title: Predictors of Bothrops jararaca venom allergy in snake handlers and snake venom handlers.
abstract: Since allergic sensitization to snake venom has been reported, anaphylactic reactions to snake venom might be an underestimated factor contributing to fatal snakebites, independently from the toxicity of the venom itself. However, little information is available on the determinants of such reaction. Hence, we studied a group of workers exposed to Bothrops jararaca venom (BJV), in order to clarify the factors related with snake venom allergy. The aim of this work was to investigate the prevalence and predictors of venom allergy among workers exposed to BJV and to confirm the involvement of IgE-mediated mechanisms in this condition. Workers exposed to BJV were assessed for venom allergy using questionnaires and immunological tests. The presence of BJV sensitization was determined through quantification of specific IgE. Allergens were studied using the Western blots and inhibition assays. Of the 67 workers evaluated, 7 (10.4%) presented specific IgE antibodies to BJV. Of those, 6 presented typical symptoms of an IgE-mediated allergic reaction when exposed to BJV. Venom sensitization was associated with length of employment (P=0.042), high levels of total IgE (P=0.034), atopy (P=0.051), and specific tasks, primarily the handling of dried venom (P=0.014). Our observations suggest that exposure to BJV can result in allergic sensitization in snake handlers through IgE-mediated mechanisms. The prevalence rate of this condition appears to be high among these workers, and the handling of dried venom, total IgE level above 100 kU/L, length of employment, and probably history of atopy were predictors of its occurrence.
authors.affiliation: Instituto Butatan, Hospital Vital Brazil, Av. Vital Brazil 1500, 05503-900 São Paulo, SP, Brazil. carlosrmedeiros@butantan.gov.br
authors.forename: Carlos R
authors.initials: CR
authors.lastname: de Medeiros
authors.forename: Kátia C
authors.initials: KC
authors.lastname: Barbaro
authors.forename: Marcela S
authors.initials: MS
authors.lastname: Lira
authors.forename: Francisco O S
authors.initials: FO
authors.lastname: França
authors.forename: Vera L
authors.initials: VL
authors.lastname: Zaher
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Kokron
authors.forename: Jorge
authors.initials: J
authors.lastname: Kalil
authors.forename: Fábio F M
authors.initials: FF
authors.lastname: Castro
mesh_terms: D000328:Adult; D000818:Animals; D017837:Bothrops; D003435:Crotalid Venoms / Q000276:immunology*; D003625:Data Collection; D005260:Female; D006801:Humans; D006967:Hypersensitivity; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
chemical_list: D003435:Crotalid Venoms; D007074:Immunoglobulin G; D007073:Immunoglobulin E