Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jun 21;11(6):e0005662.
doi: 10.1371/journal.pntd.0005662. eCollection 2017 Jun.

Incidence and mortality due to snakebite in the Americas

Jean-Philippe Chippaux  1   2
Affiliations

Incidence and mortality due to snakebite in the Americas

Jean-Philippe Chippaux. PLoS Negl Trop Dis. .

Abstract

Background: Better 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 findings: Authors 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/significances: The 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.

PubMed Disclaimer

Conflict of interest statement

I have no competing interest.

Figures

Fig 1
Fig 1. Evolution of snakebites according to time in Argentina.
A: annual incidence per 100,000 population from 2007 to 2014. B: average seasonal incidence.
Fig 2
Fig 2. Geographical distribution of incidence of snakebites in Argentina 2007–2014 (Andres Rojas, Political Map of Argentina.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Argentina#/media/File:Argentina.svg [07/24/2016]).
Fig 3
Fig 3. Epidemiological presentation of snakebites in Bolivia.
A: annual evolution of bites between 2010 and 2015. B: Incidence of snakebites per 100,000 population of each age group between 2010 and 2015. C: comparison of the seasonal incidence of snakebites between 1996 and 2000.
Fig 4
Fig 4. Geographical distribution of incidence of snakebites in Brazil 2007–2012 (Raphael Lorenzeto de Abreu, Map of Brezil’s region.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Brazil#/media/File:Brazil_Regions.svg [07/24/2016]).
Fig 5
Fig 5. Regional variation in the seasonal incidence of snake bites in Brazil between 2007 and 2012.
Fig 6
Fig 6. Evolution of snakebites according to time in Colombia.
A: annual incidence from 2009 to 2014. B: average seasonal incidence (2009–2014).
Fig 7
Fig 7. Geographical distribution of incidence of snakebites in Colombia 2009–2014 (canislupusarctos, Colombia and the departementos.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Colombia#/media/File:Colombia_departaments-numbered.svg [08/23/2015]).
Fig 8
Fig 8. Geographical distribution of incidence of snakebites in Costa Rica 2005–2012 (Golbez, Map of the Provinces of Costa Rica.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Costa_Rica#/media/File:Costa_Rica_provinces_named.png [08/24/2015]).
Fig 9
Fig 9. Epidemiology of snakebites in Costa Rica.
A: Age and gender specific incidence (per 100,000 population of each age and gender groups) of snakebites in Costa Rica 2005–2012. B: Seasonal incidence of snakebites in Costa Rica 2005–2012.
Fig 10
Fig 10. Geographical distribution of incidence of snakebites in Ecuador 2001–2007 (Anonymous, Provinces of Ecuador.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Ecuador#/media/File:Provinces_of_ecuador.png [08/23/2016] and Anonymous, Map of Ecuador Demis. Available from https://commons.wikimedia.org/wiki/Atlas_of_Ecuador#/media/File:Map_of_Ecuador_Demis.png) [08/23/2016].
Fig 11
Fig 11. Epidemiology of snakebites in El Salvador.
A: Seasonal incidence of snakebites in El Salvador 2010–2012. B: Correlation between altitude and annual incidence of snakebites (per 100,000 population) in El Salvador.
Fig 12
Fig 12. Geographical distribution of incidence of snakebites in El Salvador 2010–2012 (Anonymous, Departments of El Salvador.
Available from https://commons.wikimedia.org/wiki/Atlas_of_El_Salvador#/media/File:El_Salvador_departments_named.png [08/27/2015].
Fig 13
Fig 13. Geographical distribution of incidence of snakebites in Guatemala 2001–2010 (Anonymous, GuatemalaProvs.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Guatemala#/media/File:GuatemalaProvs.PNG [07/24/2016].
Fig 14
