title: Childhood Victims of Snakebites: 2000-2013.
abstract: Snakebites are not a reportable condition (to state health departments), and 1 major assessment of US children with snakebites was published 50 years ago. Increasing urbanization, population shifts south and west, newer antivenom therapy, and the importation of exotic snakes may have changed snakebites. Poison control centers are often consulted on treatment and collect surveillance data.
  
  
  
  Generic codes for venomous, nonvenomous, and unknown snakebites were used to characterize victims aged ≤18 years reported to US poison control centers between 2000 and 2013. Data included demographic characteristics, snake types, and outcomes.
  
  
  
  Callers reported 18 721 pediatric snakebites (annual mean, 1337). Two-thirds were male (n = 12 688 [68%]), with a mean age of 10.7 years. One-half of the snakebites were venomous (n = 9183 [49%]), with copperheads (n = 3602 [39%]) and rattlesnakes (n = 2859 [31%]) the most frequently identified. Reported copperhead bites increased 137% and unknown crotalids (venomous) increased 107%. Exotic (nonnative) exposures were reported in 2% of cases. All 50 states reported snakebites, but one-quarter occurred in Texas and Florida. Rates for total snakebites and venomous snakebites were highest in West Virginia, Oklahoma, and Louisiana. One-fifth required ICU admission. Limited data for 28% of bites for antivenom treatment suggests increasing use. Four victims died.
  
  
  
  The epidemiology of pediatric snakebites is changing. One-half of the reported exposures were venomous, and copperhead bites and exotic species are being reported more frequently. Although snakebite-related deaths are rare, ICU admission is common. Antivenom treatment is incompletely reported, but its use is increasing.
authors.affiliation: North Texas Poison Control Center, Parkland Health & Hospital System, Dallas, Texas; and joann.schulte@louisvilleky.gov.
authors.forename: Joann
authors.initials: J
authors.lastname: Schulte
authors.affiliation: North Texas Poison Control Center, Parkland Health & Hospital System, Dallas, Texas; and.
authors.forename: Kristina
authors.initials: K
authors.lastname: Domanski
authors.affiliation: North Texas Poison Control Center, Parkland Health & Hospital System, Dallas, Texas; and.
authors.forename: Eric Anthony
authors.initials: EA
authors.lastname: Smith
authors.affiliation: North Texas Poison Control Center, Parkland Health & Hospital System, Dallas, Texas; and.
authors.forename: Annelle
authors.initials: A
authors.lastname: Menendez
authors.affiliation: Division of Medical Toxicology, Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Kurt C
authors.initials: KC
authors.lastname: Kleinschmidt
authors.affiliation: North Texas Poison Control Center, Parkland Health & Hospital System, Dallas, Texas; and.|Division of Medical Toxicology, Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Brett A
authors.initials: BA
authors.lastname: Roth
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D017836:Agkistrodon; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D011039:Poison Control Centers; D017678:Sex Distribution; D012909:Snake Bites / Q000188:drug therapy / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
chemical_list: D000997:Antivenins