Epidemiology of accidents by venomous animals and distribution of antivenon: State of art and world status

Abstract

Accidents by venomous animals are discussed under the historical perspective of state actions. Considered as neglected diseases, they cause social and economic losses in the working age population from rural areas of poor countries, as few of them have public health policies for adequate prophylaxis and treatment; in fact, the largest life losses occur in Africa and Asia. The 46 world producers of antivenin do not meet the global needs, making access to treatment difficult, even in countries with own production. Notification systems lead to inaccurate surveillance surveys and antivenin needs. Despite mandatory notification, Brazil lacks robust databases with full open access in order to allow the timely distribution of antivenin for quality care of these patients. Progress has been made in diagnostic testing, but its application in poor areas is not feasible due to high costs. Improvements in quality antivenin production through good laboratory practices and manufacturing minimize unsatisfactory results of treatments carried out with products of dubious origin. Antivenin development using biotechnology and well-designed clinical trials are key for the treatment of envenoming by agents phylogenetically related from different regions (continental or universal antivenins). International partnerships are fundamental, besides regulatory stocks, similarly to those adopted for vaccines, to supply world demand. The qualification of antivenin will certainly minimize treatment mistakes. Government support to research is a driving force and the most efficient tool for preserving life and avoiding social security surcharges, particularly in developing countries.