Efficacy of the 20-minute whole blood clotting test (WBCT20) in the diagnosis of coagulation alteration related to snakebites in a Western Brazilian Amazon hospital.

INTRODUCTION: The efficacy of 20-minute whole blood clotting (WBCT20) and the Lee-White clotting time (LWCT) tests in diagnosing coagulation alterations from snakebites were compared. Methods: We evaluated 89 snakebite cases treated at the Hospital Regional do Juruá em Cruzeiro do Sul, Acre, Brazil. Results: WBCT20 results were normal in 33.7% and unclottable in 66.3% of cases, while LWCT results were normal in 23.6% and altered (prolonged or unclottable) in 76.4% of cases, with no significant differences. Conclusions: The WBCT20 is important for rapidly diagnosing coagulation alterations from snakebites. Furthermore, it is efficient, inexpensive, and can be deployed in isolated hospitals.

Efficacy of the 20-minute whole blood clotting test (WBCT20) in the diagnosis of coagulation alteration related to snakebites in a Western Brazilian Amazon hospital

Abstract Introduction: The efficacy of 20-minute whole blood clotting (WBCT20) and the Lee-White clotting time (LWCT) tests in diagnosing coagulation alterations from snakebites were compared. Methods: We evaluated 89 snakebite cases treated at the Hospital Regional do Juruá em Cruzeiro do Sul, Acre, Brazil. Results: WBCT20 results were normal in 33.7% and unclottable in 66.3% of cases, while LWCT results were normal in 23.6% and altered (prolonged or unclottable) in 76.4% of cases, with no significant differences. Conclusions: The WBCT20 is important for rapidly diagnosing coagulation alterations from snakebites. Furthermore, it is efficient, inexpensive, and can be deployed in isolated hospitals.

Epidemiological and clinical aspects of snakebites in the upper Juruá River region, western Brazilian Amazonia

This study addresses the clinical and epidemiological aspects of envenoming cases resulting from snakebites treated at a hospital in Cruzeiro do Sul, in the upper Juruá River region, western Brazilian Amazonia. The specific identity of snakes that caused the envenomings was inferred (a) from the diagnosis of patient symptoms and signs upon hospital admission, (b) by enzyme immunoassay for detection of Bothrops atrox and Lachesis muta venom from serum samples taken from patients before antivenom therapy, or (c) by direct identification of the snake, when it was brought along to the hospital or photographed. There were 133 snakebites (76.2 cases per 100,000 inhabitants) registered during one year (July 2017 to June 2018). Most snakebites (88.7%) were caused by Bothrops spp., and the rest by non-venomous snakes or dry bites. Snakebites tended to occur more often during the rainy season, coinciding with the period of greater reproductive activity of the snakes and greater availability of their prey. In addition, the increase in the water level of rivers and lakes during the rainy season tends to concentrate snakes in dry places and, thus, to increase encounters with humans. Information campaigns on prevention and first aid, specially among the most vulnerable groups (indigenous people, farmers, and children and teenagers in rural areas), and the importance of using protective equipment (boots, leggings, leather gloves) in certain high risk activities (e.g. agriculture and extractivism in forests) are fundamental for the reduction of snakebite morbidity. (AU)

Ophidian envenomings in a region of Brazilian Western Amazon / Envenenamentos ofídicos em uma região da Amazônia Ocidental Brasileira

