relaciona con los traumas directos y los derivados posteriormente tanto físicos como psicológicos, así como con aspectos relacionados con la transmisión potencial de una enfermedad mortal como es la rabia. Actualmente la rabia no se encuentra erradicada; aún se registran casos en animales de compañía de países limítrofes e incluso en provincias del norte de nuestro país. Asimismo en la Ciudad de Buenos Aires (CABA) se mantiene el ciclo aéreo de la rabia a través de los murciélagos. Éstos, al padecer la enfermedad, y por la afectación del sistema nervioso central, presentan: incoordinación, problemas de su sistema de radar, parálisis y muerte. Los perros y gatos domésticos, así como las personas, pueden tomar contacto con estos animales enfermos o muertos y contagiarse de rabia. Se analizan las denuncias efectuadas en la Ciudad de Buenos Aires durante 2017, así como los datos de los animales agresores

Acidentes por animais peçonhentos relacionados ao trabalho notificados no Rio Grande do Sul, 2013 a 2017 / work-related animal accidents reported in Rio Grande do Sul, 2013 to 2017

Análise dos acidentes com animais peçonhentos relacionados ao trabalho registrados no SINAN/MS, no Rio Grande do Sul, no período de 2013 a 2017. (AU)

Epidemiology, clinical features and risk factors for human rabies and animal bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014: Implications for public health interventions for rabies control

Background: In Mozambique, the majority of rabies outbreaks are unreported and data on the epidemiological features of human rabies and animal bites are scarce. An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted us to investigate the epidemiology, clinical features and risk factors of human rabies and animal bites in the two cities. Methodology/principal findings: We reviewed cases of human rabies and animal bites from April to July 2014, and carried out a community investigation in July and August in the neighborhoods where cases of human rabies resided. This investigation included collection of clinical, demographic and epidemiological information and a case control study to investigate the risk factors associated with human rabies. Fourteen cases of human rabies were detected in Maputo (n = 10) and Matola (n = 3) cities and neighbouring Boane district (n = 1) between April and August 2014, all of whom had been admitted to hospital. All had a recent history of dog bite. Of the 14 rabid dogs, only one had been immunized. 819 cases of animal bites were registered, of which 64.6% (529/819) were from Maputo City. Dogs were responsible for 97.8% (801/819) of all animal bites, but only 27.0% (126/467) were immunized. Factors significantly associated with human rabies were: age <15 years (p = 0.05), bite by stray dog (p = 0.002), deep wound (p = 0.02), bite in the head (p = 0.001), bite by unimmunized dog (p = 0.01), no use of soap and water (p = 0.001), and no post-exposure prophylaxis (p = 0.01). Conclusions/significance: Implementation of control measures for rabies is poor in Maputo and Matola cities, where cases of human rabies were strongly associated with bites by stray and unvaccinated dogs and irregular implementation of post-exposure measures...

Características de la población canina de Asunción / Features od the canine population of Asuncion

Introducción: la alta incidencia de mordeduras caninas en la población humana (14.903 en el2.002), hizo pensar a las autoridades municipales sobre la necesidad de poner en vigencia el registro canino, necesidad sentida desde 1868 en Asunción, en que se genera la primera Ordenanza Municipal relacionada con este aspecto y crear un sistema de control de perros callejeros y de punición a dueños irresponsables. Objetivo: Estimar la población canina existente, su distribución por sexo y edad, el porcentaje de casas-habitación que poseen estos animales en Asunción y la probabilidad de un libre acceso de los perros a la calle. Material Métodos: Se siguió la guía de caracterización de población animal del Centro Panamericano de Fiebre Aftosa, tomando como marco de referencia la población humana, realizándose un muestreo estratificado proporcional con selección sistemática en dos etapas; por conglomerados (manzanas) seleccionadas como unidades primarias y en segunda etapa, las casas-habitación como unidades secundarias. Se estimó una muestra de n = 2.600casas. Se estableció la proporción de casas con perro para cada estrato. Resultados y Conclusiones: La población canina encontrada en Asunción posee características de una población rural: alto índice de tenencia y distribución etaria con alto porcentaje de perros mayores de 4 años. El sacrificio delas hembras al nacer no es tan frecuente como en otras ciudades de América Latina. Existe un alto porcentaje de población canina con libre acceso a la calle, que explica la incidencia de mordeduras ella ciudad. Existe un afecto y un cuidado por los canes muy arraigado en la comunidad, lo que se evidencia en el alto índice de la relación hombre/perro y el alto índice de perros adultos en la población.

Introduction: the high incidence of dog bites inthe human population (14,903 in 2002), suggestedto the municipal authorities on the need toenforce the canine registry, felt need since 1868in Asuncion, in which the first ordinance on thissubject of the city council was generated, and tocreate a system for the control of stray dogs andpunishment to irresponsible owners. Objective:To estimate the dog population distribution by sexand age, the percentage of houses that have theseanimals room in Asuncion and the likelihood offree access to the street. Material and Methods:Following the Guide for the characterization ofanimal population of the Pan American Foot andMouth Disease, taking as a reference the humanpopulation, a proportional stratified sampling withsystematic selection was followed in two stages;Cluster (blocks) selected as primary units androom houses as secondary units, a sample of n =2,600 households were study. The proportion ofhouses with dogs for each stratum was established.Results and Conclusions: The canine populationfound in Asuncion has characteristics of a rural population: high rate of tenure and age distributionwith a high percentage of dogs older than 4 years.The sacrifice of females at birth is not as prevalentas in other cities in Latin America. There is a highpercentage of canine population with free access tothe street, which explains the incidence of bites inthe city. There is a deeply rooted affection and carefor dogs in the community, which is evidenced bythe high rate of human / dog relationship and thehigh rate of adult dogs in the population.

