Rattlesnake bites in Europe--experiences from southeastern France and northern Germany.
BACKGROUND
Rattlesnakes are indigenous to the New World and hence their envenomations are a significant percentage of all poisonings in North and South America. Some years ago rattlesnake bites were virtually unknown in Europe. But the biodiversity of European household fauna has changed: cats and dogs are increasingly replaced by stingrays, tarantulas, fire fish, and rattlesnakes. This phenomenon is the background of a French-German cooperation to evaluate the relevance of rattlesnake bites for European doctors.


METHODS
In a retrospective study all consultations of the GIZ-Nord poison centre in Göttingen and the Centre Antipoison in Marseille concerning bites of poisonous snakes in a 20-yr time period were analyzed.


RESULTS
Altogether 671 cases of poisonous snake bites were registered. Rattlesnake bites came up to 21 (3.1% of all consultations due to poisonous snake bites). Over the years the number increased constantly. All patients were adult men with a mean age of 37.2 (20-64) years. There were no females and no pediatric patients involved. According to the Poisoning Severity Score there were 8 minor, 5 moderate, and 8 severe envenomations; no fatalities. The leading clinical symptoms consisted of rhabdomyolysis, neurological, and coagulational disorders. In 5 cases antivenom therapy was applied, and in 4 patients surgical therapy was performed.


CONCLUSIONS
Rattlesnake bites are rare in Europe, but the incidence is rising. The patients' profile is different from large American case series. European doctors should be aware of the increase in these infrequent envenomations.
GIZ-Nord Poison Centre, University of Göttingen, Göttingen, Germany. aschaper@giz-nord.de
Andreas
A
Schaper
Luc
L
de Haro
Herbert
H
Desel
Martin
M
Ebbecke
Claus
C
Langer
D000328:Adult; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D003435:Crotalid Venoms; D017839:Crotalus; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011039:Poison Control Centers / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012909:Snake Bites / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology
D000997:Antivenins; D003435:Crotalid Venoms