@article{fdi:010054399,
  title = {{E}pidemiology of snakebites in {E}urope : a systematic review of the literature},
  author = {{C}hippaux, {J}ean-{P}hilippe},
  editor = {},
  language = {{ENG}},
  abstract = {{S}nakebites are rare medical emergency cases in {E}urope but may sometimes be severe and lead to complications. {A} better knowledge of snakebite epidemiology may help health authorities to better understand therapeutic requirements, especially concerning anti-venoms, and thus improve treatment of snakebite. {A}n extensive literature search for studies and articles published between 1970 and 2010 was performed. {B}oth indexed and non-indexed articles were examined, the analysis of which took into account the heterogeneity between the studies and weighted the studies according to size of the study population covered. {M}ost of the articles involved hospitalized patients who represented more than 90% of snakebites. {I}ncidence, mortality and population at risk were estimated after stratification into three regions (northern, central and southern {E}urope) based both on viper species distribution and climatic characteristics. {T}here was no significant variation in incidence from the north to the south of {E}urope. {I}n the whole of {E}urope, including {E}uropean {R}ussia and {T}urkey, the annual number of snakebite cases was estimated at 7992 [{CI} 95% = 6860-9178] bites, out of which approximately 15% were considered severe (grade 3). {T}hese bites usually occurred between {M}ay and {S}eptember, with a more dispersed distribution in southern {E}urope. {T}he average number of deaths per annum was 4 [0.7-7.7]. {C}hildren and male victims are more affected, contrary to what one would expect given their respective proportion in the entire population. {B}oth upper and lower limb bites were recorded at an equal frequency while the bites in other parts of the body were very rare. {I}mmunotherapy was prescribed in one out of three snakebites in {E}urope, with a very high geographical variability, in spite of excellent tolerance, at least considering highly-purified immunoglobulin fragments. {S}nakebites are uncommon in {E}urope but can cause life-threatening envenomation. {F}ragments of highly-purified immunoglobulins are now very well tolerated and dramatically reduce both severity and mortality of snakebites when used in treatment.},
  keywords = {{S}nakebite ; {E}nvenomings ; {E}pidemiology ; {A}ntivenom ; {E}urope ; {EUROPE}},
  booktitle = {},
  journal = {{T}oxicon},
  volume = {59},
  numero = {1},
  pages = {86--99},
  ISSN = {0041-0101},
  year = {2012},
  DOI = {10.1016/j.toxicon.2011.10.008},
  URL = {https://www.documentation.ird.fr/hor/fdi:010054399},
}