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Balmaceno-Criss M, Lou M, Zhou JJ, Ikwuazom CP, Andrews C, Alam J, Scheer RC, Kuharski M, Daher M, Singh M, Shah NV, Monsef JB, Diebo BG, Paulino CB, Daniels AH. What Is the Epidemiology of Cervical and Thoracic Spine Fractures? Clin Orthop Relat Res 2024:00003086-990000000-01682. [PMID: 39017523 DOI: 10.1097/corr.0000000000003189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/26/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Vertebral fractures are associated with enduring back pain, diminished quality of life, as well as increased morbidity and mortality. Existing epidemiological data for cervical and thoracic vertebral fractures are limited by insufficiently powered studies and a failure to evaluate the mechanism of injury. QUESTION/PURPOSE What are the temporal trends in incidence, patient characteristics, and injury mechanisms of cervical and thoracic vertebral fractures in the United States from 2003 to 2021? METHODS The United States National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) database collects data on all nonfatal injuries treated in US hospital emergency departments and is well suited to capture epidemiological trends in vertebral fractures. As such, the NEISS-AIP was queried from 2003 to 2021 for cervical and thoracic fractures. The initial search by upper trunk fractures yielded 156,669 injuries; 6% (9900) of injuries, with a weighted frequency of 638,999 patients, met the inclusion criteria. The mean age was 62 ± 25 years and 52% (334,746 of 638,999) of patients were females. Descriptive statistics were obtained. Segmented regression analysis, accounting for the year before or after 2019 when the NEISS sampling methodology was changed, was performed to assess yearly injury trends. Multivariable logistic regression models with age and sex as covariates were performed to predict injury location, mechanism, and disposition. RESULTS The incidence of cervical and thoracic fractures increased from 2.0 (95% CI 1.4 to 2.7) and 3.6 (95% CI 2.4 to 4.7) per 10,000 person-years in 2003 to 14.5 (95% CI 10.9 to 18.2) and 19.9 (95% CI 14.5 to 25.3) in 2021, respectively. Incidence rates of cervical and thoracic fractures increased for all age groups from 2003 to 2021, with peak incidence and the highest rate of change in individuals 80 years or older. Most injuries occurred at home (median 69%), which were more likely to impact older individuals (median [range] age 75 [2 to 106] years) and females (median 61% of home injuries); injuries at recreation/sports facilities impacted younger individuals (median 32 [3 to 96] years) and male patients (median 76% of sports facility injuries). Falls were the most common injury mechanism across all years, with females more likely to be impacted than males. The proportion of admissions increased from 33% in 2003 to 50% in 2021, while the proportion of treated and released patients decreased from 53% to 35% in the same period. CONCLUSION This epidemiological study identified a disproportionate increase in cervical and thoracic fracture incidence rates in patients older than 50 years from 2003 to 2021. Furthermore, high hospital admission rates were also noted resulting from these fractures. These findings indicate that current osteoporosis screening guidelines may be insufficient to capture the true population at risk of osteoporotic fractures, and they highlight the need to initiate screening at an earlier age. LEVEL OF EVIDENCE Level III, prognostic study.
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Affiliation(s)
- Mariah Balmaceno-Criss
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA
| | - Mary Lou
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA
| | - Jack J Zhou
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Chibuokem P Ikwuazom
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Carolyn Andrews
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Juhayer Alam
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Ryan C Scheer
- Department of Orthopaedic Surgery, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Michael Kuharski
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA
| | - Mohammad Daher
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA
| | - Manjot Singh
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA
| | - Neil V Shah
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Jad Bou Monsef
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Bassel G Diebo
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Carl B Paulino
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Alan H Daniels
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA
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Patil A, Chagi A, Poojari PG, Rashid M, Shivashankar KN, Thunga G, Nair S. Clinical characteristics, management, outcome, and cost of stings and bites in patients admitted to a tertiary care teaching hospital. Toxicol Res (Camb) 2024; 13:tfae006. [PMID: 38229978 PMCID: PMC10788677 DOI: 10.1093/toxres/tfae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 12/25/2023] [Accepted: 01/03/2024] [Indexed: 01/18/2024] Open
Abstract
AIM The objective of this study was to identify the clinical epidemiology and medical cost of stings and bites at a tertiary care hospital in South India. SUBJECTS AND METHODS The medical records of hospitalized patients in the tertiary care unit between 2016 and 2020 with the history of either being stung or bitten by insects were reviewed retrospectively. The patient's demographic details, clinical symptoms, treatment chart, expenditure details, and outcomes were collected in pre-structured case report forms. The data were analyzed using SPSS Version 20.0. RESULTS A total of 66 patients were enrolled, with a mean age of 45.86 ± 23.37 years. The majority of the incidence was due to bee stings (61%). Anaphylaxis was reported in 38% of the cases, followed by acute kidney injury (10.6%). The cost of hospitalization was found to be higher for spider bites at 896.73 ± 1414.95 USD, followed by wasp stings at 989.81 ± 1185.57 USD. In patients with complications, the average cost of stings and bites was 438.81 ± 685.81 USD. Most of the patients received antibiotics (75.8%), followed by steroids (62.1%). CONCLUSION Stings and bite injuries may appear harmless initially, but they can cause severe complications in unidentified cases and for those who do not seek urgent medical attention. Antibiotics and corticosteroids can help in the management of envenomation.
