Friday, 7 February 2014

Attacks by Jaguars (Panthera onca) on Humans in Central Brazil

Report of Three Cases, with Observation of a Death


Manoel Francisco Campos Neto, MD; Domingos Garrone Neto, MSc, PhD; Vidal Haddad Jr, MD, MSc, PhD

From the Forensic Medicine Section – POLITEC – Cáceres, Mato Grosso State, Brazil (Dr Campos Neto); Post-Graduation in Zoology, Sacred Heart University, Bauru City, São Paulo State, Brazil (Dr Garrone Neto); Botucatu School of Medicine, UNESP, São Paulo, Univ Estadual Paulista and Vital Brazil Hospital, Butantan Institute, Post-Graduation in Zoology, Biosciences Institute, Univ Estadual Paulista, São Paulo, Brazil (Dr Haddad).

Conflicts between humans and big cats have been known for centuries throughout the world, but have intensified in recent decades. Recently, attacks by Panthera onca on humans in Brazil have been brought to the forefront through exposure in the press and because of the severity of the attacks. We report 3 cases of patients attacked by jaguars in provoked and predatory situations. Two patients survived the attacks and one died. Attack mechanisms and lesions in victims are discussed. The attacks demonstrate a real risk of accidents from jaguars in certain regions, such as the Pantanal and the Amazon.

Although conflicts between humans and big cats have been known for centuries throughout the world, they have become especially prevalent in areas where expansion of urban centers and agricultural frontiers has decreased the habitat size of these animals.
Urban expansion, in addition to restricting and even preventing genetic diversity among remnant populations, reduces the availability of natural prey.
Species are forced to hunt outside of their protected areas, which may result in unintended consequences for both man and animal.
Worldwide, hundreds of deaths are caused by large cat attacks annually. In Tanzania, East Africa, it is estimated that over 1000 people have been attacked by lions (Panthera leo) in the last 20 years.4 Between 1984 and 2000, in the mangrove forests of eastern India and western Bangladesh, statistics show that at least 401 human deaths have occurred after attacks by Bengal tigers (Panthera tigris tigris), an average of 24 deaths per year.

In the Americas, the 2 species of big cats are the jaguar (Panthera onca) and the puma (Puma concolor). The jaguar is the third largest cat in the world, reaching more than 2.5 meters in length and 110kg in weight. Its original distribution included all southern United States and Latin America, but today it is restricted to the Amazon rainforest, the Pantanal (a vast wetland situated on the border of Brazil, Paraguay, and Bolivia), and protected areas of the Atlantic Forest in eastern Brazil.The cougar, also known as the mountain lion, puma, or as the suçuarana in Brazilian Indian language (P. concolor), has a wider distribution and greater tolerance to the environmental changes occurring in different habitats, ranging from Canada to Patagônia. Both species have a history of attacking humans, although only negative interactions between P. concolor and humans have been reported in the medical literature, with 20 deaths and at least 82 nonfatal attacks occurring in the United States and Canada between 1890 and 2001.

Recently, some attacks by P. onca on humans have occurred in Brazil and have been brought to the forefront through exposure in the press and because of the severity of the attacks. In this article, we report 3 P. onca attacks in humans in midwestern Brazil, in transition areas among 3 major South American ecosystems—the Cerrado (savannahlike regions), the Pantanal, and the Amazon region— highlighting the problem posed by environmental change and changing human attitudes towards wildlife.

Case Summaries
Case 1: In May 2007, a 40-year-old male Aweti Indian suffered a nonfatal attack while traveling through the woods on the shores of Lake Ipawu in the Upper Xingu Indian Reserve. The victim was traveling to a cassava plantation early in the morning accompanied by 2 dogs. The dogs attacked a jaguar lurking just off the trail, about 300 m from the village. Initially, the jaguar avoided confrontation with the dogs but eventually attacked them after dropping from the tree where it had been cornered.

The attack in Case 1 was provoked by the victim’s dogs that hunted the jaguar. Brazilian Indians kill jaguars to demonstrate power and prestige (see the necklace with the claws). Note the victim's scars. Photographs: Domingos Garrone Neti.

Armed with a machete and a stick of wood, the victim tried to help the dogs by fighting the jaguar. He saw that his dogs had been killed and he tried to flee but he was bitten immediately on the left shoulder.
The victim struck the animal in the head with the machete and the jaguar released its grip. When he struck more blows with the machete, the jaguar attacked from the front, scratching the victim deeply on the chest and left forearm. At that moment, another Indian and his dog came to the victim’s aid.

