A hidden deadly venomous insect: First eco-epidemiological assessment and risk mapping of lonomism in Argentina

Author summary Caterpillars of the genus Lonomia (Saturniidae: Hemileucinae) are considered the world's most deadly lepidopterans. Due to the increasing number of cases and the lack of antivenom therapy, envenomation by these animals constitutes an emerging and somewhat neglected public health issue in Argentina and neighboring countries. Our research has determined the eco-epidemiological scenario of such an envenomation in the Argentine province of Misiones-mainly covered by the Atlantic Forest (a suitable biome for L. obliqua)-, and identified some predictors to occurrences/accidents with this insect. This study also provides the first map of the potential risk of lonomism in this province, which has several natural attractions visited by millions of tourists worldwide. We discussed our findings in light of immediate response from health authorities to outline preventive strategies for accidents and conservation of this venomous lepidopteran in its ecological niche. Background Envenomation by the South American Lonomia saturniid caterpillars, named lonomism, constitutes an emerging and somewhat neglected public health issue in Argentina and neighboring countries. Considering that there is an intricate relationship between environment and human health in such cases, this study aimed to analyze the eco-epidemiological profile of 40 accidents and 33 occurrences of Lonomia spp. in Misiones (Argentina) between January 2014 and May 2020. Methodology/Principal findings We described the eco-epidemiological variables and characterized the abiotic scenario of such cases. Additionally, we obtained a density map that shows the punctual intensity of Lonomia records throughout Misiones. Most of the accidents occurred in the Department of Guarani and involved male victims younger than 20 years old. The accidental/occasional occurrence of Lonomia spp. (considering both adult and caterpillar stages together) was significantly higher in the rural area, whereas only adult specimens were found in urban areas. We determined that the presence of this insect in Misiones is positively related to higher temperatures and solar radiation, and larger precipitation and evapotranspiration throughout the year. Conclusion/Significance This study represents an initial step towards the global understanding of lonomism as a public health problem in Argentina. It provides a map of the risk level for this envenomation in Misiones, which could help authorities address public health policy e