Incidence and mortality due to snakebite in the Americas

Abstract

BackgroundBetter knowledge of the epidemiological characteristics of snakebites could help to take measures to improve their management. The incidence and mortality of snakebites in the Americas are most often estimated from medical and scientific literature, which generally lack precision and representativeness.Methodology/Principal findingsAuthors used the notifications of snakebites treated in health centers collected by the Ministries of Health of the American countries to estimate their incidence and mortality. Data were obtained from official reports available on-line at government sites, including those of the Ministry of Health in each country and was sustained by recent literature obtained from PubMed. The average annual incidence is about 57,500 snake bites (6.2 per 100,000 population) and mortality is close to 370 deaths (0.04 per 100,000 population), that is, between one third and half of the previous estimates. The incidence of snakebites is influenced by the abundance of snakes, which is related to (i) climate and altitude, (ii) specific preferences of the snake for environments suitable for their development, and (iii) human population density. Recent literature allowed to notice that the severity of the bites depends mainly on (i) the snake responsible for the bite (species and size) and (ii) accessibility of health care, including availability of antivenoms.Conclusions/SignificancesThe main limitation of this study could be the reliability and accuracy of the notifications by national health services. However, the data seemed consistent considering the similarity of the incidences on each side of national boundaries while the sources are distinct. However, snakebite incidence could be underestimated due to the use of traditional medicine by the patients who escaped the reporting of cases. However, gathered data corresponded to the actual use of the health facilities, and therefore to the actual demand for antivenoms, which should make it possible to improve their management.

Fatal Snakebite Envenoming and Agricultural Work in Brazil: A Case–Control Study

“…10 Annually, about 27,200 cases of snakebite occur in Brazil, causing 115 deaths/year, yielding a case fatality rate of 0.42%. 11 This study aimed to investigate the association between fatal snakebite envenoming and agricultural work in Brazil, considering the effects of relevant covariables.…”

Potential of Matrix Metalloproteinase Inhibitors for the Treatment of Local Tissue Damage Induced by a Type P-I Snake Venom Metalloproteinase

“…Snake bite envenoming is a major public health problem, which the World Health Organization has recognized as a Category A neglected tropical disease since 2017 [1]. Envenoming causes mortality and morbidity mainly in tropical and subtropical areas, such as sub-Saharan Africa, South and Southeast Asia, Papua New Guinea and Latin America [2], with annual deaths estimated at 100,000 and sequelae in more than 400,000 cases [3]. In Latin America, recent estimates suggest about 57,500 annual envenomings, with an incidence of 6.2 per 100,000 people [2].…”

“…Envenoming causes mortality and morbidity mainly in tropical and subtropical areas, such as sub-Saharan Africa, South and Southeast Asia, Papua New Guinea and Latin America [2], with annual deaths estimated at 100,000 and sequelae in more than 400,000 cases [3]. In Latin America, recent estimates suggest about 57,500 annual envenomings, with an incidence of 6.2 per 100,000 people [2]. In Colombia specifically, 5434 cases were reported in 2018, with an incidence of 10.9 per 100,000 people [4].…”

High mortality due to snakebites in French Guiana: Time has come to re-evaluate medical management protocols

“…However, these figures could be underestimated because either snakebites were not notified and/or the denominator remains imprecise due to a large population of illegal gold miners living in the Amazonian forest, some of whom may have died from snakebites without consulting the healthcare system. We compared the mortality rate with recent estimates from other countries or territories in the Americas [5]. As a consequence, specific mortality in French Guiana appears to be the fourth highest in Latin America, just after Panama, Bolivia, and Guyana (Fig 1).…”

“…The only available data appeared in a 2007 doctoral thesis on acute intoxications in the Cayenne hospital that reported only 4 deaths out of 125 ophidian envenomations treated in the intensive care unit (ICU) of the hospital of Cayenne between 1980 and 2007 [6]. Although not isolated to the Americas [5], the apparent rise of mortality by snakebites in French Guiana raises questions. The first explanation may be the rapidly growing population (67,000 inhabitants in 1980, 252,000 in 2014, and 574,000 estimated in 2040).…”