Document Type : Original Article


1 faculty of medicine Alexandria University

2 High Institute of Public Health -Alexandria University


Background: A common poisoning in tropical and subtropical areas is snake and scorpion poisoning. A massive scorpion swarm on in southern Egypt left three dead and five hundred hospitalized after heavy storms on 13 November 2021. The morbidity from scorpion sting and snake bite is a medical problem through all seasons of the year. This study was conducted to assess the clinicalepidemiological profile of snake bites and scorpion stings cases admitted to Alexandria poison center, Egypt. In addition, it compared snake bites and scorpion stings’ presentation, management, prognosis, and the effect of the polyvalent antivenom, locally produced by (VACSERA).
Subjects and Methods: A prospective observational study was conducted at Alexandria poison center (APC), Alexandria, Egypt. All cases admitted to the hospitals from 1st March 2019 to 29th February 2020 were included.
Results: The study included 130 cases of snake bites (94) and scorpion stings (36). 51.1% of patients with snake bites and 44.4% of patients with scorpion stings were in the age group <30 years. There was seasonal variation of snake bites, and scorpion stings with a reported statistically significant difference (P= 0.008). There was a significant difference between the two study groups regarding the local manifestations. 55.3 % of the cases received supportive measurements and 44.7 % received the polyvalent antivenom. Recovery was the main outcome in 95.4% of patients. 
Conclusion: There was a significant difference between the two studied groups regarding the local manifestations. The antivenom was not given to all cases. Recovery was the main outcome in 95.4% of patients.