INTRODUCTION: Snakebites are a public health problem and are considered clinical emergencies, what makes studies in high-incidence regions very importantOBJECTIVE: To describe the clinical and epidemiological aspects of patients suffering from snakebite accidents in a region of the Western Amazon, BrazilMETHODS: It is a cross-sectional, retrospective and documentary quantitative approach, from 2015 to 2016, held at the Regional Hospital of Juruá, located in the city of Cruzeiro do Sul, Acre, Brazil. Epidemiological data were obtained from the forms of the Notification Disease Information System (SINAN), in the Epidemiological Surveillance Sector of the hospital. The following variables were verified: month of occurrence, snake identification (type of accident), accident location (urban and rural), locality, municipality, victim data (age group, sex, anatomical region affected), symptoms and signs circumstances of the accident, time elapsed between accident and care, number of ampoules used, and type of serumRESULTS: An average of 124 cases of snakebites were treated per year (76.71 cases per 100,000 inhabitants/year), most of them were botropic accidents and the patients were male adult and rural workers, bitten in the lower limbs. More than 30% of cases were treated six hours after poisoning and 24-hour care is a risk factor for complications, as seven of the eight patients who had complications were treated within one day of the accidentCONCLUSION: It was presented a constant increase in the cases, which generated a worrying point of reflection, which may be associated with two factors, where one turns to the improvement in the displacement of victims (improvements in branch roads and implementation of SAMU speedboat) facilitating plus transport and telephone coverage by improving communication, or the failure of public health policies to provide better conditions and guidance to the population

INTRODUÇÃO: Os acidentes ofídicos são um problema de saúde pública e são considerados emergências clínicas, motivo este que torna os estudos em regiões de grande incidência muito importantesOBJETIVO: Descrever os aspectos clínicos e epidemiológicos de pacientes vítimas de acidentes ofídicos em uma região da Amazônia Ocidental, BrasilMÉTODO: Trata-se de um transversal, retrospectivo e documental de abordagem quantitativa, no período de 2015 a 2016, realizado no Hospital Regional do Juruá, localizado na cidade de Cruzeiro do Sul, Acre, Brasil. Os dados epidemiológicos foram obtidos a partir das fichas do Sistema de Informação de Agravos de Notificação (SINAN), no Setor de Vigilância Epidemiológica do hospital. Foram verificadas as seguintes variáveis: mês de ocorrência, identificação da serpente (tipo de acidente), local do acidente (zona urbana e rural), localidade, município, dados da vítima (faixa etária, sexo, região anatômica atingida), sintomas e sinais apresentados, circunstâncias do acidente, tempo decorrido entre o acidente e o atendimento, a quantidade de ampolas utilizadas e o tipo de soro no tratamento das vítimasRESULTADOS: Foram atendidos em média 124 casos de acidentes ofídicos por ano (76,71 casos por 100.000 habitantes/ano), sendo a maioria acidentes botrópicos e os pacientes constituídos por indivíduos adultos do sexo masculino e trabalhadores rurais, picados nos membros inferiores. Mais de 30% dos casos foram atendidos seis horas após o envenenamento e o atendimento após 24 horas é um fator de risco para complicações, uma vez que sete dos oito pacientes que apresentaram complicações foram atendidos depois de um dia do acidenteCONCLUSÃO: Apresentou um crescente constante nos casos, o que gerou um ponto de reflexão preocupante, que pode estar associado a dois fatores, onde um volta-se para a melhora no deslocamento das vítimas (melhorias nas estradas dos ramais e implantação de lancha do SAMU) facilitando mais o transporte e na cobertura de telefonia melhorando a comunicação, ou a falha das políticas de saúde pública na oferta de melhores condições e orientações para a população

Epidemiological and clinical aspects of snakebites in the upper Juruá River region, western Brazilian Amazonia / Aspectos clínicos e epidemiológicos de acidentes ofídicos na região do Alto Juruá, oeste da Amazônia brasileira

