Snakebite Accidents and Healthcare in Brazil

By Dr. Thiago Salomão de Azevedo, pós-doutorando Guedes Lab/UNESP

Dra. Thais Barreto Guedes, coordenadora Guedes Lab/UNESP

Snakebite accidents requiring medical attention are a significant public health problem in Brazil, especially in rural areas, forests, trails, rivers, and waterfalls. Environmental and climatic factors directly influence the occurrence of these accidents involving humans, with an increase in cases during the warmer and rainier periods of the year, coinciding with greater snake activity and intensified outdoor human activities.

Processes such as deforestation, uncontrolled urban expansion, and climate change also contribute to increased contact between humans and snakes. Due to their epidemiological and toxicological nature, these medically significant snakebite accidents require immediate attention, appropriate clinical management, and, in many cases, the administration of antivenom, which is provided free of charge and systematically by the Brazilian Unified Health System (SUS).

In this sense, the Brazilian Unified Health System (SUS) has a structured network of surveillance, emergency services, and specific antivenoms strategically distributed across various referral units, covering all Brazilian states, ensuring timely care for victims of snakebites. These supplies and therapeutic protocols are the result of national guidelines and intergovernmental actions, ensuring healthcare assistance to the population in accordance with best clinical and public health practices.

RECENT CASE

In this context, it should be noted that the situation recently reported in southern Bahia, in which a tourist suffered an accident with a venomous snake at the Tijuípe Waterfall, in the Serra Grande district, municipality of Uruçuca, between Ilhéus and Itacaré, constitutes a rare and exceptional event. As reported by local media, the victim was hospitalized in serious condition, presenting a complex clinical evolution that culminated in the amputation of one of her lower limbs.

In general, more serious outcomes in medically significant snakebites are associated with a combination of factors: a high amount of venom injected by the snake into the victim, the severity of the accident, the location on the body where the bite occurred, the long time elapsed between the bite and specialized care, inadequate initial management of the victim until reaching a medical center, and failures in the care provided by healthcare professionals.

On the other hand, the favorable evolution observed in most cases is related to the occurrence of dry and/or low-severity bites, early identification of the condition, rapid access to health services and trained professionals, non-use of alternative medicine practices or home treatments, and the rapid, timely, and appropriate administration of antivenom.

Thus, despite the unfortunate severity of this specific episode, Brazilian experience in managing snakebite accidents requiring medical attention demonstrates that the vast majority of cases resolve without serious permanent sequelae when treatment is provided in a timely, protocol-driven, and evidence-based manner.

Thus, this case should be understood as a clinical and circumstantial exception that still needs to be better understood, but which reinforces the importance of expanding the reach of emergency services, especially in remote areas, strengthening health education and environmental prevention actions, improving patient care, and ensuring adequate and rapid transport of victims to referral units with the capacity for the correct management of these accidents.

From a preventative standpoint, reducing the risk of accidents with venomous snakes depends on adopting specific measures, considering different exposure profiles. For rural workers and people who work continuously in high-risk areas, the systematic use of personal protective equipment (PPE) is recommended, such as high-top boots, gaiters, and appropriate gloves, in addition to periodic training on snake identification and safe workplace practices. For tourists and occasional visitors to natural areas, preventative measures include wearing closed and sturdy footwear, paying extra attention when walking on trails, in areas of dense vegetation, near rocks and tree trunks, as well as avoiding placing hands or feet in burrows, crevices, or under rocks.

In any situation, upon sighting a snake, one should maintain a safe distance without attempting to capture or handle it. At a collective level, health education initiatives, adequate signage in high-risk areas, responsible environmental management, control of waste accumulation, and strengthened environmental surveillance are fundamental strategies to minimize the occurrence of these events. The integration of environmental, tourism, and public health policies is therefore an essential axis for the sustainable prevention of snakebite accidents, promoting safety for both local populations and visitors.

Surucucu-pico-de-jaca (Lachesis muta). By Thaís B. Guedes