Fig 14. Geographical distribution of incidence of snakebites in Guyana 2010–2012 (Golbez, Map of the regions of Guyana.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Guyana#/media/File:Guyana_regions_english.png [13/11/2016].
Fig 15
Fig 15. Geographical distribution of incidence of snakebites in Honduras 2009–2012 (Golbez, Map of the departments of Honduras.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Honduras#/media/File:Honduras_departments_named.png [28/07/2015].
Fig 16
Fig 16. Geographical distribution of incidence of snakebites in Martinique Island 1991–1994 (data from [40]) (BigonL, Carte de la Martinique avec ses 4 arrondissements.
Available from https://en.wikipedia.org/wiki/Martinique#/media/File:Martinique_legende_arrs.PNG [12/06/2016].
Fig 17
Fig 17. Evolution of snakebites according to time in Mexico.
A: annual incidence from 2003 to 2015. B: annual mortality from snakebites in Mexico (1979–2014) [after 43].
Fig 18
Fig 18. Geographical distribution and seasonal incidence of snakebites in Mexico 2003–2015.
A: monthly mean of cases in Northern Mexico (Chihuahua, Cohuila, Nuevo Léon, Sonora, Tamaulipas); B: monthly mean of cases in Central Mexico (Hidalgo, Michoacan, San Luis de Potosi, Puebla); C: monthly mean of cases in Southern Mexico (Campeche, Chiapas, Oaxaca); (Anonymous, States of Mexico. Available from https://commons.wikimedia.org/wiki/Atlas_of_Mexico#/media/File:States_of_Mexico.svg [07/10/2016].
Fig 19
Fig 19. Geographical distribution of incidence of snakebites in Paraguay 2010–2015 (Anonymous, Paraguay Departements.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Paraguay#/media/File:Paraguay_departements.png [11/28/2016].
Fig 20
Fig 20. Geographical distribution of incidence of snakebites in Peru 2000–2015 (Guillermo Romero, Political Map of Peru.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Peru#/media/File:Peru_-_Regions_and_departments_(labeled).svg [08/26/2015].
Fig 21
Fig 21. Geographical distribution of incidence of snakebites in the USA.
A: data of 1959 from [47]); B: data of 2001–2005 from [53]).
Fig 22
Fig 22. Geographical distribution of incidence of snakebites in Uruguay 1993–2002 (Golbez, Map of the departments of Uruguay.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Uruguay#/media/File:Uruguay_departments_named.png [07/24/2016].
Fig 23
Fig 23. Geographical distribution of incidence of snakebites in Venezuela 1996–2011 (The Photographer, División Político Territorial de Venezuela.
Available from https://commons.wikimedia.org/wiki/Atlas_of_Venezuela#/media/File:Venezuela_Division_Politica_Territorial.svg [07/28/2016].
See this image and copyright information in PMC

References

    1. Chippaux JP. Snake-bites: appraisal of the global situation. Bull World Health Organ. 1998;76(5):515–24. - PMC - PubMed
    1. Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK, Pathmeswaran A, Premaratna R, Savioli L, Lalloo DG, de Silva HJ. The global burden of snakebite: a literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med. 2008;5(11):e218 doi: 10.1371/journal.pmed.0050218 - DOI - PMC - PubMed
    1. Chippaux JP. Estimating the global burden of snakebite can help to improve management. PLoS Med. 2008;5(11):e221 doi: 10.1371/journal.pmed.0050221 - DOI - PMC - PubMed
    1. Gutiérrez JM, Higashi HG, Wen FH, Burnouf T. Strengthening antivenom production in Central and South American public laboratories: report of a workshop. Toxicon. 2007;49(1):30–5. doi: 10.1016/j.toxicon.2006.09.005 - DOI - PubMed
    1. Gutiérrez JM, Fan HW, Silvera CL, Angulo Y. Stability, distribution and use of antivenoms for snakebite envenomation in Latin America: report of a workshop. Toxicon. 2009;53(6):625–30. doi: 10.1016/j.toxicon.2009.01.020 - DOI - PubMed

LinkOut - more resources