This study addresses the clinical and epidemiological aspects of envenoming cases resulting from snakebites treated at a hospital in Cruzeiro do Sul, in the upper Juruá River region, western Brazilian Amazonia. The specific identity of snakes that caused the envenomings was inferred (a) from the diagnosis of patient symptoms and signs upon hospital admission, (b) by enzyme immunoassay for detection of Bothrops atrox and Lachesis muta venom from serum samples taken from patients before antivenom therapy, or (c) by direct identification of the snake, when it was brought along to the hospital or photographed. There were 133 snakebites (76.2 cases per 100,000 inhabitants) registered during one year (July 2017 to June 2018). Most snakebites (88.7%) were caused by Bothrops spp., and the rest by non-venomous snakes or dry bites. Snakebites tended to occur more often during the rainy season, coinciding with the period of greater reproductive activity of the snakes and greater availability of their prey. In addition, the increase in the water level of rivers and lakes during the rainy season tends to concentrate snakes in dry places and, thus, to increase encounters with humans. Information campaigns on prevention and first aid, specially among the most vulnerable groups (indigenous people, farmers, and children and teenagers in rural areas), and the importance of using protective equipment (boots, leggings, leather gloves) in certain high risk activities (e.g. agriculture and extractivism in forests) are fundamental for the reduction of snakebite morbidity

Epidemiological and clinical aspects of snakebites in the upper Juruá River region, western Brazilian Amazonia / Aspectos clínicos e epidemiológicos de acidentes ofídicos na região do Alto Juruá, oeste da Amazônia brasileira

This study addresses the clinical and epidemiological aspects of envenoming cases resulting from snakebites treated at a hospital in Cruzeiro do Sul, in the upper Juruá River region, western Brazilian Amazonia. The specific identity of snakes that caused the envenomings was inferred (a) from the diagnosis of patient symptoms and signs upon hospital admission, (b) by enzyme immunoassay for detection of Bothrops atrox and Lachesis muta venom from serum samples taken from patients before antivenom therapy, or (c) by direct identification of the snake, when it was brought along to the hospital or photographed. There were 133 snakebites (76.2 cases per 100,000 inhabitants) registered during one year (July 2017 to June 2018). Most snakebites (88.7%) were caused by Bothrops spp., and the rest by non-venomous snakes or dry bites. Snakebites tended to occur more often during the rainy season, coinciding with the period of greater reproductive activity of the snakes and greater availability of their prey. In addition, the increase in the water level of rivers and lakes during the rainy season tends to concentrate snakes in dry places and, thus, to increase encounters with humans. Information campaigns on prevention and first aid, specially among the most vulnerable groups (indigenous people, farmers, and children and teenagers in rural areas), and the importance of using protective equipment (boots, leggings, leather gloves) in certain high risk activities (e.g. agriculture and extractivism in forests) are fundamental for the reduction of snakebite morbidity

Accident and vascular injury with stingray in the Alto Juruá, Acre, Brazil: a case report / Acidente e lesão vascular com arraia no Alto Juruá, Acre, Brasil: um relato de caso

INTRODUCTION: Injuries caused by fish are common and considered a neglected health problem with high morbidity and low lethality. Noteworthy are the envenomings by freshwater stingrays, which are considered very serious and one of the most important injuries caused by aquatic animals in South America. CASE PRESENTATION: To describe an accident and vascular injury with venomous stingray animals in the Alto do Juruá, Acre, Brazil. Male patient admitted due to stingray in the left lower extremity 20 days ago. CONCLUSION: The freshwater stingray, due to its sharp characteristics, injured the great saphenous vein, requiring surgical intervention. The situation presented negative evolution due to the lack of necessary procedures in the first attendance, such as the proper cleaning of the wound and the removal of the sting.

INTRODUÇÃO: Acidentes com peixes, denominados de ictismo, são comuns e são considerados um problema de saúde negligenciado, de alta morbidade e baixa letalidade. Destacam-se os envenenamentos por arraias de água doce, pois são considerados muito graves e uma das mais importantes lesões causadas por animais aquáticos na América do Sul. APRESENTAÇÃO DO CASO: Descrever um acidente e lesão vascular com animais peçonhentos do tipo arraia no alto do Juruá, Acre, Brasil. Paciente do sexo masculino, admitido devido a ferroada de arraia no membro inferior esquerda há 20 dias. CONCLUSÃO: O ferrão da arraia de água doce por possuir características pontiagudas lesionou a veia safena magna, necessitando de uma intervenção cirúrgica. O quadro apresentou evolução negativa devido a não realização de procedimentos necessários no primeiro atendimento, como a limpeza adequada do ferimento e a retirada do ferrão.

