Tityus asthenes scorpion stings: epidemiological, clinical and toxicological aspects
Keywords:
scorpion venoms, epidemiology, toxicology, Colombia
Abstract
Introduction. Scorpion stings are a public health problem in many countries. However, in Colombia, very few epidemiological, clinical or toxicological studies have been undertaken.Objective. Ecological and epidemiological aspects were related to the prevalence of scorpion stings by Tityus asthenes. The clinical features of envenomization were described in patients and in an experimental animal model.
Materials and methods. The study was conducted in four localities of Mutatá and Urabá Counties in the province of Antioquia, Colombia. The sample consisted of 1,593 (929 urban, 664 rural) of the 5,305 exposed people, inhabitating 324 households (188 urban (58%); 136 rural (42%) of 1,448 houses total in the study area. An interview survey was performed in every selected family for a more realistic estimate of sting prevalence. Additionally, a prospective study was directed toward patients presenting scorpion stings at care at the local hospital over an 18-month period.
Results. The probability was 12.9 times greater of finding T. asthenes inside or around houses in places near to forest and high agrarian plantations (odds ratio=13). Eighty scorpion stings were reported in the retrospective study (4.1% prevalence [95% CI 3.3-4.8%] ), but only 14 of the patients (17.5%) sought care in the local hospital (an 82.5% underreportage). Seventy percent of the stings occurred in rural places; 50% occurred in the locality of Caucheras, with an attack rate of 10.6%. The overall household infestation rate was 269% (95% CI 22.9-30.8%) and an area dispersion ratio of 100%. Signs of systemic envenomization occurred mainly in children (67%). The 50% lethal dose of T. asthenes venom was 121.6 μg for 18-20 g Swiss Webster rats (95% CI 103.7-139.6). Immunodetection of T. asthenes and Centruroides gracilis/C.margantatus venoms in the experimental animals was possible when were tested by Western blot against Alacramyn® (Instituto Bioclón, México) and Soro antiaracnídico® (Instituto Butantan, Brasil) antivenoms. Scorpion interspecific differences were noted.
Conclusions. The prevalence of stings by T. asthenes were common and their presence was associated with tropical rainforests. Envenomization at low density can be neutralized efficiently by anti-scorpion antivenoms produced in México and Brazil but with differing specificities for the venom of each scorpion species.
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References
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2. Flórez DE. Escorpiones de la familia Buthidae (Chelicerata: Scorpiones) de Colombia. Biota Colombiana. 2001;2:25-30.
3. Lourenço WR, von Eickstedt VR. Escorpiões de importãncia médica. En: Cardoso JL, França FO, Fan HW, Málaque CM, Haddad J, ed. Animais peçonhentos no Brasil: biologia, clínica e terapêutica dos acidentes. São Paulo: Sarvier; 2003. p. 182-97.
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5. Gómez JP, Otero R. Ecoepidemiología de los escorpiones de importancia médica en Colombia. Rev Fac Nac Salud Pública. 2007;25:50-60.
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7. Rezende NA, Amaral CSF, Freire-Maia L. Immunotherapy for scorpion envenoming in Brazil. Toxicon. 1998; 36:1507-13.
8. Gibly R, Williams M, Walter FG, McNally J, Conroy C, Berg RA. Continuous intravenous Midazolam infusion for Centruroides exilicauda scorpion envenomation. Ann Emerg Med. 1999;34:620-5.
9. Dehesa-Dávila M, Possani LD. Scorpionism and serotherapy in Mexico. Toxicon. 1994;32:1015-8.
10. Ismail M. The treatment of the scorpion envenoming syndrome: The Saudi experience with serotherapy. Toxicon. 1994;32:1019-26.
11. Krifi MN, Miled K, Abderrazek M, El Ayeb M. Effects of antivenom on Buthus occitanus tunetanus (Bot) scorpion pharmacokinetics: Towards an optimization of antivenom inmunotheraphy in a rabbit model. Toxicon. 2000;39:1317-26.