1-Morsy AT, Khat AM .Principal management of snake bites with reference to Egypt. JESP. 2021; 51 (2): 333 - 42 (Online: 2090-2549).
2-Dortaj S. The Toxic Components and the Clinical Uses of Snake Venom: A Review Document Type: Review Article. APJMT. 2021; 10, 3(3):107-11.
3- Salama W M, Sharshar KM. Surveillance study on scorpion species in Egypt and comparison of their crude venom protein profiles. The Journal of Basic & Applied Zoology. 2013; 66 (2): 76-86. ISSN 2090-9896,
4-Ghanem M, Mohammed S, Hamdy M. Assessment of resources and services utilization of Alexandria poison center. Asian J Biomed Pharmaceut Sci. 2018 
5- Gutiérrez JM, Calvete JJ, Habib AG, Harrison RA, Williams DJ, Warrell DA. Snakebite envenoming. Nat Rev Dis Primers. 2017 ;14;3:17063. doi: 10.1038/nrdp.2017.63. Erratum in: Nat Rev Dis Primers. 2017 Oct 05;3:17079. PMID: 28905944.
6- Gouda A, Elnabarawy N, Badawy S. A study of snakebite envenomation cases admitted to Egyptian national poisoning center. Acta medica international.2017; 4 (2):34-40
7-Ahmadi S, Knerr JM, Argemi L,  Bordon K , Pucca M , Cerni F, et al.  Scorpion Venom: Detriments and Benefits. Biomedicines.2020; 8(5):118. doi:10.3390/biomedicines8050118 
8- Saravu K, Somavarapu V, Shastry AB, Kumar R. Clinical profile, species-specific severity grading, and outcome determinants of snake envenomation: An Indian tertiary care hospital-based prospective study. Indian J Crit Care Med. 2012; 16(4):187-92. doi:10.4103/0972-5229.106499
9- World health organization (WHO).Snakebite envenoming: an interactive data platform to support the 2030 targets. [Internet]. 2021. Available from:
10- Khatony A, Abdi A, Fatahpour T, Towhidi F .The epidemiology of scorpion stings in tropical areas of Kermanshah province, Iran, during 2008 and 2009. J Venom Anim Toxins Incl Trop Dis. 2015;21-45. doi:10.1186/s40409-015-0045-4
11- Abd El-Aziz FE, El Shehaby DM, Elghazally SA, Hetta HF. Toxicological and epidemiological studies of scorpion sting cases and morphological characterization of scorpions (Leiurusquin questriatus and Androctonus crassicauda) in Luxor, Egypt. Toxicol Rep. 2019; 8(6):329-35. doi: 10.1016/j.toxrep.03.004.
.12- Al-Lawati A, Al-Abri SS, Lalloo DG. Epidemiology and outcome of snake bite cases evaluated at a Tertiary Care Hospital in Oman. J Infect Public Health. 2009; 2(4):167-70. doi: 10.1016/j.jiph.2009.09.001. Epub 2009 Nov 7. PMID: 20701878.
13- Asif N, Fkk A. A study of ninety snake bite cases at Pakistan Air Force (PAF) Hospital, Shorkot, Pakistan. Pak Armed Forc Med J. 2015; 65-333.
Associated Press:   Nov. 16, 2021, 2:14 AM EET / Updated Nov. 16, 2021, 3:13 PM EET          
14- Chafiq F, El Hattimy F, Rhalem N, Chippaux JP, Soulaymani A, Mokhtari A, et al. Snakebites notified to the poison control center of Morocco between 2009 and 2013. J Venom Anim Toxins Incl Trop Dis. 2016 ; 16:22-8. doi: 10.1186/s40409-016-0065-8. PMID: 26985186; PMCID: PMC4793752.
15- El Hattimy F, Chafiq F, Hami H, Mokhtari A, Soulaymani A, Rachida SB . Geographical distribution of health indicators related to snake bites and envenomation in Morocco between 1999 and 2013. Epidemiol Health. 2018,  40:e2018024. doi:10.4178/epih.e2018024
16- Cheng Scorpion Envenomation .Medscape 2021
17- Chatterjee S, Verma VK, Hazra A, Pal J. An observational study on acute poisoning in a tertiary care hospital in West Bengal, India. Perspect Clin Res.2020; 11(2):75-80. doi:10.4103/picr.PICR_181_eighteen
18- Şahin A, Arıcı MA, Hocaoğlu N, Kalkan Ş, Tunçok Y. Antivenom use in bite and sting cases presenting to a public hospital. Ulus Travma Acil Cerrahi Derg. 2018;24(4):343-50. doi: 10.5505/tjtes.2017.99692.
19- Rahman R, Faiz MA, Selim S, Rahman B, Basher A, Jones A ,et al. Annual incidence of snake bite in rural bangladesh. PLoS Negl Trop Dis. 2010; 4(10):e860. doi:10.1371/journal.pntd.0000860
20- Mitra S, Agarwal A, Shubhankar BU, Masih S , Krothapalli V, Lee B,  et al. Clinico-epidemiological Profile of Snake Bites over 6-year Period from a Rural Secondary Care Centre of Northern India: A Descriptive Study. Toxicol Int. 2015; 22(1):77-82. doi:10.4103/0971-6580.172263
21- Alcoba G, Chabloz M, Eyong J, Wanda F, Ochoa C, Comte E, et al.  Snakebite epidemiology and health-seeking behavior in Akonolinga health district, Cameroon: Cross-sectional study. PLoS Negl Trop Dis. 2020;14(6): e0008334.
22- Tongpoo A, Trakulsrichai S, Putichote K, Sriapha C, Wananukul W. Recurrent neurotoxic envenoming of cobra bite. Toxicon. 2019;(167):180-83. doi: 10.1016/j.toxicon.2019.05.011. Epub 2019 May 23. PMID: 31129162.
23- Park EJ, Choi S, Kim HH, Jung YS. Novel Treatment Strategy for Patients with Venom-Induced Consumptive Coagulopathy from a Pit Viper Bite. Toxins (Basel). 2020, 12(5):295. doi:10.3390/toxins12050295
24-Hui Wen F, Monteiro WM, Moura da Silva AM, Tambourgi DV, Mendonça da Silva I, Sampaio VS, et al. Snakebites and Scorpion Stings in the Brazilian Amazon: Identifying Research Priorities for a Largely Neglected Problem. PLoS Negl Trop Dis. 2015; 9(5): e0003701.