Injuries by marine and freshwater stingrays: history, clinical aspects of the envenomations and current status of a neglected problem in Brazil

Abstract

Stingrays are a group of rays – cartilaginous fish related to sharks – that have whiplike tails with barbed, usually venomous spines and are found around the world, especially the marine species. Despite recent reports of accidents involving these fish, they are not aggressive, reacting only when stepped on or improperly handled. Injuries by stingrays are seldom mentioned by historians, although they have always been present in riverine communities of inland waters and in South American coasts. Indeed, envenomations by stingrays are quite common in freshwater and marine fishing communities. Although having high morbidity, such injuries are neglected because they have low lethality and usually occur in remote areas, which favor the use of folk remedies. In the present review article, historical aspects of injuries caused by stingrays in Brazil and their distribution on the coast of São Paulo state and riverine communities of the North, Midwest and Southeast regions were studied. In addition, other aspects were analyzed such as clinical features, therapeutic methods, preventive measures and trends in occurrence of these accidents in the country, particularly in areas in which freshwater stingrays had not been previously registered, being introduced after breaching of natural barriers.

Injuries and envenomation by exotic pets in Hong Kong

“…They are regarded as dangerous by the native people of the Amazon and frequent sting during fishing season. 19 Freshwater stingrays are not aggressive by nature; stings frequently occur when people step on them or handle them improperly. Different species of freshwater stingrays have different colour patterns on their body.…”

Case Report: Iatrogenic Infection from Traditional Treatment of Stingray Envenomation

“…On impalement, the secreting cells are unroofed and the venom diffuses into the wound causing damaging effects locally through vasoconstriction, leading to ischemia and necrosis. 8,9 The most frequent symptoms/signs after an injury are local pain, swelling, erythema, bruising, and inflammation. Generalized symptoms such as nausea, abdominal pain, shortness of breath, and signs of cardiac arrhythmias are rare (< 5%).…”

Accident and vascular injury with stingray in the Alto Juruá, Acre, Brazil: a case report

“…Passive poisoning occurs through the ingestion of poisonous fish such as pufferfish 1,2 . There are other fish that are venomous (eg stingrays, lionfish, rockfish) and can cause poisoning through stings 1,3 .…”

“…Poisoning by this type of stingray is considered very serious and one of the most important injuries caused by aquatic animals in South America 6 . Stingray accidents cause severe local pain, erythema, edema, ulceration and skin necrosis, and secondary infections and retention of sting fragments may occur in the wound 3 .…”

“…Complications such as amputation of fingers, hands and feet may also occur 3,5 . Less frequent are fatal cases caused by freshwater and marine stingrays, resulting from immediate penetrating chest trauma or delayed cardiac tamponade, cervical lacerations with airway compromise, vascular injury with hemorrhagic shock, gangrene wound infections and septic shock 7 .…”