Keywords
Lethality
Epidemiology
SINAN
Public health
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Abstract
Objective: To analyze cases, deaths, and case fatality rates of snakebite accidents in Brazil between 2007 and 2024, according to taxonomic groups registered in SINAN. Methods: Ecological time-series study with secondary data from SINAN referring to accidents caused by Bothrops, Crotalus, Micrurus, Lachesis, and records with unknown species. The total number of cases, deaths, and case fatality rate per group were calculated. The analysis was descriptive, aiming to identify epidemiological patterns and differences between species. Results: 3,697,056 cases and 5,365 deaths were recorded during the period, resulting in an overall case fatality rate of 0.14%. Among venomous species, there were 445,335 accidents and 2,028 deaths (case fatality rate of 0.45%). The highest lethality was observed in accidents caused by Crotalus (0.97%), followed by Lachesis (0.82%) and Bothrops (0.38%). Micrurus showed low incidence, but relevant lethality (0.20%). Records with unknown species represented a large volume (3.2 million cases). Conclusion: The epidemiological profile reinforces the predominance of Bothrops accidents, but with a higher risk of death associated with Crotalus and Lachesis snakes. The findings highlight the urgency of reducing unidentified records, expanding rapid access to antivenom, and strengthening surveillance strategies, especially in rural and remote areas.
References
AFROZ A, et al. Snakebite Envenoming: A Systematic Review and Meta-Analysis of Global Morbidity and Mortality. PLoS Neglected Tropical Diseases. 2024;18(4):e0012080.
ALVES R, et al. Delay in antivenom administration and mortality risk. Clin Toxicol. 2020; 58(7):1–8.
BERNARDE PS, et al. Clinical and epidemiological profile of Lachesis bites in Western Amazon. J Venom Anim Toxins. 2019; 25:e14818.
BOCHNER R, STRUCHINER CJ. Epidemiologia dos acidentes ofídicos nos últimos 100 anos no Brasil: uma revisão. Cadernos de Saúde Pública, 2003; 19(1): 7–16.
BRASIL. Ministério da Saúde. Boletim Epidemiológico – Volume 55 – Nº 15: Acidentes por animais peçonhentos no Brasil. Brasília: Ministério da Saúde, 2024. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos/edicoes/2024/boletim-epidemiologico-volume-55-no-15.pdf. Acessado em: 26 nov. 2025.
BRASIL. Ministério da Saúde. Acidentes por animais peçonhentos: situação epidemiológica dos acidentes ofídicos no Brasil. Brasília: Ministério da Saúde, 2023. Disponível em: https://www.gov.br/saude/. Acessado em: 11 nov. 2025.
BRASIL. Ministério da Saúde. Comissão Nacional de Incorporação de Tecnologias no SUS (CONITEC). Protocolo Clínico e Diretrizes Terapêuticas: Acidentes Ofídicos. Brasília: Ministério da Saúde, 2023. Disponível em: https://www.gov.br/conitec/pt-br/midias/protocolos/pcdt-acidentes-ofidicos. Acessado em: 26 nov. 2025.
BRASIL. Ministério da Saúde. Secretaria de Vigilância em Saúde. Sistema de Informação de Agravos de Notificação (SINAN) [online]. Brasília, 2025. Disponível em: http://tabnet.datasus.gov.br/cgi/tabcgi.exe?sinannet/animaisp/bases/animaisbrnet.def. Acessado em 25 out. de 2025.
CALVETE JJ. Venomics: integrative venom proteomics and beyond. Biochemical Journal, 2020; 477(19): 3703–3725.
CHIPPAUX JP. Snakebite envenomation turns again into a neglected tropical disease! Journal of Venomous Animals and Toxins including Tropical Diseases, 2017; 23(1): 38.
DE MELO DO, et al. “PE-010 Tendência Das Taxas De Mortalidade E Letalidade Por Acidentes ofídicos No Brasil: Um cenário Desafador”. Jornal de assistência farmacêutica e farmacoeconomia, 2025: 9 (s.2): 18.
FEITOSA EL, et al. Older Age and Time to Medical Assistance Are Associated With Severity and Mortality of Snakebites in the Brazilian Amazon: A Case-Control Study. PloS One, 2015; 10(7):e0132237.
GUILE L, et al. Factors Associated With Mortality After Snakebite Envenoming in Children: A Scoping Review. Transactions of the Royal Society of Tropical Medicine and Hygien, 2023; 117(9):617-627.
GUTIÉRREZ JM, et al. Global efforts toward reducing snakebite burden. Toxicon, 2023; 228: 107–118.
GUTIÉRREZ JM, et al. Snakebite Envenoming. Nature Reviews. Disease Primers, 2017; 3:17063.
HABIB AG, et al. Snakebite mortality in Africa: gaps and opportunities. Toxicon, 2020; 178:80–88.
HARRISON RA, et al. Improving the availability of antivenoms: production, storage and distribution challenges. Toxicon, 2019; 167: 107–115.
LONGBOTTOM J, et al. Varying estimates of snakebite incidence and mortality in sub-Saharan Africa: a literature review and modelling study. PLoS Neglected Tropical Diseases, 2018; 12(3): e0006454.
MEDRONHO RA, et al. Epidemiologia. 3. ed. São Paulo: Atheneu, 2023; 982p.
PARDAL PPO, et al. Challenges in the treatment of bushmaster (Lachesis) envenomation. Toxicon, 2020; 186: 105–112.
OLIVEIRA SS, et al. Mortality trends from snakebite envenoming in Brazil. Rev Soc Bras Med Trop, 2021; 54: e0262.
RIBEIRO LA, et al. Identificação de serpentes e impacto na conduta terapêutica. Rev Pan-Amaz Saúde, 2018; 9:37–45.
RODRIGUES DS, et al. Access to antivenom in remote regions of Brazil. BMJ Global Health, 2022; 7: e009821.
RORIZ KR, et al. Factors associated with severity of rattlesnake envenomation in the Amazon. Toxicon, 2018; 147:29–36.
SAMPATH G, et al. Neurotoxicity and clinical outcomes in crotalid snakebites. Toxins, 2020; 12:745.
SEIFERT SA, et al. Snake Envenomation. The New England Journal of Medicine, 2022; 386(1):68-78.
SILVA IM, et al. Incompleteness in SINAN records of venomous animal accidents. Epidemiol Serv Saúde. 2023; 32:e2022445.
SLAGBOOM J, et al. Innovations in snakebite surveillance and treatment. Nature Communications, 2021; 12:6162.
SOUZA AD, et al. Snakebites as Cause of Deaths in the Western Brazilian Amazon: Why and Who Dies? Deaths From Snakebites in the Amazon. Toxicon: Official Journal of the International Society on Toxinology, 2018; 145:15-24.
THRALL MA, et al. Veterinary Hematology and Clinical Chemistry. 3. ed. Hoboken: Wiley-Blackwell, 2021; 618p.
VIEIRA ML, et al. Clinical characterization of Bothrops envenomation in Brazil. Acta Tropica, 2019;199: 105–111.
WARRELL DA, WILLIAMS DJ. Clinical Aspects of Snakebite Envenoming and Its Treatment in Low-Resource Settings. Lancet (London, England), 2023; 401(10385):1382-1398.
WILLIAMS HF, et al. Addressing global disparities in snakebite burden, Lancet Global Health. 2019; 7:e387–e388.
WOOD D. Clinical Risk Factors Associated With Poor Outcomes in Snake Envenoming: A Narrative Review. Toxins, 2023; 15(12):675.