Bomba Aurore, Favaro Pascal, Haus Rachel, Aigle Luc, Jean François-Xavier, Dauphin Isabelle, Guigon Pierre, Fontaine Bruno, Puidupin Marc, Demoncheaux Jean-Paul, Larréché Sébastien
French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France.
French Armed Forces Health Products Supply Directorate, Orléans, France.
Wilderness Environ Med. 2020 Jun;31(2):174-180. doi: 10.1016/j.wem.2020.01.006. Epub 2020 Apr 21.
Depending on their theatre of operation, French soldiers may potentially be exposed to scorpion stings and snakebites. Following the recommendations of a French military health service (FMHS) technical committee for envenomation, the FMHS provides antivenoms appropriate to each deployment. This work aimed to evaluate this risk of envenomation and to assess the antivenoms used by the FMHS in operational theatres since the creation of this committee in 2015.
Cases were identified based on a review of temporary authorization of use application forms for the use of antivenom. Data were collected retrospectively from these forms, and prescribing physicians were contacted for any missing data.
Between 2015 and 2017, 28 requests for temporary authorization of use were identified: 19 for Scorpifav (Sanofi-Pasteur, Lyon, France) and 9 for Fav-Afrique (Sanofi-Pasteur). The FMHS treated 15 soldiers and 4 civilians for scorpion envenomation with Scorpifav: 15 in Mali, 3 in Chad, and 1 in Niger. Systemic signs were observed in 7 patients. Two soldiers and 7 civilians were treated with Fav-Afrique for ophidian envenomation: 5 in Djibouti, 3 in Mali, and 1 in the Republic of Côte d'Ivoire. These 28 patients were treated without sequelae. Other than moderate erythema that resolved with an antihistamine, no adverse effects were reported. Medical evacuation to France was unnecessary.
This study shows that the risk of envenomation for soldiers on deployment is low but real. Antivenoms used by the FMHS were efficient and well tolerated, preserving the operational capacity of deployed troops.
根据其作战区域，法国士兵可能会面临蝎子蜇伤和蛇咬的风险。按照法国军事卫生服务（FMHS）中毒委员会的建议，FMHS会为每次部署提供合适的抗蛇毒血清。这项工作旨在评估这种中毒风险，并评估自该委员会于2015年成立以来FMHS在作战区域使用的抗蛇毒血清。
通过审查抗蛇毒血清使用临时授权申请表来确定病例。从这些表格中回顾性收集数据，对于任何缺失的数据会联系开处方的医生。
在2015年至2017年期间，共确定了28份临时使用授权申请：19份针对Scorpifav（赛诺菲巴斯德公司，法国里昂），9份针对Fav-Afrique（赛诺菲巴斯德公司）。FMHS用Scorpifav治疗了15名士兵和4名平民的蝎子蜇伤：15例在马里，3例在乍得，1例在尼日尔。7名患者出现全身症状。2名士兵和7名平民用Fav-Afrique治疗蛇咬伤：5例在吉布提，3例在马里，1例在科特迪瓦共和国。这28名患者均无后遗症地接受了治疗。除了用抗组胺药后消退的中度红斑外，未报告有不良反应。无需将患者紧急疏散至法国。
本研究表明，部署中的士兵中毒风险虽低但确实存在。FMHS使用的抗蛇毒血清有效且耐受性良好，保持了部署部队的作战能力。