12. Lourenço WR, Otero-Patiño R. Tityus antioquensis sp. a new species of scorpion from the Department Antioquia, Central Cordillera of Colombia (Scorpiones, Buthidae), with a checklist and key for the Colombian species of the genus. Ent Mitt Zool Mus Hamburg. 1998;12:297-07.
13. Lourenço WR. Synopsis de la faune de scorpions de Colombie, avec des considerations sur la systématique et la biogéographie des especes. Rev Suisse Zool. 1997;104:61-94.
14. Lourenço WR. Synopsis of the Colombian species of Tityus Koch (Chelicerata, Scorpiones, Buthidae) with descriptions of three new species. J Nat Hist. 2000;34:449-61.
15. Lourenço WR, Flórez E. Los escorpiones (Chelicerata) de Colombia. I. La fauna de la Isla Gorgona. Aproximación biogeográfica. Caldasia 1989;16:66-70.
16. Gómez JP, Velásquez P, Saldarriaga M, Díaz A, Otero R. Aspectos biológicos y ecológicos del escorpión Tityus fuhrmanni (Kraepelin, 1914), en poblaciones del cerro El Volador y barrios aledaños de la ciudad de Medellín. Actual Biol. 2002;24:103-11.
17. Gómez JP, Otero R, Núñez V, Saldarriaga M, Díaz A, Velásquez P. Aspectos toxinológicos, clínicos y epidemiológicos del envenenamiento producido por el escorpión Tityus fuhrmanni Kraepelin. Medunab. 2002;5:159-65.
18. Possani LD, Alagón AC, Fletcher JR, Erickson BW. Purification and properties of mammalian toxins from the venom of the Brazilian scorpions Tityus serrulatus Lutz and Mello. Arch Biochem Biophys. 1977;180:394-403.
19. Possani LD, Martin BM, Mochca-Morales J, Svendsen I. Purification and chemical characterization of the major toxins from the venom of the Brazilian scorpions Tityus serrulatus, Lutz and Mello. Carlsberg Res Commun. 1981;46:195-205.
20. Hering SE, De Azevedo-Marques MM, Cupo P. Escorpionismo. En: Schvartsman S, editor. Plantas venenosas e animais peçonhentos. Sao Paulo: Sarvier; 1992. p. 216-27.
21. Becerril B, Marangoni S, Possani LD. Toxins and genes isolated from scorpions of the genus Tityus. Toxicon. 1997;35:821-35.
22. Ceárd B, De Lima ME, Bougis P, Martín-Eauclaire MF. Purification of the main beta-toxin from Tityus serrulatus scorpion venom using high-performance liquid chromatography. Toxicon. 1992;30:105-10.
23. Otero R, Uribe FL, Sierra A. Envenenamiento escorpiónico en niños. Actualizaciones Pediátricas. 1998;8:88-92.
24. Cupo P, Jurca M, De Azevedo-Marques MM, Oliveira JS, Hering SE. Severe scorpion envenomation in Brazil. Clinical, laboratory and anatomopathological aspects. Rev Inst Med Trop. 1994;36:67-76.
25. Ismail M. The scorpion envenoming syndrome. Toxicon. 1995;33:825-58.
26. Freire-Maia L, Campos JA, Amaral CS. Approaches to the treatment of scorpion envenoming. Toxicon. 1994;32:1009-14.
27. Pineda D, Castellanos JA. Escorpionismo en Girardot. Hospital San Rafael, enero–junio de 1994. Tribuna Médica. 1998;98:19-28.
28. World Health Organization. Progress in the characterization of venoms and standardization of antivenoms. Geneva: WHO, 1981. p. 1-44.
29. Robles A, Gené JA. Determinación de la dosis letal 50% por el método de Spearman-Karber. Toxicalc. Instituto Clodomiro Picado, Universidad de Costa Rica, San José: Publicación Offset; 1990. p.1-6.
30. Laemmli UK. Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature. 1970;227:680-5.
31. Lomonte VB, Rojas LG. Inmunología: manual de laboratorio. San José de Costa Rica: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica; 1996.