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Affiliation(s)
- Amar Patil
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Madhav Nagar, Manipal, Udupi District, Karnataka 576104, India
| | - Ayyappa Chagi
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Madhav Nagar, Manipal, Udupi District, Karnataka 576104, India
| | - Pooja Gopal Poojari
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Madhav Nagar, Manipal, Udupi District, Karnataka 576104, India
| | - Muhammed Rashid
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Madhav Nagar, Manipal, Udupi District, Karnataka 576104, India
| | - K N Shivashankar
- Department of Medicine, Kasturba Medical College, Manipal,Manipal Academy of Higher Education, Madhav Nagar, Manipal, Udupi District, Karnataka 576104, India
| | - Girish Thunga
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Madhav Nagar, Manipal, Udupi District, Karnataka 576104, India
| | - Sreedharan Nair
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Madhav Nagar, Manipal, Udupi District, Karnataka 576104, India
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Buyurgan ÇS, Köse A, Babuş SB, Yarkaç A, Usluer HO, Temel GO. Patients with Arthropod Bites and Stings Presenting to the Emergency Department: Clinical Features and Burden on the Emergency Department. J Arthropod Borne Dis 2023; 17:287-298. [PMID: 38860201 PMCID: PMC11162548 DOI: 10.18502/jad.v17i3.14988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/24/2023] [Indexed: 06/12/2024] Open
Abstract
Background There are few studies analyzing the epidemiological characteristics and clinical features of arthropod bites and stings, emergency department (ED) admission rate and cost burden. This study aimed to evaluate the clinical features and ED burden of such cases. Methods We retrospectively analyzed 954 patients who presented to ED after exposure to arthropods. The demographic and clinical characteristics, treatment rates, consultation and hospitalization requirements, and costs were evaluated. Results The rate of presentation to the ED after exposure to arthropods was 0.36%. Among the identifiable insects, 25%, 22%, 5%, 3% and 1% patients were exposed to bees, ticks, scorpions, spiders, and centipedes, respectively. Of the included patients, 51% were male and the mean age was 39.4±14.8 years. Exposure to arthropods was most commonly seen in the summers (45%). Local and systemic toxicities developed in 11% and 1% of patients, respectively. Further examinations were requested in 50% of cases and 83% of cases received treatment. 4% of cases were hospitalized, and 21% were prescribed medicines.. The average cost per patient of exposure to spiders, scorpions, centipedes, ticks and bees were 45.5, 28.3, 17.3, 12.6, and 10.1 US Dollars, respectively. The total cost of ED for all patients was calculated as $12,694.65. Conclusion We believe that a better understanding of the characteristics and prevalence of arthropod bites and stings will have a positive impact on primary prevention, health resource planning and reducing the burden on EDs by improving people's knowledge and practices to reduce the incidence of bites and stings.
