Lonomia envenomation in Brazil: an epidemiological overview for the period 2007-2018

Abstract

Background: Among the Lepidoptera with medical importance in Brazil, larvae of Lonomia moth (Saturniidae: Hemileucinae) stand out by being the etiological agent of the lonomism, a form of erucism in which the most troubling symptoms include systemic hemorrhage that can lead to death. Methods: This study provides an epidemiological overview of accident notifications with Lonomia registered by the Brazilian Reportable Disease Information System (SINAN) between 2007 and 2018. The categories of sociodemographic aspects of the victim, accident characteristics, and clinical data (6,636 records) were analysed by the chi-square test for goodness of fit (α=0.05). By the same test, accident frequencies by month, year, and state were also compared. To explore the spatial distribution of notifications and to identify significant space-time and purely spatial clusters, a spatial scan statistic (SaTScan) was used. Results: The epidemiological profile of most of the victims had at least one of the following characteristics: male, >50 y of age, ethnically classified as white, and with a low level of education. Accidents in urban areas were as frequent as in rural areas. A higher frequency of non-work-related accidents was detected. Victims were mostly stung on the upper limbs. Most victims received medical care within the first 3 h after the accident. Most cases were classified as mild, although 12 deaths were reported. The south states of Brazil concentrate the highest frequencies of notifications. Summer was the season with the greatest number of cases, and the majority of the notifications occurred between 2017 and 2018. Conclusion: These results provide an overall and current situation assessment of the lonomism in Brazil, and they should enable health authorities to improve the management of this envenomation in states/regions that share the high epidemiological risk of exposure to Lonomia.