Scorpion stings rarely cause deaths in adults and only a few deaths have been reported in very young children, said Professor Courtenay Bartholomew, Emiritus Professor of Medicine at the University of the West Indies.
Prof Bartholomew, responding to a story on Newsday, June 20, which reported Allyson Dookie, 19, as having surviving a sting from a scorpion, said there was much relative ado about nothing with respect to deaths from scorpion stings.
Scorpion stings are very common in Trinidad and Tobago and how it affects young children would depend on the question of the dose of the scorpion venom and the body weight of the victim, he said. Dookie was stung by a scorpion on her right leg and was taken to the San Fernando General Hospital where her parents were told that the hospital’s supply of intravenous fluid had run out.
Prof Bartholomew, responding to the report, said that as regards scorpion stings, Dr Theo Poon King in 1963, had noted that cardiac and respiratory irregularities may occur as well as minor electrocardiographic (ECG) changes and that other cardiac irregularities have been reported by other researchers.
Bartholomew said, however, that much more common and scientifically interesting was the effect of the scorpion of Trinidad, Tityus trinitatis, on the pancreas. This scorpion accounts for almost 90 percent of the scopion population in Trinidad and Tobago. It is commonly found under logs and debris in forests, in sugar canefields, in banana, cocoa and coconut plantations, and sometimes even in houses, mainly in rural areas,
Professor Barthlomew said the scorpion does not always inject venom when it stings as its sack may be empty or only partially filled.
Referring to 1969 data for the months of July and August when over 30 cases of scorpion stings were referred to the University Unit at the Port-of-Spain General hospital, most of them having been referred from the district hospitals of Arima and Sangre Grande which served the rural population, he noted that, “Laboratory evidence of a rise in serum amylase, indicating the development of an acute inflammation of the pancreas, was observed in 16 (53 percent) of the (30) patients, all of whom had abdominal pain but made uneventful recoveries.”
Worldwide clinical papers have recorded that Tityus trinitatis as the only scorpion in the world which causes an acute pancreatitis, Professor Bartholomew also said.On a research grant by the Welcome Trust Foundation of London, to study the scientific mechanism of the venom’s ability to cause acute pancreatitis and cardio-respiratory effects, Professor Bartholomew went to the Institute Butantan in Sao Paulo, Brazil, one of the world’s leading research centres on the venoms and antivenoms of snakes and scorpions, to have discussions with scientists there.
Back in Trinidad, the professor proceeded to conduct research based on his Brazil studies. Hundreds of scorpions were collected at night in the Mayaro forest, identified on trees with an ultraviolet flourescent light which made them bright green.
Applying the technique of milking the venom which he has learnt in Brazil, and conducting research on mice and guinea pigs in a CAREC laboratory assigned to him in 1974, he subsequently travelled to Dublin Ireland to do collaborative studies with the Irish university colleagues on mongrel dogs.
The research showed that the scorpion venom exerts its toxicity by the release of a chemical called acetylcholine and not due to any allergic reaction.
Barthlomew’s original work has been published in several medical journals including the British Journal of Surgery, the British Medical Journal and in several textbooks of medicine.
As for the need for an antivenom, Professor Bartholomew said discussions at the Insitutute Buntant concluded that it would be more dangerous to give any anti-venom to the scorpion Tityus trinitatis, which needs to be given intravenously (10m) and which could cause anaphylactic reactions.
Conservative clinical management has been deemed to be all that is needed, he said.