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Affiliation(s)
- Çağrı S. Buyurgan
- Department of Emergency Medicine, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Ataman Köse
- Department of Emergency Medicine, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Seyran B. Babuş
- Department of Emergency Medicine, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Akif Yarkaç
- Department of Emergency Medicine, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Halil O. Usluer
- Department of Emergency Medicine, Mersin University, Faculty of Medicine, Mersin, Turkey
| | - Gülhan O. Temel
- Department of Biostatistics and Medical Informatics, Mersin University, Faculty of Medicine, Mersin, Turkey
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Rust MK, Lee CY, Park HE, Campbell K, Choe DH, Sorensen M, Sutherland A, Hubble C, Nobua-Behrmann B, Kabashima J, Tseng SP, Post L. The Potential of Fluralaner as a Bait Toxicant to Control Pest Yellowjackets in California. INSECTS 2023; 14:311. [PMID: 37103126 PMCID: PMC10143787 DOI: 10.3390/insects14040311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/13/2023] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
The western yellowjacket, Vespula pensylvanica (Saussure), is an important seasonal pest of recreational and outdoor venues in the western United States. Its propensity to scavenge food increases the likelihood of stinging incidences. Control measures are limited to intensive trapping and treating subterranean nests. The only toxicant registered for baiting in the US is esfenvalerate, which is ineffective. The objective of this study was to determine the potential of the isoxazoline fluralaner as a bait toxicant. With microsatellite genotyping, a minimum of 27 different colonies were shown to forage at a single monitoring site. Some colonies disappeared after baiting, and new colonies were detected. The implications for baiting and monitoring are discussed. Minced chicken and hydrogel baits containing 0.022% and 0.045% fluralaner significantly reduced foraging yellowjackets. Several bait applications covering large areas will be necessary to provide long-term control.
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Affiliation(s)
- Michael K. Rust
- Department of Entomology, University of California, Riverside, CA 92521, USA
| | - Chow-Yang Lee
- Department of Entomology, University of California, Riverside, CA 92521, USA
| | - Ho Eun Park
- Department of Entomology, University of California, Riverside, CA 92521, USA
| | - Kathleen Campbell
- Department of Entomology, University of California, Riverside, CA 92521, USA
| | - Dong-Hwan Choe
- Department of Entomology, University of California, Riverside, CA 92521, USA
| | - Mary Sorensen
- Placer Mosquito & Vector Control District, Roseville, CA 95678, USA
| | - Andrew Sutherland
- University of California Cooperative Extension, Alameda County, Hayward, CA 94544, USA
| | - Casey Hubble
- University of California Cooperative Extension, Alameda County, Hayward, CA 94544, USA
| | | | - John Kabashima
- University of California Cooperative Extension, Orange County, Irvine, CA 92618, USA
| | - Shu-Ping Tseng
- Department of Entomology, National Taiwan University, Taipei City 10617, Taiwan
| | - Linda Post
- San Diego Zoo Safari Park, Escondido, CA 92027, USA
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Prentice KC, Himstead AS, Briggs AL, Algaze-Gonzalez IM. Emergency Management Strategies and Antimicrobial Considerations for Nonmammalian Marine Vertebrate Penetrating Trauma in North America, the Caribbean, and Hawaii: A Review Article. Wilderness Environ Med 2023; 34:106-112. [PMID: 36610916 DOI: 10.1016/j.wem.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/06/2022] [Accepted: 09/16/2022] [Indexed: 01/06/2023]
Abstract
There are numerous emergency department visits in the United States for all types of marine animal injuries each year. These injuries may result in significant morbidity or mortality if not managed appropriately. Accurate identification of the offending species, thorough wound hygiene, and judicious use of antibiotics are important for preventing infections. This review aims to describe management strategies and antimicrobial considerations for nonmammalian marine vertebrate penetrating trauma in North America, the Caribbean, and Hawaii. A literature search was performed to identify studies on this subject. This literature consisted of clinical case reports and case series. Reports extracted included those on sharks, barracuda, eels, catfish, stingrays, lionfish, stonefish, and scorpionfish. The majority of reported trauma occurred to beachgoers, fishermen, or commercial aquarium employees who routinely handle these animals. Injury patterns depended on the species but most commonly affected the lower extremities. Infections were seen from saltwater bacteria, human skin flora, or marine animal oral flora. After thorough wound irrigation and exploration, most authors recommended prophylactic antimicrobials to cover Vibrio species, in addition to other gram-negative and gram-positive species. The literature is notable for the lack of controlled studies. Some authors recommended radiographic and/or ultrasonographic imaging to identify retained foreign bodies, such as spines, sand, or teeth.