The jaguar attacked and killed the third dog but the owner eventually drove the jaguar away and it disappeared into the woods. The victim was taken back to the village, where he was treated by the tribe’s shaman. The shaman applied herbal preparations to the injuries. He now only shows the scars of the scratches caused by the attack.

Case 2: Around 6 PM on July 14, 2010, a 17-year-old white male from Mateus Lemos (Minas Gerais State)was attacked while returning from a fishing trip in Caceres, Mato Grosso State, in North Pantanal. His companions reported that a jaguar jumped out of a ravine onto the boat and bit the victim on the right shoulder, tipping him into the water.
Shortly after, the jaguar surfaced in the river with the victim’s head between its teeth. The boat skipper then smashed an iron pipe into the jaguar nd the animal released the victim and escaped into the ravine.
The first responder on scene applied compressive bandaging to the injuries of the scalp. En route to medical care they encountered another boat that had a doctor aboard; that doctor improved placement of the compressive bandages, established venous access, and administered intravenous saline solution, an antibiotic (cephalosporin), an anti-inflammatory, and analgesics. He also recommended the administration of rabies and tetanus vaccinations.
The victim was admitted to a hospital about 8 hours after the attack. Physical examination showed perforations from the jaguar’s fangs (marked in the fractured and extracted bone fragments of the skull) and facial, right arm, and right back scratches, as well as perforations to the victim’s body. He was diagnosed with cranial-encephalic trauma, with brain and bone tissue loss on the left side of the head.
Surgeons removed bone fragments and devitalized brain tissue, repaired the dura mater, and sutured skin lesions with rigorous attention to hemostasis of affected vessels. The victim survived and currently has a memory deficit (traumatic amnesia and aphasia) and awaits further surgery for placement of a cranial acrylic prosthesis.

Case 3: A 21year-old fisherman from Cáceres (Mato Grosso State) was attacked in a remote area of Cáceres county. The attack occurred around 7: 30 PM on June 24, 2008, in a place known as “Pacu Gordo” on the banks of the Paraguay River near Taiamã Nature Reserve. It is an open site, measuring about 25 m wide and 10 m deep, surrounded by native vegetation with poor natural lighting, requiring the use of open fire and artificial lighting so that fishermen can spend the night. The victim was sleeping in a tent with the entrance closed.
The animal entered the tent and inflicted bites to the posterior cervical region and head of the fisherman (bilaterally, with tissue and bone loss) as well as claw scratches and punctures, especially in the pectoral region and the back of the shoulders and limbs.
Death was attributed to high cervical transection of the spinal cord. The body was dragged approximately 60 m into the woods and recovered by fishermen who responded to a radio warning from the victim’s father. The attack was classified as predatory.
Necropsy, performed by one of the authors (MFCN), described the following: The body had comminuted fractures (several fragments) associated with traumatic dislocation of the cervical spine, with severe spinal cord injury, cerebrospinal fluid leakage, tissue loss, and multiple lesions from mixed action (perforations, cuts, and contusions) directed to the posterior regions of the cervical spine.
There were significant vascular-nerve cervical lesions (arteries, veins, and nerves) and traumatic brain injury with fracture and tearing of part of the left hemicranium and perforations and scratches from claws on various parts of the body.

Discussion and Conclusions
The 3 attacks took place under different situations. In the first case, the jaguar was likely provoked after being cornered by the dogs. The outcome of this encounter did not result in the victim’s death probably because of his defensive reaction, striking the animal’s face, and the support from a passerby.
The second and third attacks, however, could be considered predatory in nature.
In Case 2 (non-fatal attack), the jaguar held the young man’s head with its fangs thereby restraining its prey in an unprovoked attack. The blows from an iron pipe forced the cat to abandon its prey and flee. A combination of factors contributed to the patient’s survival, despite the long interval between the attack and the medical treatment. These measures included field first aid measures to control the bleeding, intravenous medication administration, and a lack of major vessel involvement along with the protection given by the skull and subsequent efforts of the medical team headed up by a neurosurgeon.
In Case 3, the situation was by definition a predatory attack, as the animal broke into the tent where the victim was sleeping, attacked the posterior cervical region and dragged the body into the woods. The locations of the bites, punctures, and scratches reinforce these observations (prey immobilization and restraint), adding a sequential character to the predation movements. The marks and trauma to the victim’s body suggested some characteristic features of jaguar attacks: the main injuries (possibly causing instantaneous death) were bites to the cervical spine with torn nerve, muscle, and cutaneous tissue, as well as cervical vertebrae fractures; the force of the bite and rotational movements to promote spine displacement is characteristic of prey kills by this species. Other lesions were the perforations caused by the claws when gripping the victim’s shoulders (indicating a strong compression into the ground at the time of restraint and feeding). There was also a skull fracture with tissue removal on the side of the head (mainly the left side), associated with the beginning of feeding, and multiple scratch marks on the upper chest (anterior, near the neck and back) and on proximal portions of the upper moving the victim and starting to feed.