Non-venomous snakebites in the Western Brazilian Amazon.

INTRODUCTION: In this study, we examined the clinical manifestations, laboratory evidence, and the circumstances of snakebites caused by non-venomous snakes, which were treated at the Regional Hospital of Juruá in Cruzeiro do Sul. METHODS: Data were collected through patient interviews, identification of the species that were taken to the hospital, and the clinical manifestations. RESULTS: Eight confirmed and four probable cases of non-venomous snakebites were recorded. CONCLUSIONS: The symptoms produced by the snakes Helicops angulatus and Philodryas viridissima, combined with their coloration can be confused with venomous snakes (Bothrops atrox and Bothrops bilineatus), thus resulting in incorrect bothropic snakebite diagnosis.

Extractivism of palm tree fruits: A risky activity because of snakebites in the state of Acre, Western Brazilian Amazon.

INTRODUCTION: We present here the risk from snakebites because of palm extractivism in western Amazonia. METHODS: The data were extracted from a cross-sectional sample study, from January 2016 to April 2018, at the Juruá Regional Hospital of Cruzeiro do Sul (Acre). RESULTS: There were 14 Bothrops incidents involving males, most of them occurring during the harvesting of "açaí" (Euterpe precatoria). CONCLUSIONS: During the harvesting of "açaí," there is the risk of the presence of B. atrox on the ground near the palm tree, and of B. bilineatus at the top of the palm tree.

Ethno-knowledge and attitudes regarding snakebites in the Alto Juruá region, Western Brazilian Amazonia

Background The Alto Juruá region, located in the extreme western part of the Brazilian Amazonia, possesses an indigenous and riverine population which is involved in agricultural and forest extraction activities, and is a region that stands out for its high incidence of snakebites. Objectives To assess the attitudes of the victims, the characteristics of the snakes and the circumstances of the snakebites which occurred in a region where human populations are highly exposed to snakes. Methods The study was conducted at the Regional Hospital of Juruá in the Municipality of Cruzeiro do Sul (Acre), which regularly attends victims of snakebites in the Alto Juruá region. The snakes that caused the envenomations were identified from clinical and epidemiological diagnosis of the symptoms and signs that patients presented during hospital, and by enzyme immunoassay for venom detection using serum samples of the patients, or by identification of the snake responsible for the envenomation when it was taken to the hospital or photographed. People who suffered or witnessed the snakebite were interviewed to assess the circumstances of the bite, the attitude adopted after the accident and whether they recognized the species of snake that caused the envenomation. Results There were 133 cases of snakebite (76.24/100.000 inhabitants), mainly involving male individuals living in the rural area and who had a low level of education. The most affected groups were farmers (48%) and children and teenagers (39%). It was observed that 8.3% of them presented a history of recurrence for bites. The lower limbs were the most affected anatomical region (84%). The Bothrops atrox snake, mainly small specimens (mostly juveniles), was the main species involved in the envenomations (83.4%). Snakebites occurred mainly in forest areas, backyards of houses in rural areas and near to aquatic environments, during activities (walking, farming, extractivism, hunting). Most of the time, the snake was on the ground and the bite occurred because of the approximation of the individual, either by trampling or by approximation of a hand. Half of the victims performed some kind of inadequate first aid (not drinking water, use of tourniquet, incision at the site of the bite, use of black stone, drinking a compound "Específico Pessoa"). Conclusions Snakebite is an important cause of morbidity in the Alto Juruá region. Bothrops bites are mostly caused by small-sized specimens, probably due to the greater abundance of B. atrox juveniles, and also because small snakes are more difficult for people to see. People are more often bitten on the lower limbs probably due to the size of B. atrox (small and medium) and because the snakes are usually on the ground in most situations. Many victims resort to ineffective actions that can cause complications and also delay serotherapy. A low level of education is a factor that may contribute to worse outcomes in snakebites since it is associated with a lack of knowledge of preventive and first aid measures.