32. Nishikawa AK, Caricati CP, Lima ML, Dos Santos MC, Kipnis TL, Eickstedt VR, et al. Antigenic cross reactivity among the venoms from several species of Brazilian scorpions. Toxicon. 1994;32:989-98.
33. Barona J, Otero R, Núñez V. Aspectos toxinológicos e inmunoquímicos del veneno del escorpión Tityus pachyurus Pocock de Colombia: capacidad neutralizante de antivenenos producidos en Latinoamérica. Biomédica. 2004;24:42-9.
34. Díaz A. Regresión lineal simple. En: Díaz A, editor. Diseño estadístico de experimentos. Medellín: Universidad de Antioquia; 1999. p. 231-61.
35. Gordis L. Epidemiología. 3ª edición. Madrid: Elsevier; 2005.
36. Londoño JL. Metodología de la investigación epidemiológica. 3ª edición. Bogotá: Manual Moderno; 2004.
37. Endler JA. Pleistocene forest refuges: fact or fancy? En: Prance GT, editor. Biological diversification in the tropics. New York: Columbia University Press; 1982. p. 644-57.
38. Segura E, Escobar-Mesa A. Epidemiología de la enfermedad de Chagas en el estado de Veracruz. Salud Pública Mex. 2005;47:201-8.
39. Borges A, García CC, Lugo E, Alfonzo MJ, Jowers MJ, Op den Camp HJ. Diversity of long-chain toxins in Tityus zulianus and Tityus discrepans venoms (Scorpiones, Buthidae): Molecular, immunological, and mass spectral analyses. Comp Biochem Physiol C Toxicol Pharmacol. 2006;142:240-52.
40. Borges A, De Sousa L, Espinoza J, Martins-Melo M, Santos R, Valadares D, et al. Characterization of Tityus venoms using synaptosome binding assays and reactivity towards Venezuelan and Braziliam antivenoms. Toxicon. 2008;51:66-79.
41. Marinkelle CJ, Stahnke HL. Toxicological and clinical studies on Centruroides margaritatus (Gervais), a common scorpion in western Colombia. J Med Entomol. 1965;2:197-9.
42. Spirandeli-Cruz EF, Winther-Yassuda CR, Jim J, Barraviera B. Programa de controle de surto de escorpião Tityus serrulatus, Lutz e Mello 1922, no Municipio de Aparecida, SP (Scorpiones, Buthidae). Rev Soc Bras Med Trop. 1995;28:123-8.
43. Calderon-Aranda ES, Riviére G, Choumet V, Possani LD, Bon C. Pharmacokinetics of the toxic fraction of Centruroides limpidus limpidus venom in experimentally envenomed rabbits and effects of immunotherapy with specific F(ab´)2 . Toxicon. 1999:37:771-82.
2. Flórez DE. Escorpiones de la familia Buthidae (Chelicerata: Scorpiones) de Colombia. Biota Colombiana. 2001;2:25-30.
3. Lourenço WR, von Eickstedt VR. Escorpiões de importãncia médica. En: Cardoso JL, França FO, Fan HW, Málaque CM, Haddad J, ed. Animais peçonhentos no Brasil: biologia, clínica e terapêutica dos acidentes. São Paulo: Sarvier; 2003. p. 182-97.
4. Otero R, Navio E, Céspedes FA, Núñez MJ, Lozano L, Moscoso ER, et al. Scorpion envenoming in two regions of Colombia: clinical, epidemiological and therapeutic aspects. Trans R Soc Trop Med Hyg. 2004;98:742-50.
5. Gómez JP, Otero R. Ecoepidemiología de los escorpiones de importancia médica en Colombia. Rev Fac Nac Salud Pública. 2007;25:50-60.
6. Dehesa-Dávila M, Alagón AC, Possani LD. Clinical toxicology of scorpion stings. In: Meier J, White J, editors. Handbook of clinical toxicology of animal venoms and poisons. Boca Raton: CRC Press; 1995. p. 221-38.