Dog Bite Prevention: Effect of a Short Educational Intervention for Preschool Children.

This study aimed to investigate whether preschool children can learn how to interpret dogs' behaviours, with the purpose of helping avoid dog bites. Three- to five-year-old children (N = 70) were tested on their ability to answer questions about dogs' emotional states before and after participating in either an educational intervention about dog behaviour (intervention group) or an activity about wild animals (control group). Children who had received training about dog behaviour (intervention group) were significantly better at judging the dogs' emotional states after the intervention compared to before. The frequency with which they referred to relevant behaviours in justifying their judgements also increased significantly. In contrast, the control group's performance did not differ significantly between the two testing times. These results indicate that preschool children can be taught how to correctly interpret dogs' behaviours. This implies that incorporating such training into prevention programmes may contribute to reducing dog bite incidents.

Environmental dermatology: skin manifestations of injuries caused by invertebrate aquatic animals.

Contact between humans and coastal areas has increased in recent decades, which has led to an increase in injuries from aquatic animals. The majority of these present dermatological manifestations, and some of them show typical lesions. The highest percentages of injuries that occur in marine environments are associated with invertebrates such as sea urchins, jellyfish and Portuguese men-of-war (echinoderms and cnidarians). In this review, we discuss the clinical, therapeutic and preventive aspects of injuries caused by marine and freshwater invertebrates, focusing on first aid measures and diagnosis for dermatologists and professionals in coastal areas.

Environmental dermatology: skin manifestations of injuries caused by invertebrate aquatic animals / Dermatologia ambiental: manifestacoes dermatologicas de acidentes por animais aquaticos (invertebrados)

Contact between humans and coastal areas has increased in recent decades, which has led to an increase in injuries from aquatic animals. The majority of these present dermatological manifestations, and some of them show typical lesions. The highest percentages of injuries that occur in marine environments are associated with invertebrates such as sea urchins, jellyfish and Portuguese men-of-war (echinoderms and cnidarians). In this review, we discuss the clinical, therapeutic and preventive aspects of injuries caused by marine and freshwater invertebrates, focusing on first aid measures and diagnosis for dermatologists and professionals in coastal areas.

O contato entre a Humanidade e as áreas litorâneas vem aumentando nas últimas décadas e com isso também aumentaram os acidentes por animais aquáticos. A maioria destes apresenta manifestações dermatológicas, sendo algumas bem características. As maiores porcentagens das lesões em ambientes marinhos estão associadas aos invertebrados, como os ouriços-do-mar, águas-vivas e caravelas (equinodermos e cnidários). Nesta revisão, são discutidos os aspectos clínicos, terapêuticos e preventivos de acidentes por invertebrados marinhos e fluviais e ressaltados os primeiros cuidados e os auxílios diagnósticos para os dermatologistas e profissionais das áreas litorâneas.

Candiru--a little fish with bad habits: need travel health professionals worry? A review.

BACKGROUND: Over the last 150 years, a little South American fish with alleged unsavory habits has become the stuff legends are made of. With growing visitor numbers to the Amazon basin, the question of whether the animal poses a threat to the many travelers to the region arises. METHODS: Scientific literature was identified by searching MEDLINE, ScienceDirect, ProQuest, and Google Scholar. The reference lists of all obtained sources served to refine the search, including the original historical writings where obtainable. Nonscientific material was discovered through extensive web searches. RESULTS: First, the current popular understanding of the fish and its interaction with humans are presented followed by an overview of the historical literature on which this understanding is based. Next, the fish and its supposed attraction to humans are introduced. Finally, this review queries the evidence current medical advice utilizes for the prevention of attacks and the treatment of unfortunate hosts. CONCLUSIONS: Until evidence of the fish's threat to humans is forthcoming, there appears to be no need for considering the candiru in health advice for travelers to the Amazon.

Dog bite prevention: an assessment of child knowledge.

OBJECTIVES: To determine what children know about preventing dog bites and to identify parental desires for dog bite prevention education. STUDY DESIGN: This cross-sectional study sampled 5- to 15-year-olds and their parents/guardians presenting to a pediatric emergency department with nonurgent complaints or dog bites. The parent/guardian-child pairs completed surveys and knowledge-based simulated scenario tests developed on the basis of American Academy of Pediatrics and Centers for Disease Control and Prevention dog bite prevention recommendations. Regression analyses modeled knowledge test scores and probability of passing; a passing score was ≥11 of 14 questions. RESULTS: Of 300 parent/guardian-child pairs, 43% of children failed the knowledge test. Older children had higher odds of passing the knowledge test than younger children, as did children with white parents vs those with nonwhite parents. No associations were found between knowledge scores and other sociodemographic or experiential factors. More than 70% of children had never received dog bite prevention education, although 88% of parents desired it. CONCLUSIONS: Dog bites are preventable injures that disproportionately affect children. Dog bite prevention knowledge in our sample was poor, particularly among younger children and children with nonwhite parents. Formal dog bite prevention education is warranted and welcomed by a majority of parents.