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Hernández-Muñoz EA, Zavala-Sánchez EV, Rubio-Atondo A, López-Chávez JA, Arredondo-Rojas V, Reyes-Reyes JS. Scorpion sting envenomation outbreak in Mexico. Strategies for prevention and control. Toxicon 2024; 237:107549. [PMID: 38061672 DOI: 10.1016/j.toxicon.2023.107549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/22/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023]
Abstract
In Mexico occurs 25% of all worldwide cases of scorpion sting envenomation (SSE). An outbreak of SSE was identified in Villa Unión, Sinaloa, Mexico. The objective of this study is to describe the outbreak, and prevention and control strategies implemented. The design was a cross-sectional study. Eligibility criteria included confirmed cases (n = 425) identified from the date the outbreak was recognized (from November 08, 2023 to July 10, 2023). The cases from Villa Unión (n = 231) were included for the analysis of epidemiological and clinical findings. The research followed the recommendations of the Initiative Reporting of studies Conducted Using Observational Routinely collected Data (RECORD). Of the total cases (n = 425), 398 (93.6%) were from the municipality of Mazatlán, and 231 (58%) were from Villa Unión. The incidence rate was 13.64 per 1000 persons. The average cases per week was 51.5(SD ± 12). The male-to-female ratio was 3:4, the average age was 30.7(SD ± 19) years. Most of cases occurred in the 25-44 age group. The sting occurred mostly inside houses (n = 200, 86.5%). The predominant symptoms were local pain (95.2%), and local paresthesia (75.8%). The Case fatality rate was 0%. Implementation of prevention and control strategies based on field epidemiological research and scientific evidence are necessary to reduce the incidence and prevent fatal complications.
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Affiliation(s)
- E A Hernández-Muñoz
- Unit of Epidemiological Surveillance, Family Medicine Unit N 53, Mexican Institute of Social Security, Avenida Juan Pablo II Esq Hidalgo 150 Zapopan, Col. Zapopan Centro, Zapopan 45100, Jalisco, Mexico; Postgraduate Specialty Program in Epidemiology, University Center of Health Sciences (CUCS), University of Guadalajara, Sierra Mojada 950, Puerta 7, Edificio A, Col. Independencia, Guadalajara C.P. 44340, Jal, Mexico; Coordination of Epidemiology and Preventive Medicine, Villa Unión Hospital N°16, Mexican Institute of Social Security, Leandro Valle y Carr. Internacional S/N Centro, Villa Unión, Mazatlán 82210, Sinaloa, Mexico; College of History and Philosophy of Medicine of the State of Guanajuato, León, Guanajuato, Mexico.
| | - E V Zavala-Sánchez
- Unit of Epidemiological Surveillance, Family Medicine Unit N 53, Mexican Institute of Social Security, Avenida Juan Pablo II Esq Hidalgo 150 Zapopan, Col. Zapopan Centro, Zapopan 45100, Jalisco, Mexico; Postgraduate Specialty Program in Epidemiology, University Center of Health Sciences (CUCS), University of Guadalajara, Sierra Mojada 950, Puerta 7, Edificio A, Col. Independencia, Guadalajara C.P. 44340, Jal, Mexico.
| | - A Rubio-Atondo
- Coordination of Epidemiology and Preventive Medicine, Villa Unión Hospital N°16, Mexican Institute of Social Security, Leandro Valle y Carr. Internacional S/N Centro, Villa Unión, Mazatlán 82210, Sinaloa, Mexico.
| | - J A López-Chávez
- Villa Unión Hospital N°16, Mexican Institute of Social Security, Villa Unión, Leandro Valle y Carr, Internacional S/N Centro, Mazatlán 82210, Sinaloa, Mexico.
| | - V Arredondo-Rojas
- Department of Vector-Borne and Zoonotic Diseases, Health Ministry, Río Culiacan 38, Tellería, Mazatlán, 82017, Sinaloa, Mexico.
| | - J S Reyes-Reyes
- Department of Epidemiology, Health Ministry, Río Culiacan 38, Tellería, Mazatlán 82017, Sinaloa, Mexico.
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Dehghani R, Ghorbani A, Varzandeh M, Karami-Robati F. Toxicity Mechanism of Dangerous Scorpion Stings in Iran. J Arthropod Borne Dis 2023; 17:105-119. [PMID: 37822761 PMCID: PMC10562200 DOI: 10.18502/jad.v17i2.13616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/29/2023] [Indexed: 10/13/2023] Open
Abstract
Background Considering the importance of scorpions and recognizing the mechanisms of toxicity caused by their medically important species in Iran and adopting the best therapeutic approach based on these mechanisms, this study was performed by reviewing the clinical manifestations of scorpion stings. Methods The research was conducted by searching for articles and researches in related websites (PubMed, EMBASE, Scopus, Web of Science and CINAHL) and using domestic and international authoritative journals using the keywords of scorpion, clinical manifestations, in a review method. Finally, 104 qualified sources were selected and after reviewing and criticizing these studies, the author's point of view was presented. Results Clinical manifestations of Scorpion sting toxicity vary due to the existence of two toxic classes of neurotoxins and cytotoxins or hemotoxins in these arthropods in Iran. The number and distribution of species with neurotoxic venom are higher than the scorpions with cytotoxic venom and are reported throughout Iran. Scorpions with cytotoxic venom are mostly widespread in south and southwest of Iran. Conclusion Treatment and prevention of scorpion stings in Iran and neighboring countries in the Middle East should be planned based on the mechanism of toxicity and the presence of toxic classes with neurotoxic or cytotoxic venoms.
