Schulte Joann, Haynes Ashley, Smith Eric Anthony, Fleming John, Kleinschmidt Kurt, Roth Brett
Houston Health Department, Houston, TX; North Texas Poison Control Center, Parkland Health and Hospital System, Dallas, TX.
North Texas Poison Control Center, Parkland Health and Hospital System, Dallas, TX; Department of Emergency Medicine, Toxicology Section, UT Southwestern Medical Center, Dallas, TX.
Wilderness Environ Med. 2020 Jun;31(2):197-201. doi: 10.1016/j.wem.2020.01.008. Epub 2020 Apr 21.
Anecdotal media reports suggest an increase in snakebites after hurricanes. After Hurricane Harvey, several households called Texas poison control centers to report snakebites that occurred when rising water flooded homes. Patterns of snakebite before and after hurricane landfalls have not been well studied.
We reviewed retrospective surveillance data from the Texas Poison Control Network to examine snakebites possibly related to tropical storms/hurricanes that hit Texas between 2000 and 2017. For that assessment, we compared 2 groups of counties: those designated for individual assistance (impact counties) by the Federal Emergency Management Agency and all others (nonimpact counties). Typically, counties with individual assistance declarations are those in which damage is worse and resident return may be delayed.
Eleven named tropical storms/hurricanes struck Texas between 2000 and 2017; 9 received individual assistance declarations. During the 18 y, 2037 snakebites were reported in the 30 d after and the 30 d before landfalls in 9 storms; 132 (6%) occurred poststorm in impact counties, and 13 of 132 (9%) of the case narratives mentioned hurricanes as a contributing factor. Impact counties were not statistically more likely to report snakebites in the 30 d after landfall for any of the 9 storms or overall, nor did we find differences in patient demographic characteristics, type of snake, and care patterns post- and prestorm.
There was no evidence of increases in snakebites after hurricanes in Texas during the study period. More detailed evaluations may be warranted in other regions that experience hurricanes and have venomous snake populations.
媒体轶事报道表明飓风过后蛇咬伤事件有所增加。哈维飓风过后，多个家庭致电德克萨斯州中毒控制中心，报告家中因洪水上涨而发生的蛇咬伤事件。飓风登陆前后蛇咬伤的模式尚未得到充分研究。
我们回顾了德克萨斯州中毒控制网络的回顾性监测数据，以检查2000年至2017年间袭击德克萨斯州的可能与热带风暴/飓风相关的蛇咬伤事件。为了进行该评估，我们比较了两组县：那些被联邦紧急事务管理局指定为个人援助的县（受灾县）和所有其他县（非受灾县）。通常，有个人援助声明的县是那些受灾更严重且居民返家可能延迟的县。
2000年至2017年间，有11个命名的热带风暴/飓风袭击了德克萨斯州；其中9个获得了个人援助声明。在这18年中，9次风暴登陆前30天和登陆后30天共报告了2037起蛇咬伤事件；132起（6%）发生在受灾县的风暴过后，132起中的13起（9%）病例记录提到飓风是一个促成因素。对于9次风暴中的任何一次或总体而言，受灾县在登陆后30天内报告蛇咬伤事件的可能性在统计学上并不更高，我们也未发现风暴前后患者人口统计学特征、蛇的种类和护理模式存在差异。
在研究期间，没有证据表明德克萨斯州飓风过后蛇咬伤事件有所增加。对于其他经历飓风且有毒蛇种群的地区，可能需要进行更详细的评估。
