title: Temporal analyses of coral snakebite severity published in the American Association of Poison Control Centers' Annual Reports from 1983 through 2007.
abstract: BACKGROUND
  The only U.S. Food and Drug Administration-approved coral snake antivenom was officially discontinued in 2007, causing ever-diminishing supplies. This study describes the severity of U.S. coral snakebites during the last 25 years to determine trends in annual rates of these bites' medical outcomes.
  
  
  METHODS
  This study retrospectively analyzed all human coral snakebites voluntarily reported by the public and/or health care professionals to poison centers that were subsequently published in the Annual Reports of the American Association of Poison Control Centers (AAPCC) from 1983 through 2007. Annual rates of medical outcomes from coral snakebites were calculated by dividing the annual number of people bitten by coral snakes who developed fatal, major, moderate, minor, or no effect outcomes by the total annual number of people bitten by coral snakes. Negative binomial regression was used to examine trends in annual rates.
  
  
  RESULTS
  From 1983 through 2007, the incidence rate of coral snakebites producing no effects significantly decreased by 4.7% per year [incidence rate ratio (IRR) = 0.953; 95% confidence interval (CI) = 0.920-0.987]. From 1985 through 2007, the incidence rates of minor and major outcomes did not significantly change; however, moderate outcomes significantly increased by 3.4% per year (IRR = 1.034; 95% CI = 1.004-1.064). No fatalities were reported from 1983 through 2007.
  
  
  CONCLUSIONS
  Annual rates of coral snakebites producing no effects significantly decreased and those producing moderate outcomes significantly increased in our analyses of data from the last 25 years of published AAPCC Annual Reports. This study has important limitations that must be considered when interpreting these conclusions.
authors.affiliation: Department of Emergency Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA. frank@aemrc.arizona.edu
authors.forename: Frank G
authors.initials: FG
authors.lastname: Walter
authors.forename: Uwe
authors.initials: U
authors.lastname: Stolz
authors.forename: Farshad
authors.initials: F
authors.lastname: Shirazi
authors.forename: Jude
authors.initials: J
authors.lastname: McNally
mesh_terms: D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D004546:Elapid Venoms; D017815:Elapidae; D006801:Humans; D011039:Poison Control Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012909:Snake Bites / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000997:Antivenins; D004546:Elapid Venoms