7. Rezende NA, Amaral CSF, Freire-Maia L. Immunotherapy for scorpion envenoming in Brazil. Toxicon. 1998; 36:1507-13.
8. Gibly R, Williams M, Walter FG, McNally J, Conroy C, Berg RA. Continuous intravenous Midazolam infusion for Centruroides exilicauda scorpion envenomation. Ann Emerg Med. 1999;34:620-5.
9. Dehesa-Dávila M, Possani LD. Scorpionism and serotherapy in Mexico. Toxicon. 1994;32:1015-8.
10. Ismail M. The treatment of the scorpion envenoming syndrome: The Saudi experience with serotherapy. Toxicon. 1994;32:1019-26.
11. Krifi MN, Miled K, Abderrazek M, El Ayeb M. Effects of antivenom on Buthus occitanus tunetanus (Bot) scorpion pharmacokinetics: Towards an optimization of antivenom inmunotheraphy in a rabbit model. Toxicon. 2000;39:1317-26.
12. Lourenço WR, Otero-Patiño R. Tityus antioquensis sp. a new species of scorpion from the Department Antioquia, Central Cordillera of Colombia (Scorpiones, Buthidae), with a checklist and key for the Colombian species of the genus. Ent Mitt Zool Mus Hamburg. 1998;12:297-07.
13. Lourenço WR. Synopsis de la faune de scorpions de Colombie, avec des considerations sur la systématique et la biogéographie des especes. Rev Suisse Zool. 1997;104:61-94.
14. Lourenço WR. Synopsis of the Colombian species of Tityus Koch (Chelicerata, Scorpiones, Buthidae) with descriptions of three new species. J Nat Hist. 2000;34:449-61.
15. Lourenço WR, Flórez E. Los escorpiones (Chelicerata) de Colombia. I. La fauna de la Isla Gorgona. Aproximación biogeográfica. Caldasia 1989;16:66-70.
16. Gómez JP, Velásquez P, Saldarriaga M, Díaz A, Otero R. Aspectos biológicos y ecológicos del escorpión Tityus fuhrmanni (Kraepelin, 1914), en poblaciones del cerro El Volador y barrios aledaños de la ciudad de Medellín. Actual Biol. 2002;24:103-11.
17. Gómez JP, Otero R, Núñez V, Saldarriaga M, Díaz A, Velásquez P. Aspectos toxinológicos, clínicos y epidemiológicos del envenenamiento producido por el escorpión Tityus fuhrmanni Kraepelin. Medunab. 2002;5:159-65.
18. Possani LD, Alagón AC, Fletcher JR, Erickson BW. Purification and properties of mammalian toxins from the venom of the Brazilian scorpions Tityus serrulatus Lutz and Mello. Arch Biochem Biophys. 1977;180:394-403.
19. Possani LD, Martin BM, Mochca-Morales J, Svendsen I. Purification and chemical characterization of the major toxins from the venom of the Brazilian scorpions Tityus serrulatus, Lutz and Mello. Carlsberg Res Commun. 1981;46:195-205.
20. Hering SE, De Azevedo-Marques MM, Cupo P. Escorpionismo. En: Schvartsman S, editor. Plantas venenosas e animais peçonhentos. Sao Paulo: Sarvier; 1992. p. 216-27.
21. Becerril B, Marangoni S, Possani LD. Toxins and genes isolated from scorpions of the genus Tityus. Toxicon. 1997;35:821-35.
22. Ceárd B, De Lima ME, Bougis P, Martín-Eauclaire MF. Purification of the main beta-toxin from Tityus serrulatus scorpion venom using high-performance liquid chromatography. Toxicon. 1992;30:105-10.
23. Otero R, Uribe FL, Sierra A. Envenenamiento escorpiónico en niños. Actualizaciones Pediátricas. 1998;8:88-92.
24. Cupo P, Jurca M, De Azevedo-Marques MM, Oliveira JS, Hering SE. Severe scorpion envenomation in Brazil. Clinical, laboratory and anatomopathological aspects. Rev Inst Med Trop. 1994;36:67-76.
