Red-back spider bites to Perth children, 1979-1988.

The aim of this study was to describe the pattern of illness caused by red-back spider bites to children in Perth, Western Australia, over a 10 year period, and to compare it with that in adults. The case-notes of 241 (89%) of the 271 children admitted to Princess Margaret Hospital and Fremantle Hospital with suspected red-back spider bite from 1979 to 1988 were available for analysis. A definite bite was defined as a definite bite by a positively identified red-back spider, positive identification of a red-back spider with no definite bite but the later development of typical symptoms or no definite history of red-back spider bite but strong clinical evidence and complete recovery after administration of antivenom. Systemic envenomation was accepted if there were symptoms of vomiting, generalized pain or sweating, or abdominal pain. Sixty-five per cent of children were definitely bitten. As found in previous adult and mixed studies, there was a peak incidence in the warmer months with a male preponderance (68%); 81% of bites were to the extremities and 83% of bites occurred in the daytime. The syndrome produced in children was usually similar to that seen in adults. Twenty-one per cent of children received antivenom, a rate comparable to previous studies in older age groups; however, no child received more than one ampoule. Compared with data extracted from a previously published study at Fremantle Hospital, in which 37% of adults treated with antivenom received more than one ampoule, these findings suggest that contrary to current opinion children may not be at an increased risk of morbidity from latrodectism.