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Affiliation(s)
- Kylie C Prentice
- School of Medicine, University of California, Irvine, Irvine, CA
| | | | - Amy L Briggs
- Department of Emergency Medicine, University of California, Irvine, Irvine, CA
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Vaughn AK, Larson LR, Peterson MN, Pacifici LB. Factors associated with human tolerance of snakes in the southeastern United States. FRONTIERS IN CONSERVATION SCIENCE 2022. [DOI: 10.3389/fcosc.2022.1016514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Conservation of snakes is influenced by humans’ beliefs, attitudes, and behaviors toward these often-maligned animals. We investigated public attitudes toward snakes through an online survey of undergraduate students (n = 743) at a large public university in a southeastern U.S. state. We used behavioral intent (i.e., how a person would react if they encountered a snake) to assess tolerance of different snake species. We also examined various predictors of tolerance including demographic attributes and a variety of cognitive (e.g., knowledge, value orientations) and affective (e.g., emotions) social-psychological variables. Tolerance of snakes varied based on whether the snake was venomous or non-venomous: about 36% of students said they were likely to kill venomous snakes they encountered, compared with 9% who said they would kill non-venomous snakes and 21% of students who said they would kill snakes whose identity was uncertain. However, most students (54%) could not distinguish between venomous and non-venomous species. Value orientations and emotions were strong predictors of tolerance for snakes, suggesting snake outreach and management strategies should account for both cognitive and affective antecedents of behavior.
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Sheele JM. Analysis of Patients With Bed Bugs in the Emergency Department. Adv Emerg Nurs J 2022; 44:229-241. [PMID: 35900244 DOI: 10.1097/tme.0000000000000406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective was to evaluate the clinical characteristics, triage information, diagnostic evaluation, and disposition for emergency department patients with and without bed bug infestation. A retrospective case-control study of patients with and without bed bugs was performed from February 1, 2011, through February 1, 2017. Cases (n = 332) and controls (n = 4,952) were matched by age, sex, and emergency department location. Patient characteristics and clinical information were compared between groups. On univariable and multivariable analysis, patients with bed bugs had higher heart rate, lower systolic blood pressure, higher pain scores, and more frequent tobacco use in the past year. They were also more likely to screen positive in triage for an unsafe home; require an abuse consultation; be diagnosed in the emergency department or inpatient setting with malnutrition, marasmus, and/or cachexia; have more emergency department and hospital visits; and have longer hospital encounter lengths of stay (all p ≤ 0.02). On univariable analysis, patients with bed bugs were also more likely than uninfested controls to be single, be Black, come to the emergency department from home, arrive to the emergency department by ambulance, and not be discharged back to their homes from the hospital.
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Varela K, Brown JA, Lipton B, Dunn J, Stanek D, Behravesh CB, Chapman H, Conger TH, Vanover T, Edling T, Holzbauer S, Lennox AM, Lindquist S, Loerzel S, Mehlenbacher S, Mitchell M, Murphy M, Olsen CW, Yager CM. A Review of Zoonotic Disease Threats to Pet Owners: A Compendium of Measures to Prevent Zoonotic Diseases Associated with Non-Traditional Pets: Rodents and Other Small Mammals, Reptiles, Amphibians, Backyard Poultry, and Other Selected Animals. Vector Borne Zoonotic Dis 2022; 22:303-360. [PMID: 35724316 PMCID: PMC9248330 DOI: 10.1089/vbz.2022.0022] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Kate Varela
- One Health Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer A. Brown
- National Association of State Public Health Veterinarians
- Indiana Department of Health
| | - Beth Lipton
- National Association of State Public Health Veterinarians
- Seattle & King County Public Health
| | - John Dunn
- National Association of State Public Health Veterinarians
- Tennessee Department of Health
| | - Danielle Stanek
- National Association of State Public Health Veterinarians
- Florida Department of Health
| | | | - Helena Chapman
- Division of Infectious Diseases and Global Medicine, University of Florida College of Medicine
- American Association for the Advancement of Science at NASA Applied Sciences
| | - Terry H. Conger
- U.S. Department of Agriculture Animal (USDA) and Plant Health Inspection Service (APHIS) Veterinary Services
| | | | | | - Stacy Holzbauer
- Minnesota Department of Health
- CDC Preparedness and Response Career Epidemiology Field Officer Program
| | | | | | | | | | - Mark Mitchell
- Louisiana State University School of Veterinary Medicine, Veterinary Clinical Sciences
| | - Michael Murphy