25. Ismail M. The scorpion envenoming syndrome. Toxicon. 1995;33:825-58.
26. Freire-Maia L, Campos JA, Amaral CS. Approaches to the treatment of scorpion envenoming. Toxicon. 1994;32:1009-14.
27. Pineda D, Castellanos JA. Escorpionismo en Girardot. Hospital San Rafael, enero–junio de 1994. Tribuna Médica. 1998;98:19-28.
28. World Health Organization. Progress in the characterization of venoms and standardization of antivenoms. Geneva: WHO, 1981. p. 1-44.
29. Robles A, Gené JA. Determinación de la dosis letal 50% por el método de Spearman-Karber. Toxicalc. Instituto Clodomiro Picado, Universidad de Costa Rica, San José: Publicación Offset; 1990. p.1-6.
30. Laemmli UK. Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature. 1970;227:680-5.
31. Lomonte VB, Rojas LG. Inmunología: manual de laboratorio. San José de Costa Rica: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica; 1996.
32. Nishikawa AK, Caricati CP, Lima ML, Dos Santos MC, Kipnis TL, Eickstedt VR, et al. Antigenic cross reactivity among the venoms from several species of Brazilian scorpions. Toxicon. 1994;32:989-98.
33. Barona J, Otero R, Núñez V. Aspectos toxinológicos e inmunoquímicos del veneno del escorpión Tityus pachyurus Pocock de Colombia: capacidad neutralizante de antivenenos producidos en Latinoamérica. Biomédica. 2004;24:42-9.
34. Díaz A. Regresión lineal simple. En: Díaz A, editor. Diseño estadístico de experimentos. Medellín: Universidad de Antioquia; 1999. p. 231-61.
35. Gordis L. Epidemiología. 3ª edición. Madrid: Elsevier; 2005.
36. Londoño JL. Metodología de la investigación epidemiológica. 3ª edición. Bogotá: Manual Moderno; 2004.
37. Endler JA. Pleistocene forest refuges: fact or fancy? En: Prance GT, editor. Biological diversification in the tropics. New York: Columbia University Press; 1982. p. 644-57.
38. Segura E, Escobar-Mesa A. Epidemiología de la enfermedad de Chagas en el estado de Veracruz. Salud Pública Mex. 2005;47:201-8.
39. Borges A, García CC, Lugo E, Alfonzo MJ, Jowers MJ, Op den Camp HJ. Diversity of long-chain toxins in Tityus zulianus and Tityus discrepans venoms (Scorpiones, Buthidae): Molecular, immunological, and mass spectral analyses. Comp Biochem Physiol C Toxicol Pharmacol. 2006;142:240-52.
40. Borges A, De Sousa L, Espinoza J, Martins-Melo M, Santos R, Valadares D, et al. Characterization of Tityus venoms using synaptosome binding assays and reactivity towards Venezuelan and Braziliam antivenoms. Toxicon. 2008;51:66-79.
41. Marinkelle CJ, Stahnke HL. Toxicological and clinical studies on Centruroides margaritatus (Gervais), a common scorpion in western Colombia. J Med Entomol. 1965;2:197-9.
42. Spirandeli-Cruz EF, Winther-Yassuda CR, Jim J, Barraviera B. Programa de controle de surto de escorpião Tityus serrulatus, Lutz e Mello 1922, no Municipio de Aparecida, SP (Scorpiones, Buthidae). Rev Soc Bras Med Trop. 1995;28:123-8.
43. Calderon-Aranda ES, Riviére G, Choumet V, Possani LD, Bon C. Pharmacokinetics of the toxic fraction of Centruroides limpidus limpidus venom in experimentally envenomed rabbits and effects of immunotherapy with specific F(ab´)2 . Toxicon. 1999:37:771-82.
How to Cite
1.
Gómez JP, Quintana JC, Arbeláez P, Fernández J, Silva JF, Barona J, et al. Tityus asthenes scorpion stings: epidemiological, clinical and toxicological aspects. Biomed. [Internet]. 2010 Mar. 1 [cited 2025 Apr. 4];30(1):126-39. Available from: https://revistabiomedicaorg.biteca.online/index.php/biomedica/article/view/160
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