Perspectives and recommendations towards evidence-based health care for scorpion sting envenoming in the Brazilian Amazon: a comprehensive review

Although underreported across the Amazon region, scorpion stings are very prevalent in some areas and can be potentially life-threatening, especially in children. The most vulnerable populations are those living in locations far from the capitals, hence having limited access to the health system where the appropriate structure for the treatment of severe cases is found. An abundant and diverse fauna of scorpions is found in the region, but few studies have been conducted to decipher the clinical characteristics and therapeutic response of the available antivenoms in envenomings caused by the various species. Antivenom underdosage as well as delayed medical assistance are common among indigenous populations, resulting in poor outcome rates. An in depth understanding of the epidemiological, clinical and therapeutic aspects of scorpion sting envenomings in the Amazon is necessary to improve the outcome of these cases.

Extractivism of palm tree fruits: A risky activity because of snakebites in the state of Acre, Western Brazilian Amazon

Abstract INTRODUCTION: We present here the risk from snakebites because of palm extractivism in western Amazonia. METHODS: The data were extracted from a cross-sectional sample study, from January 2016 to April 2018, at the Juruá Regional Hospital of Cruzeiro do Sul (Acre). RESULTS: There were 14 Bothrops incidents involving males, most of them occurring during the harvesting of "açaí" (Euterpe precatoria). CONCLUSIONS: During the harvesting of "açaí," there is the risk of the presence of B. atrox on the ground near the palm tree, and of B. bilineatus at the top of the palm tree.

Non-venomous snakebites in the Western Brazilian Amazon

Abstract INTRODUCTION: In this study, we examined the clinical manifestations, laboratory evidence, and the circumstances of snakebites caused by non-venomous snakes, which were treated at the Regional Hospital of Juruá in Cruzeiro do Sul. METHODS: Data were collected through patient interviews, identification of the species that were taken to the hospital, and the clinical manifestations. RESULTS: Eight confirmed and four probable cases of non-venomous snakebites were recorded. CONCLUSIONS: The symptoms produced by the snakes Helicops angulatus and Philodryas viridissima, combined with their coloration can be confused with venomous snakes (Bothrops atrox and Bothrops bilineatus), thus resulting in incorrect bothropic snakebite diagnosis.

Perspectives and recommendations towards evidence-based health care for scorpion sting envenoming in the Brazilian Amazon: a comprehensive review

Although underreported across the Amazon region, scorpion stings are very prevalent in some areas and can be potentially life-threatening, especially in children. The most vulnerable populations are those living in locations far from the capitals, hence having limited access to the health system where the appropriate structure for the treatment of severe cases is found. An abundant and diverse fauna of scorpions is found in the region, but few studies have been conducted to decipher the clinical characteristics and therapeutic response of the available antivenoms in envenomings caused by the various species. Antivenom underdosage as well as delayed medical assistance are common among indigenous populations, resulting in poor outcome rates. An in depth understanding of the epidemiological, clinical and therapeutic aspects of scorpion sting envenomings in the Amazon is necessary to improve the outcome of these cases.

Ethno-knowledge and attitudes regarding snakebites in the Alto Juruá region, Western Brazilian Amazonia