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Affiliation(s)
- Rouhullah Dehghani
- Social Determinants of Health (SDH) Research Center and Department of Environmental Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Ahmad Ghorbani
- Toxicology Research Center, Medical Basic Sciences Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Masoomeh Varzandeh
- Department of Clinical Toxicology and Poisoning, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Karami-Robati
- Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
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Abstract
INTRODUCTION The preponderance of medical literature regarding severe bark scorpion envenomation describes pediatric patients; however, the majority (>66%) of annual poison center calls pertain to adults. This retrospective review sought to evaluate the clinical manifestations of adults with severe Centruroides sculpturatus envenomation and determine if significant morbidity occurred. METHODS This is a retrospective review of adults presenting to a single tertiary referral center with Grade-III or Grade-IV scorpion envenomation from 1 January 2007 to 3 March 2013. The primary objective is to describe clinical findings, treatment strategies, complications and short-term outcomes. RESULTS Thirty-three patients were included; 61% were female (20/33), average age was 40.7 (19-81) years. The average time to healthcare facility was 142 (14-720) minutes. The most common signs and symptoms of envenomation were: pain/paresthesias 94%, opsoclonus 82%, excessive motor activity 76%, visual disturbance 76%. Benzodiazepines 85% (29/33) and opioids 83% (28/33) were the most frequently used agents to control envenomation. Cardiac evaluation was performed in 24% of patients, 6% were pregnant and underwent fetal monitoring, 6% were intubated and 3% developed rhabdomyolysis. Average length of stay (LOS) was 28.3 (1.5-307) hours; 58% (19/33) required hospital admission. Four patients had LOS >48 h, with pre-existing cardiac disease, substance misuse disorder, acute ethanol withdrawal and medical errors identified as factors contributing to prolonged LOS. CONCLUSIONS Bark scorpion envenomation in adults may be severe, necessitating medical intervention and hospital admission. Comorbid conditions and complications arising from treatment may contribute to prolonged LOS.
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Affiliation(s)
- Ayrn D O'Connor
- a Department of Medical Toxicology , Banner - University Medical Center Phoenix , Phoenix , AZ , USA.,b Center for Toxicology and Pharmacology Education and Research , University of Arizona College of Medicine - Phoenix , Phoenix , AZ , USA.,c Division of Medical Toxicology and Precision Medicine, Department of Medicine , University of Arizona College of Medicine - Phoenix , Phoenix , AZ , USA
| | - Angela Padilla-Jones
- d Banner Research Institute , Banner - University Medical Center Phoenix , Phoenix , AZ , USA.,e Division of Clinical Data Analytics and Decision Support, Department of Medicine , University of Arizona College of Medicine - Phoenix , Phoenix , AZ , USA
| | - Anne-Michelle Ruha
- a Department of Medical Toxicology , Banner - University Medical Center Phoenix , Phoenix , AZ , USA.,b Center for Toxicology and Pharmacology Education and Research , University of Arizona College of Medicine - Phoenix , Phoenix , AZ , USA.,c Division of Medical Toxicology and Precision Medicine, Department of Medicine , University of Arizona College of Medicine - Phoenix , Phoenix , AZ , USA
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ElFessi-Magouri R, Peigneur S, Khamessi O, Srairi-Abid N, ElAyeb M, Mille BG, Cuypers E, Tytgat J, Kharrat R. Kbot55, purified from Buthus occitanus tunetanus venom, represents the first member of a novel α-KTx subfamily. Peptides 2016; 80:4-8. [PMID: 26079392 DOI: 10.1016/j.peptides.2015.05.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/26/2015] [Accepted: 05/28/2015] [Indexed: 01/13/2023]
Abstract
Kbot55 is a 39 amino acid peptide isolated from the venom of the Tunisian scorpion Buthus occitanus tunetanus. This peptide is cross-linked by 3 disulfide bridges and has a molecular mass of 4128.65Da. Kbot55 is very low represented in the venom and thus represents a challenge for biochemical characterization. In this study, Kbot55 has been subjected to a screening on ion channels expressed in Xenopus laevis oocytes. It was found that Kbot55 targets voltage-gated potassium channels with high affinity. Kbot55 shows very low amino acid identity with other scorpion potassium toxins and therefore was considered a bona fide novel type of scorpion toxin. Sequence alignment analysis indicated that Kbot55 is the first representative of the new α-Ktx31 subfamily and therefore was classified as α-Ktx31.1.
