AMAZONIAN DISEASES IN ISOLATE POPULATIONS (M NACHER, SECTION EDITOR) Bothrops Snakebite Envenomings in the Amazon Region Dabor Resiere 1 & Wuelton Monteiro 2,3 & Stephanie Houcke 4 & Jean Marc Pujo 5 & Cyrille Mathien 4 & Claire Mayence 4 & Rémi Neviere 1 & Didier Hommel 4 & Jacqueline de Almeida Gonçalves Sachett 2,6 & Hossein Mehdaoui 1 & José María Gutiérrez 7 & Hatem Kallel 4 # Springer Nature Switzerland AG 2020 Abstract Purpose of Review Snakebite envenoming is a neglected tropical disease with a high burden in the Amazon basin. Our review aimed to give information about the epidemiology and the management of SB in the Amazon region. Recent Findings The Amazon basin, which comprises the largest portion of tropical rainforest on earth, includes territories of nine South American countries. The Amazon harbors a rich herpetofauna, among which the species of the Bothrops genus (family Viperidae) cause the highest number of bites and envenomings. The management of snakebite envenomings poses a difficult challenge for the public health systems of these countries for several reasons: bites occur in remote rural locations far from urban centers and health facilities; there are transportation difficulties for; health posts and personnel are in insufficient numbers; and antivenoms are insufficiently available in some regions. In addition, the species causing the highest number of accidents, i.e. Bothrops atrox, often causes severe envenomings. Summary The present review summarizes the main aspects of envenomings by Bothrops sp. snakes in the Amazonia, including the epidemiology, pathophysiology, clinical manifestations, and therapy of envenomings. In a context of global efforts to reduce the impact of snakebite envenomings, there is a need for international cooperative efforts by public health authorities and civil society in these countries. Keywords Amazonia . Snakebite . Bothrops sp. . Bothrops atrox . Epidemiology . Pathophysiology . Antivenom Introduction Snakebite envenoming is a neglected tropical disease hav- ing its highest burden in sub-Saharan Africa, Asia, and Latin America. It is estimated that 1.8 to 2.7 million cases of snakebite envenoming occur every year worldwide, resulting in 81,000 to 138,000 fatalities and an estimated 400,000 people left with some type of permanent physical and psychological sequelae [1••]. Snakebites predominantly affect young agricultural workers in socially and econom- ically vulnerable settings, thus being a typical “disease of poverty” [2]. This article is part of the Topical Collection on Amazonian Diseases in Isolate Populations * Hatem Kallel Kallelhat@yahoo.fr 1 Intensive Care Unit, Martinique University Hospital, Fort-de-France, Martinique 2 Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil 3 Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil 4 Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana 5 Emergency Department, Cayenne General Hospital, Cayenne, French Guiana 6 Diretoria de Ensino e Pesquisa, Fundação Alfredo da Matta, Manaus, Amazonas, Brazil 7 Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica Current Tropical Medicine Reports https://doi.org/10.1007/s40475-020-00203-4