EPIDEMIOLOGY OF POISONOUS SNAKE-BITES - A STUDY OF CASES ASSISTED IN 1988

The attendance given to patients by ta specialized Hospital, in S.Paul o, Brazil, during 1988 is studied. The study is based on the medical r ecords of 322 patients and on questionnaires filled out by author duri ng interviews with 209 patients or their companions. The 322 snake-bit es occurred mainly between October and April, in the diurnal period, m ainly in the afternoon. Most of patients were adult males, mainly betw een 10 and 20 years of age. The parts of the body most fequently affec ted were the feet, hands and legs. The snakes of the genera Bothrops, Crotalus and Micrurus were responsible, respectively, for 306 (95.0%) 14 (4.4%) and 2 (0.6%) of the accidents under study. Among the 160 sna kes that were classified at the Herpetological Section of the IB, 152 were Bothrops; 142 B. jararaca, mostly young reptiles, and 8 were of t he genus Crotalus. Of the patients, 90.4% recovered completely, 2.2% p resented sequelae, 7.5% were transferred and thus it was impossible to follow them up. Of the 209 persons interviewed the occupational group most prone to snake bites was agricultural workers, followed by stude ntes; nearly 60% of the accidents ocurred during work; most of the pat ients had their inferior extremities unprotected at the moment of the bite. On hundred and sixty patients (76.6%) submitted to some from of treatment before coming to the HVB-IB, the more common being the use o f a tourniquet (50.2%), local squeezing in an attemp to remove part of the venom (33.5), application of substances on the site of the snake bite (36.8%) and the ingestion of others (12.9%). Slightly over a quar ter of the patients under went some kind or medical treatment before c oming to the HVB-IB, the most common being antissepsis (8.2%), adminis tration of antivenom (6.2%), antihistamines (5.7%) and analgesics (5.3 %). The snake was seen before it struch by 187 (89.5%) of the 209 pers ons interviewed and in most cases ii adopted the strike posture just b efore the first bite.