Review of Scorpion Stings and Snakebites Treated by the French Military Health Service During Overseas Operations Between 2015 and 2017

Abstract

IntroductiondDepending on their theatre of operation, French soldiers may potentially be exposed to scorpion stings and snakebites. Following the recommendations of a French military health service (FMHS) technical committee for envenomation, the FMHS provides antivenoms appropriate to each deployment. This work aimed to evaluate this risk of envenomation and to assess the antivenoms used by the FMHS in operational theatres since the creation of this committee in 2015.MethodsdCases were identified based on a review of temporary authorization of use application forms for the use of antivenom. Data were collected retrospectively from these forms, and prescribing physicians were contacted for any missing data.ResultsdBetween 2015 and 2017, 28 requests for temporary authorization of use were identified: 19 for Scorpifav (Sanofi-Pasteur, Lyon, France) and 9 for Fav-Afrique (Sanofi-Pasteur). The FMHS treated 15 soldiers and 4 civilians for scorpion envenomation with Scorpifav: 15 in Mali, 3 in Chad, and 1 in Niger. Systemic signs were observed in 7 patients. Two soldiers and 7 civilians were treated with Fav-Afrique for ophidian envenomation: 5 in Djibouti, 3 in Mali, and 1 in the Republic of Côte d'Ivoire. These 28 patients were treated without sequelae. Other than moderate erythema that resolved with an antihistamine, no adverse effects were reported. Medical evacuation to France was unnecessary.ConclusionsdThis study shows that the risk of envenomation for soldiers on deployment is low but real. Antivenoms used by the FMHS were efficient and well tolerated, preserving the operational capacity of deployed troops.

Terrestrial venomous animals, the envenomings they cause, and treatment perspectives in the Middle East and North Africa

“…The use of this antivenom was associate with a decrease in envenoming clinical signs in patients who received prompt and specific antivenoms [ 204 ]. Additionally, a study by the French military demonstrated that 19 patients were effectively treated with SCORPIFAV (MicroPharm) [ 205 ]. There also exists some preclinical data indicating the potential usefulness of antivenoms in treating scorpionism for Polyvalent Scorpion Antivenom (Razi) [ 206 – 209 ], Purified polyvalent anti-scorpion serum (VACSERA) [ 210 ], Inoscorpi (Inosan Biopharma) [ 211 ].…”