AAPCC database characterization of native U.S. venomous snake exposures, 2001-2005

Background. Differences in victim demographics, clinical effects, managements, and outcomes among native viperid (rattlesnake, copperhead, and cottonmouth) and elapid (coral snake) species have not been systematically characterized. Methods. The database of the American Association of Poison Control Centers from 2001 through 2005 was analyzed.Results. Between 2001 and 2005, there were 23,676 human exposures (average 4,735year) to native venomous snakes in the United States reported to U.S. poison centers in all states except Hawaii: 98 were to viperid snakes and 2 to elapids. Overall, 77 of victims were male, 70 were adults >20 years, and 12 were aged less than 10 years. Sixty-five cases involved pregnant women, with rattlesnake bites resulting in moderate or greater effects in over 70. The overall hospital admission rate was 53. Outcomes were generally more severe with rattlesnake and copperhead envenomations and in children <6 years of age. The fatality rate of reported cases was 0.06.Conclusions. Native U.S. venomous snakebite results in considerable morbidity and mortality. Rattlesnake and copperhead envenomations, and those in children <6 years of age, produce the most severe outcomes, but coral snakebites result in similar hospital admission rates.