Epidemiology of snakebite and use of antivenom in Argentina

Fil: Dolab, Jorge Adrián. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Producción de Biológicos; Argentina.Fil: de Roodt, Adolfo Rafael. Universidad de Buenos Aires. Facultad de Medicina. Centro de Patología Experimental y Aplicada. Laboratorio de Toxinopatología; Argentina.Fil: de Titto, Ernesto Horacio. Ministerio de Salud. Dirección Nacional de Determinantes de la Salud e Investigación; Argentina.Fil: García, Susana Isabel. Ministerio de Salud. Dirección Nacional de Determinantes de la Salud e Investigación; Argentina.Fil: Funes, Raúl. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Producción de Biológicos; Argentina.Fil: Salomón, Oscar Danie. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Medicina Tropical; Argentina.Fil: Chippaux, Jean-Philippe. Institut de Recherche pour le Développement; Francia.Background: The incidence and case fatality rate of snakebite in Argentina are poorly known. Methods: The authors used questionnaires provided with antivenoms by the primary manufacturer of anti-venoms in Argentina. Results: A total of 8083 completed questionnaires was collected between 1978 and 1998. The annual incidence of snakebite was 1.8 bites per 100,000 inhabitants, with a high geographical heterogeneity; in the northern provinces of the country, the incidence can exceed 150 snakebites per 100,000 people per year. Bothrops (pit viper) bites predominated, accounting for 96.6% (6720/6957) of envenomations, bites from Crotalus (rattlesnake) accounted for 2.8% (195/6957), and bites from Micrurus (coral snake) for 0.6% (42/6957). Most patients were young men, who were generally bitten during agricultural activities, i.e. while working in the fields. Most snakebites (78.9%, 5852/7419) were to the lower limb, including 58.3% (4322/7419) to the foot. The case fatality rate was