Brasão Governo de São Paulo

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Vital Brazil Hospital

Vital Brazil Hospital Vital Brazil Hospital
Credit: Butantan Communication

The Vital Brazil Hospital (HVB), specialized in the care of patients bitten by venomous animals, began its activities in November 1945. With an accumulated experience of more than six decades dedicated to care, teaching and research, attested by its more than 100,000 medical records, it is recognized as one of the most important references in the area of envenomation. The hospital maintains an emergency service and has 10 beds for observation or hospitalization.

Development of clinical and epidemiological studies related to human accidents caused by venomous animals. In addition to patient care, the Hospital also plays an important role in clinical research and standardization of therapeutic procedures for accidents caused by venomous animals in Brazil.

The main lines of research developed at the HVB are related to the treatment of human accidents caused by venomous animals. In order to reduce morbidity and lethality caused by envenomation and reduce reactions to antivenoms, clinical trials have been carried out to evaluate the efficacy of different treatments.

With training programs for health professionals and guides for the diagnosis and treatment of human accidents caused by venomous animals, the HVB welcomes doctors, medical students, nurses and other health professionals for training and voluntary internships. The hospital technicians also take part in courses at the Institute itself (see Courses and Internships), teach in hospitals, colleges and other teaching and research institutions. As a reference service in the state of São Paulo, the HVB participates in the development of technical standards and training of teams for patient care and provides technical support to the Ministry of Health.

In Brazil, antivenoms are produced by Instituto Butantan (São Paulo), Fundação Ezequiel Dias (Minas Gerais) and Instituto Vital Brazil (Rio de Janeiro). All production is purchased by the Brazilian Ministry of Health, which distributes the product across the country through the State Departments of Health. Thus, the antivenoms are available in health services and administered to victims free of charge.

In São Paulo, the list of strategic points for dealing with accidents caused by venomous animals is available on the website www.cve.saude.sp.gov.br.

Snake accidents
Bothrops (accidents caused by snakes of the pit viper group): pain and swelling at the bite site, sometimes with purplish spots and bleeding from the wound caused by the bite; bleeding gums, skin and urine may occur. The most importante complications are infection and necrosis in the bite area and renal failure.

Lachesis (accidents caused by bushmasters): a condition similar to the bothrops, followed by vomiting, diarrhea, decrease in heart rate and low blood pressure.

Crotalus (accidents caused by rattlesnake): tingling sensation at the site, without evident injury; difficulty keeping eyes open, looking drowsy, blurred or double vision, generalized muscle pain, and dark urine.

Elapid (accidents caused by genuine coral snakes): no significant change is observed at the bite site; manifestations of venomation are characterized by blurred or double vision, drooping eyelids and drowsiness.

Observations

Non-venomous snakes can also cause accidents. Venomous snakes are not always able to inject venom during an accident.

Spider accidents
There are three genera of medically important spiders in Brazil:

Loxosceles (“brown spider”): attacks when compressed; thus, it is common for the accident to occur while the individual is sleeping or getting dressed, with the torso, abdomen, thigh and arm being the most common sting sites. The venom causes a skin lesion, which can be confused with other skin diseases. In some cases there may be destruction of red blood cells and kidney impairment.

Phoneutria (Brazilian wandering/armed spider): most accidents occur in the months of April and May. It is quite common for the accident to occur when the individual is putting on shoes. The venom causes significant pain at the sting site. It can cause reactions such as profuse sweating, vomiting, respiratory and heart problems.

Latrodectus (“black widow”): found predominantly on the northeastern coast, they cause mild and moderate accidents with local pain followed by muscle contractions, agitation and sweating.

Observations

  • Crab spiders and tarantulas, although very common, do not cause envenomation.
  • Spiders that make geometric webs, many found inside houses, also pose no danger.

Caterpillar accidents
The caterpillars that can cause accidents are larval forms of moths that have pointed bristles containing venom glands. It is common for the accident to occur when the person touches the trees where the caterpillars live.

The accident is relatively benign in the vast majority of cases. Contact causes pain and local burning, with swelling and redness. Only the genus Lonomia can cause envenomation with hemorrhages and complications such as renal failure.