Background The Alto Juruá region, located in the extreme western part of the Brazilian Amazonia, possesses an indigenous and riverine population which is involved in agricultural and forest extraction activities, and is a region that stands out for its high incidence of snakebites. Objectives To assess the attitudes of the victims, the characteristics of the snakes and the circumstances of the snakebites which occurred in a region where human populations are highly exposed to snakes. Methods The study was conducted at the Regional Hospital of Juruá in the Municipality of Cruzeiro do Sul (Acre), which regularly attends victims of snakebites in the Alto Juruá region. The snakes that caused the envenomations were identified from clinical and epidemiological diagnosis of the symptoms and signs that patients presented during hospital, and by enzyme immunoassay for venom detection using serum samples of the patients, or by identification of the snake responsible for the envenomation when it was taken to the hospital or photographed. People who suffered or witnessed the snakebite were interviewed to assess the circumstances of the bite, the attitude adopted after the accident and whether they recognized the species of snake that caused the envenomation. Results There were 133 cases of snakebite (76.24/100.000 inhabitants), mainly involving male individuals living in the rural area and who had a low level of education. The most affected groups were farmers (48%) and children and teenagers (39%). It was observed that 8.3% of them presented a history of recurrence for bites. The lower limbs were the most affected anatomical region (84%). The Bothrops atrox snake, mainly small specimens (mostly juveniles), was the main species involved in the envenomations (83.4%). Snakebites occurred mainly in forest areas, backyards of houses in rural areas and near to aquatic environments, during activities (walking, farming, extractivism, hunting). Most of the time, the snake was on the ground and the bite occurred because of the approximation of the individual, either by trampling or by approximation of a hand. Half of the victims performed some kind of inadequate first aid (not drinking water, use of tourniquet, incision at the site of the bite, use of black stone, drinking a compound "Específico Pessoa"). Conclusions Snakebite is an important cause of morbidity in the Alto Juruá region. Bothrops bites are mostly caused by small-sized specimens, probably due to the greater abundance of B. atrox juveniles, and also because small snakes are more difficult for people to see. People are more often bitten on the lower limbs probably due to the size of B. atrox (small and medium) and because the snakes are usually on the ground in most situations. Many victims resort to ineffective actions that can cause complications and also delay serotherapy. A low level of education is a factor that may contribute to worse outcomes in snakebites since it is associated with a lack of knowledge of preventive and first aid measures.

Accidents with poisonous animals in Brazil by age and sex / Acidentes com animais peçonhentos no Brasil por sexo e idade

INTRODUCTION: accidents with poisonous animals are a common clinical emergency in several tropical countries, mainly in the fields and rural areas, constituting a public health problem, including pediatric OBJECTIVE: The objective is to analyze the morbidity, mortality and lethality according to age and sex in cases of poisoning by snakes, scorpions and spiders in Brazil METHODS: data on poisoning by snakes, scorpions and spiders that occurred from 2009 to 2013 were collected in the online database of the Information System on Diseases of Compulsory Declaration (SINAN) of the Ministry of Health RESULTS: were recorded 28.812 cases of snake bites per year, 60.370,8 with scorpions and 25.786,4 with spiders. Most deaths were caused by snakes (119 per year) and also showed higher lethality (0.41%), followed by scorpions (79.6 deaths) with a lethality of 0.13% and spiders (13.2) and the lowest mortality (0.05%). In males individuals were most cases of snake bites, whereas in accidents scorpions and spiders was observed little difference in frequency between men and women. The age group with the largest number of poisonings records was 20-39 years CONCLUSIONS: there is a progressive increase in cases of poisoning from the first year of age until the age range 20-39 years, and after this, begins a decrease in cases. Children, adolescents and elderly adults are most vulnerable because they have higher lethality rates, especially in the snake and scorpion accidents.(AU)

INTRODUÇÃO: acidentes com animais peçonhentos são uma emergência clínica frequente em vários países tropicais, principalmente nos campos e áreas rurais, constituindo um problema de Saúde Pública, inclusive pediátrica OBJETIVO: analisar a morbidade, mortalidade e letalidade de acordo com a faixa etária e sexo nos casos de envenenamentos por serpentes, escorpiões e aranhas no Brasil MÉTODO: Os dados sobre envenenamentos por serpentes, escorpiões e aranhas ocorridos no período de 2009 a 2013 foram obtidos na base de dados online do Sistema de Informação de Agravos de Notificação - SINAN do Ministério da Saúde RESULTADOS: foi registrada uma média de 28.812 casos por ano de acidentes ofídicos, 60.370,8 com escorpiões e 25.786,4 com aranhas. A maioria dos óbitos foi causada por serpentes (119 por ano) e também apresentou maior letalidade (0,41%), seguida por escorpiões (79,6 óbitos) com letalidade de 0,13% e, aranhas (13,2) com menor letalidade (0,05%). Em indivíduos do sexo masculino ocorreram a maioria dos casos de acidentes ofídicos, enquanto que nos acidentes com escorpiões e aranhas foi observado pouca diferença na frequência entre homens e mulheres. A faixa etária com maior número de registros de envenenamentos foi a de 20 a 39 anos CONCLUSÕES: ocorre um aumento progressivo de casos de envenenamentos a partir do primeiro ano de idade até a faixa etária compreendida entre 20 a 39 anos e após esta, começa uma diminuição. Crianças, adolescentes e adultos idosos, constituem grupos mais vulneráveis por apresentarem maiores índices de letalidade, especialmente nos acidentes ofídicos e escorpiônicos.(AU)