- Food and Drug Administration Center for Veterinary Medicine
| | - Christopher W. Olsen
- AVMA Council on Public Health
- Department of Pathobiological Sciences, University of Wisconsin-Madison School of Veterinary Medicine
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Sheele JM. Respiratory diseases in patients with bed bugs. CLINICAL RESPIRATORY JOURNAL 2021; 16:27-34. [PMID: 34498401 PMCID: PMC9060000 DOI: 10.1111/crj.13447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 06/22/2021] [Accepted: 09/05/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Some arthropods such as cockroaches can exacerbate asthma, but it is unknown is this is true of bed bugs. OBJECTIVES The objective of this work is to determine if bronchospastic diseases like asthma and chronic obstructive pulmonary disease (COPD) would be higher for ED patients who have bed bug infestation compared with patients who do not have bed bug infestation. METHODS A case-control study was performed with 332 adult emergency department (ED) patients with bed bug infestation and 4952 without infestation. Univariable and multivariable regression analysis was performed. RESULTS AND CONCLUSION Patients with bed bug infestation were not more likely to have a past history of or an ED diagnosis of asthma or chronic obstructive pulmonary disease (COPD). However, bed bug infested patients were significantly more likely to undergo chest radiography, be admitted to the hospital, and receive albuterol in the ED (P < 0.05). Infested patients receiving albuterol in the ED were more likely to be admitted to the hospital compared with uninfested patients receiving albuterol (P < 0.001). Patients with an ED or inpatient diagnosis of asthma or COPD and bed bugs (compared with those without bed bugs) had significantly more ED visits during the study (P < 0.03). Bed bug infestations may be associated with respiratory pathology, which requires further investigation.
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Affiliation(s)
- Johnathan M Sheele
- Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, USA
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10
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Sheele JM. Association between bed bugs and allergic reactions. Parasite Immunol 2021; 43:e12832. [PMID: 33704797 DOI: 10.1111/pim.12832] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 12/15/2022]
Abstract
AIMS To evaluate whether bed bugs are associated with allergic reactions in patients seen in the emergency department (ED). METHODS AND RESULTS This retrospective study included data from 9 EDs in Ohio between February 2011 and February 2017. The study comprised 332 patients with bed bug infestation matched 1:15 with 4952 control patients without bed bugs on the basis of age, sex and the presenting ED. Compared with uninfested patients, patients infested with bed bugs were more likely to have an ED or inpatient diagnosis of pruritus, hives or urticaria (odds ratio [OR], 9.12 [95% CI, 3.41-24.42]) and to be treated in the ED with an antihistamine (OR, 3.20 [95% CI, 1.87-5.50]) or albuterol (OR, 1.59 [95% CI, 1.07-2.36]) (P ≤ .02 for all). There were no significant differences in the rates of anaphylaxis and angioedema diagnosed in patients with and without bed bugs, which occurred in <1% in both groups. CONCLUSION Bed bug-infested patients are more likely to be diagnosed and treated for itchy cutaneous rashes, but are not clearly associated with more severe allergic reactions.
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Sheele JM, Pritt BS, Libertin CR, Wysokinska EM. Bed bugs are associated with anemia. Am J Emerg Med 2020; 46:482-488. [PMID: 33221110 DOI: 10.1016/j.ajem.2020.10.070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Bed bugs are hematophagous insects that can be problematic in some urban emergency departments. The objective was to determine if red blood cell (RBC) and coagulation indices of bed bug-infested emergency department (ED) patients differed from those of noninfested control patients. METHODS A chart review from a single health system was performed for ED patients between February 1, 2011, and February 1, 2017. Bed bug-infested patients were matched to noninfested control patients on the basis of age, sex, and the presenting ED. Variables were analyzed with the t-test and Pearson χ2 test and were modeled with multivariable logistic regression. RESULTS The study had 332 bed bug-infested patients and 4952 controls. Infested patients had lower hemoglobin (11.7 g/dL vs 12.8 g/dL), hematocrit (35.0% vs 37.9%), RBC counts (4.1 × 109/L vs 4.4 × 109/L), mean corpuscular volume (86.0 vs 87.5 fL/cell), and mean corpuscular hemoglobin concentrations (33.2 vs 33.7 g/dL) and higher RBC distribution width-coefficient of variation (RDW-CV) (15.2% vs 14.2%) than noninfested patients (all P ≤ .003). Infested patients were more likely to be anemic (59.5% vs 36.9%) and to have severe anemia (4.4% vs 0.7%) (P < .001 for both). Blood transfusions were more common in those with bed bugs (5.1%) than those without bed bugs (2.3%) (P < .001). CONCLUSION Bed bug infestated patients in the ED are associated with anemia.
