Clinical and epidemiological characteristics of injuries caused by venomous snakes observed at the Hospital for Tropical Diseases of Araguaína, Tocantins State, Brazil, from 1995 to 2000

Injuries caused by venomous snakes are considered a problem of public health in Brazil, and further studies for a better knowledge are very important. The aim of this work is to describe clinical and epidemiological characteristics that were observed from 1995 to 2000 in the Hospital for Tropical Diseases of Araguaína, Tocantins State, Brazil, which is a unit of health that takes care of patients suffering from tropical diseases. We studied 440 individuals and the most common characteristics observed were masculine sex, age among 15-45 years, bite in low members, and injuries caused by snakes of the Bothrops genus. The signs and symptoms more frequently observed were edema, pain, erythema, and bleeding. The most observed systemic manifestation was alteration of blood coagulation. The most frequent complications were abscess, necrosis, bacterial infection, and renal failure. The mortality rate was 3%. These data are very important for the evaluation of the problem

Use of doxycycline for leptospirosis after high-risk exposure in São Paulo, Brazil.

A clinical trial pilot study, double-blinded, randomized, and controlled with a placebo to assess the effectiveness of oral doxycycline (200 mg, single dose) in preventing leptospirosis after high exposure to potentially contaminated water was performed in São Paulo, SP, Brazil. Confirmed cases were defined as those with leptospira IgM antibody and symptoms; asymptomatic cases were those presenting with IgM antibodies but no symptoms; and suspected cases were individuals with symptoms but no IgM antibody. Forty subjects were given doxycycline and 42 were given placebo. In the drug-treated group there were 2 confirmed cases, 11 asymptomatic cases, and 6 suspected cases. In the placebo group there were 5 confirmed, 6 symptomatic, and 5 suspected cases. Even though we found a protective association of doxycycline for confirmed leptospirosis cases (RR = 2.3) and seroconversion only (RR = 2.0), the association was not statistically significant because of the small number of individuals enrolled in this pilot study. We observed that the 22% of the volunteers already had IgM antibodies to leptospirosis at the first sampling. Finally, the attack rate to confirmed, asymptomatic, and suspected cases of Leptospirosis was 8.5%, 22%, and 13%, respectively, in this population.