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Wilderness Environ Med. 2018 Jun;29(2):176-184. doi: 10.1016/j.wem.2018.01.004. Epub 2018 Mar 9.

Snakebites Treated in North Carolina Emergency Departments, October 2013-September 2015.

Author information

Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC (Ms Harmon). Electronic address:
Division of Public Health, Communicable Disease Branch, North Carolina Department of Health and Human Services, Raleigh, NC (Dr Haskell).
Pediatric Emergency Medicine Fellowship, University of North Carolina at Chapel Hill, WakeMed Health and Hospitals, Raleigh, NC (Dr Mann).
Carolina Center for Health Informatics and the Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Waller).



North Carolina (NC) is home to more than 30 species of indigenous venomous and nonvenomous snakes. Snakebites can cause debilitating and potentially fatal injuries. However, there is a lack of current information available describing the incidence of snakebites in NC. Therefore, we performed this study of snakebites treated in NC emergency departments (EDs) using the statewide syndromic surveillance system, the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT).


This was a descriptive epidemiologic study characterizing NC ED visits collected by NC DETECT between October 1, 2013 and September 30, 2015 with an assigned International Classification of Diseases, 9th Revision, Clinical Modification code or keyword indicating a snakebite.


Over the 2-year period, the absolute count of snakebite-related ED visits was 2080 visits with an incidence rate of 10.4 visits per 100 000 person-years (95% confidence interval: 10.0-10.9). The frequency of snakebite was highest during the summer months and evening hours. Men had higher incidence rates of snakebite-related ED visits than women, and residents of the Coastal Plain geographic region of NC had higher incidence rates than persons in other regions.


The current study indicated that snakebites are common injuries treated at NC EDs, with a strong seasonal and geographic component. Additional research is needed to further characterize the circumstances associated with snakebites for the development of preventive measures and public health education.


epidemiology; morbidity; public health surveillance; snake venom

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