Situation of Brazillian program for surveillance of accidents caused by venomous snakes

About 100,000 accidents are caused by venomous animals every year in Brazil. The most important are snakes (genus Bothrops, Crotalus, Lachesis, Micrurus), scorpions (genus Tytius), spiders (genus Loxosceles, Phoneutria, Latrodectus), bees (genus Apis), caterpillars (genus Lonomia and other Saturnidae) and fishes (sting rays), according to Notification Hazard Information System - SINAN. Since 1986, after the creation program of surveillance of accidents caused by venomous animals, the amount of accident notifications has increased every year, due to orientation of health professionals and improvement of the data system. However, since the year 2000, this increase augmented drastically, but the cause is still hypothetical, because of the lack of information. The snakes, due to the high number of accidents and the severity of their envenomation, are annually responsible for about 80 deaths (26% - lethality of 0.3% of 26,537 cases). Within the snakes, the rattlesnakes (Crotalus) have the highest lethality (0.6%), followed by Lachesis (0.5%), Bothrops (0.2%) and Micrurus (0.05%).The number of deaths is proportionally higher within victims of accidents caused by snakes than by other animals, and the control is more difficult, because they concentrate on rural zones. So the strategy of the program consists of three main approaches: production and distribution of antivenoms, capacitating human resources and actions of health and environmental education for prevention and controlling the incidence of each of the types of accidents. Every year the government of Brazil purchases about 540,000 ampoules of antivenoms and distributes to the whole country. Some places are of hard access, and many different means of transport are required. It takes a long time between accident and treatment, making the accident more severe and increasing the chance of complications. Sometimes the problem is lack of information of the patient and the health professional, causing delay in the treatment, or even mistreatment.