These attacks, although different in motivation, demonstrate that the risk of accidents from jaguars (P. onca) is real in certain regions. Important factors contributing to this risk include the increasing loss of hunting habitats and availability of wild prey (pecaris, deer, and capibaras), the destruction and fragmentation of jaguars’ natural habitat, as well as the intentional presence of tourists, fishermen, and hunters in territorial areas of adult animals during the mating season or when they have offspring.
The treatment of attacks by big cats is multifactorial. The patient usually presents with extensive skin lacerations and may have fractures and neurovascular injuries, especially in the neck and head. Ideally, these injuries should be managed in a trauma center by a surgical team employing radiological examinations searching for possible fractures. Suturing the wounds may be necessary (there are 3 considerations to suture a wound caused by a wild animal: cosmetics, function, and risk factors) but predisposes them to infection caused mainly by streptococci and staphylococci and, rarely, Pasteurella multocida. The preparation and cleansing of the wounds to be sutured are main factors in the success of the measure.

The risk factors for infection are:
1) location of the lesions (for example higher risk in areas of compromised vascularity);
2) type of the wound (deep punctures, macerated/ crushed tissue are associated with joint or fracture contamination);
3) the characteristics of the victim (older than 50 years, chronic diseases, immunocompromised); and 4) biting species (large cats produce deep punctures).

The use of prophylactic antibiotics is not recommended in all cases but should be reserved for use in moderate-to-high risk cases. If used, antibiotics must be administered early and the recommended antibiotics include a penicillin and a first generation cephalosporin, or a second generation cephalosporin or Clindamycin and a fluoroquinolone.

Tetanus prophylaxis is necessary and rabies post-exposure prophylaxis treatment may be indicated depending on the epidemiology of terrestrial rabies in the specific area. In the Porto Jofre region (Cáceres county) and the west and north regions of the Pantanal, package tours are offered to view jaguars in the wild. The animals are attracted with food (cevas) or by simulating calls made by females in the breeding season, using the esturrador, a type of instrument made from bamboo (MFCN, personal observation). These practices have made human presence less intimidating for certain animals.

Big cats can become very dangerous when surprised by sudden movements or unwary postures by tourists, especially during the mating season or when cubs are present.

Jaguar hunting has been practiced for centuries among the indigenous peoples in the Upper Xingu Reserve, who inhabit the protected areas of Mato Grosso State. Hunting is stimulated by social prestige of wearing the fur and claws from a jaguar.

One of the authors (DGN), during field work conducted in the Gaucha do Norte and Canarana municipalities (Mato Grosso State) reported 16 jaguar specimens killed by a single hunter over a period of about 10 years.

Case 1 (non-fatal attack on the Aweti Indian) mimicked circumstances when hunting jaguars, where dogs are used to corner the cats in trees or water. It is noteworthy that jaguar attacks under natural conditions are rare and that these animals prefer to feed on natural prey such as capybara (Hydrochoerus hydrochaeris), peccaries (Pecari tajacu and Tayassu peccary), tapirs (Tapirus terrestris), and caimans (Alligatoridae family). The disappearance of wild spaces, however, has limited their pursuit of natural prey, and these animals need large areas to survive. This fact has favored the increase of conflicts between big cats and man in many locations around the world.

Efforts by governmental and nongovernmental organizations in recent decades have had some success in finding ways to minimize the deleterious effects of these contacts and to preserve the species.

There are projects to indemnify farmers in areas where jaguars attack cattle, minimizing the impact of predation and compensating the farmers to prevent hunting of jaguars. Other organizations follow the movement of jaguars through electronic monitoring, contributing to jaguar preservation.

However, such encounters and potential fatalities in human/jaguar encounters may continue to occur in places where there is limited awareness of the potential threat, and when jaguar habitat and natural prey are compromised.

The authors would like to thank Centro Nacional de Pesquisas para a Conservação de Predadores Naturais (CENAP) for information on the fatal attacks.

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