Approach to the epidemiology of venomous bites in Spain

This review presents a geographic distribution of the three autochthonous venomous snake species, which are the only viperids present in Spain, among the Iberian fauna: Vipera aspid; Vipera seoianei and Vipera latasti. This is followed by a detailed descriptive analysis of hospital care provided to patients admitted into hospital due to venomous bites, in the period from 1997 to 2009, using the data from the Spanish hospital discharge registry database. This analysis reveals that in Spain, during this period, 1649 cases were recorded, which means that hospital care was required for more than one hundred cases per year, of which nearly 1% of the cases resulted in death. Cases were recorded in all the Autonomous communities, but more than half (54, 14%) were concentrated in the following four regions: Cataluña, Castilla and León, Galicia and Andalucía. It is notable that this concentration of cases is not associated only with the population demographics of the community, but is also the result of the concurrence of very diverse factors of exposure including: habitat of venomous fauna, volume of rural population, farming activities, and practice of outdoor leisure activities. We also carried out a gross economic calculation for the use of hospital resources by each snakebite case requiring hospital care in Spain, which provided us with an approximate figure of 2000€ per case.
We would like to thank Dra. María Ángeles Gogorcena Aoiz, from the Institute of Health Information of the Ministry of Health, Social Services and Equality, for her help in accessing the data from the hospital discharge registry database. We would also like to thank Mr. Mario García París, Mr. Jesús Dorda and Ms. Soledad Alonso, from the National Museum of Natural Sciences of Madrid who have provided us the images of the three autochthonous viper species that appear in the article. This work is a partial result of the research agreement signed between the Instituto de Salud Carlos III and Instituto Bioclon S.L. de C.V. partially funded by “Fondo de Cooperación Internacional en Ciencia y Tecnología entre México y la Unión Europea” (FONCICYT) (application number 93608). It is part of a research project (ref. PI08/90612) of the Spanish National R&D plan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.