Acidentes com animais peçonhentos no Brasil por sexo e idade / Accidents with poisonous animals in Brazil by age and sex

INTRODUÇÃO: acidentes com animais peçonhentos são uma emergência clínica frequente em vários países tropicais, principalmente nos campos e áreas rurais, constituindo um problema de Saúde Pública, inclusive pediátricaOBJETIVO: analisar a morbidade, mortalidade e letalidade de acordo com a faixa etária e sexo nos casos de envenenamentos por serpentes, escorpiões e aranhas no BrasilMÉTODO: Os dados sobre envenenamentos por serpentes, escorpiões e aranhas ocorridos no período de 2009 a 2013 foram obtidos na base de dados online do Sistema de Informação de Agravos de Notificação - SINAN do Ministério da SaúdeRESULTADOS: foi registrada uma média de 28.812 casos por ano de acidentes ofídicos, 60.370,8 com escorpiões e 25.786,4 com aranhas. A maioria dos óbitos foi causada por serpentes (119 por ano) e também apresentou maior letalidade (0,41%), seguida por escorpiões (79,6 óbitos) com letalidade de 0,13% e, aranhas (13,2) com menor letalidade (0,05%). Em indivíduos do sexo masculino ocorreram a maioria dos casos de acidentes ofídicos, enquanto que nos acidentes com escorpiões e aranhas foi observado pouca diferença na frequência entre homens e mulheres. A faixa etária com maior número de registros de envenenamentos foi a de 20 a 39 anosCONCLUSÕES: ocorre um aumento progressivo de casos de envenenamentos a partir do primeiro ano de idade até a faixa etária compreendida entre 20 a 39 anos e após esta, começa uma diminuição. Crianças, adolescentes e adultos idosos, constituem grupos mais vulneráveis por apresentarem maiores índices de letalidade, especialmente nos acidentes ofídicos e escorpiônicos.

INTRODUCTION: accidents with poisonous animals are a common clinical emergency in several tropical countries, mainly in the fields and rural areas, constituting a public health problem, including pediatric OBJECTIVE: The objective is to analyze the morbidity, mortality and lethality according to age and sex in cases of poisoning by snakes, scorpions and spiders in Brazil METHODS: data on poisoning by snakes, scorpions and spiders that occurred from 2009 to 2013 were collected in the online database of the Information System on Diseases of Compulsory Declaration (SINAN) of the Ministry of Health RESULTS: were recorded 28.812 cases of snake bites per year, 60.370,8 with scorpions and 25.786,4 with spiders. Most deaths were caused by snakes (119 per year) and also showed higher lethality (0.41%), followed by scorpions (79.6 deaths) with a lethality of 0.13% and spiders (13.2) and the lowest mortality (0.05%). In males individuals were most cases of snake bites, whereas in accidents scorpions and spiders was observed little difference in frequency between men and women. The age group with the largest number of poisonings records was 20-39 years CONCLUSIONS: there is a progressive increase in cases of poisoning from the first year of age until the age range 20-39 years, and after this, begins a decrease in cases. Children, adolescents and elderly adults are most vulnerable because they have higher lethality rates, especially in the snake and scorpion accidents.