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Affiliation(s)
- Rym ElFessi-Magouri
- Laboratoire des Venins et Molécules Thérapeutiques, Institut Pasteur de Tunis, 13 Place Pasteur, BP-74, 1002 Tunis, Tunisia
| | - Steve Peigneur
- Toxicology & Pharmacology, University of Leuven (K.U. Leuven), Campus Gasthuisberg O&N2, Herestraat 49, P.O. Box 922, B-3000 Leuven, Belgium
| | - Oussema Khamessi
- Laboratoire des Venins et Molécules Thérapeutiques, Institut Pasteur de Tunis, 13 Place Pasteur, BP-74, 1002 Tunis, Tunisia
| | - Najet Srairi-Abid
- Laboratoire des Venins et Molécules Thérapeutiques, Institut Pasteur de Tunis, 13 Place Pasteur, BP-74, 1002 Tunis, Tunisia
| | - Mohamed ElAyeb
- Laboratoire des Venins et Molécules Thérapeutiques, Institut Pasteur de Tunis, 13 Place Pasteur, BP-74, 1002 Tunis, Tunisia
| | - Bea Garcia Mille
- Toxicology & Pharmacology, University of Leuven (K.U. Leuven), Campus Gasthuisberg O&N2, Herestraat 49, P.O. Box 922, B-3000 Leuven, Belgium
| | - Eva Cuypers
- Toxicology & Pharmacology, University of Leuven (K.U. Leuven), Campus Gasthuisberg O&N2, Herestraat 49, P.O. Box 922, B-3000 Leuven, Belgium
| | - Jan Tytgat
- Toxicology & Pharmacology, University of Leuven (K.U. Leuven), Campus Gasthuisberg O&N2, Herestraat 49, P.O. Box 922, B-3000 Leuven, Belgium
| | - Riadh Kharrat
- Laboratoire des Venins et Molécules Thérapeutiques, Institut Pasteur de Tunis, 13 Place Pasteur, BP-74, 1002 Tunis, Tunisia.
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Elatrous S, Ouanes-Besbes L, Ben Sik-Ali H, Hamouda Z, BenAbdallah S, Tilouche N, Jalloul F, Fkih-Hassen M, Dachraoui F, Ouanes I, Abroug F. Study of severe scorpion envenoming following subcutaneous venom injection into dogs: Hemodynamic and concentration/effect analysis. Toxicon 2015; 104:1-6. [PMID: 26166304 DOI: 10.1016/j.toxicon.2015.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 06/27/2015] [Accepted: 07/01/2015] [Indexed: 11/30/2022]
Abstract
To evaluate the dose-effects of Androctonus australis hector (Aah) venom injected subcutaneously on hemodynamics and neurohormonal secretions, 10 anesthetized and ventilated mongrel dogs, were split in two groups (n = 5/group). Subcutaneous injection was done with either 0.2 mg/kg or 0.125 mg/kg of the purified G50 scorpion toxic fraction. Hemodynamic parameters using right heart catheter were recorded and plasma concentrations of catecholamine, troponin, and serum toxic fraction were measured sequentially from baseline to 120 min. We identified the dose of toxic fraction evoking characteristic hemodynamic perturbation of severe envenomation, the time-lapse to envenomation, and the associated plasma level. The injection of 0.125 mg/kg toxic fraction was not associated with significant variations in hemodynamic parameters, whereas the 0.2 mg/kg dose caused envenomation characterized by significant increase in plasma catecholamines, increased pulmonary artery occluded pressure, mean arterial pressure, and systemic vascular resistance (p < 0.05), in association with sustained decline in cardiac output (p < 0.001). Envenomation occurred by the 30th minute, and the corresponding concentration of toxic fraction was 1.14 ng/ml. The current experiment allowed the identification of the sub-lethal dose (0.2 mg/kg) of the toxic fraction of Aah administered by the subcutaneous route. Two parameters with potential clinical relevance were also uncovered: the time-lapse to envenomation and the corresponding concentration of toxic fraction.
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Affiliation(s)
- Souheil Elatrous
- Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Tahar Sfar. Mahdia, University of Monastir, Tunisia.
| | - Lamia Ouanes-Besbes
- Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia
| | - Habiba Ben Sik-Ali
- Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Tahar Sfar. Mahdia, University of Monastir, Tunisia
| | - Zineb Hamouda
- Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia
| | - Saoussen BenAbdallah
- Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia
| | - Nejla Tilouche
- Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Tahar Sfar. Mahdia, University of Monastir, Tunisia
| | - Faten Jalloul
- Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia
| | - Mohamed Fkih-Hassen
- Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Tahar Sfar. Mahdia, University of Monastir, Tunisia
| | - Fahmi Dachraoui
- Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia
| | - Islem Ouanes
- Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia
| | - Fekri Abroug
- Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia
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