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Affiliation(s)
| | - Bobbi S Pritt
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Ewa M Wysokinska
- Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA
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Langley R, Haskell MG, Hareza D, King K. Fatal and Nonfatal Snakebite Injuries Reported in the United States. South Med J 2020; 113:514-519. [DOI: 10.14423/smj.0000000000001156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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13
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Haskell MG, Langley RL. Animal-Encounter Fatalities, United States, 1999-2016: Cause of Death and Misreporting. Public Health Rep 2020; 135:831-841. [PMID: 32933400 DOI: 10.1177/0033354920953211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Errors and misreporting on death certificates are common, along with potential inaccuracies in cause-of-death coding. We characterized and compared fatalities by animal-encounter mentions reported as underlying cause of death (UCD) with animal-encounter mentions reported as multiple cause of death (MCD) to determine factors associated with misreporting UCD. METHODS We analyzed fatality data from 1999-2016 from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research by UCD and MCD animal-encounter mentions (International Classification of Diseases, 10th Revision codes W53-59, X20-27 and X29, T63.0-63.6, T63.8-63.9, and T78.2-78.4). We examined differences in reporting by age, sex, race, autopsy (yes, no, unknown), allergic reactions, and toxicities. RESULTS The number of animal-encounter mentions by UCD was 3638 (202 average per year) and by MCD was 4280 (238 average per year), a difference of 18% (n = 642; 36 average per year) by MCD analysis. The number of nonvenomous animal-encounter mentions increased 20% (from 2138 UCD to 2567 MCD), and the number of venomous animal-encounter mentions increased 14% (from 1500 UCD to 1713 MCD). Decedents aged ≥65 had the highest additional number of animal-encounter mentions among all age groups, primarily encounters with other reptiles (n = 113), other mammals (n = 71), and dogs (n = 42). Of 642 MCD additional animal-encounter mentions, heart disease (n = 211, 33%) and infections (n = 146, 23%) represented more than half of the UCD. Of 553 dog-encounter fatalities, 165 (30%) were among children aged ≤4. CONCLUSIONS Animal-encounter fatalities, analyzed by UCD alone, may be underreported. An initiating animal injury, complicated by comorbidities and fatality, may obscure the causal chain, resulting in misreporting UCD. Ongoing training for medical certifiers is recommended, highlighting accurate identification of UCD and contributing causes in the causal chain of death.
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Affiliation(s)
| | - Ricky Lee Langley
- 12278 Department of Public Health, East Carolina University, Greenville, NC, USA
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Boğan M, Sabak M, Oktay MM, Gümüşboğa H, Tek T, Alatlı T. Unknown biological materials brought to the emergency department. J Rural Med 2020; 15:98-103. [PMID: 32704335 PMCID: PMC7369404 DOI: 10.2185/jrm.2020-005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 04/09/2020] [Indexed: 11/27/2022] Open
Abstract
Objective: This study is unique as it examines biological materials brought
to the emergency department. The purpose of this study was to investigate the reasons
behind the presence of nonhuman biological material in the emergency department. Methods: The materials brought were photographed and a pre-prepared survey
form was filled in following examination. Results: A total of 46 biological materials were brought to the emergency
department within a 12-month period. Ticks were the most frequently brought material, and
the most common reason for bringing them was to get the creature removed from the
body. Situations in which the physician did not have knowledge about the
material were more frequent among those that were neutral about being satisfied with
the attitude of the physician towards the material brought, and
satisfaction was higher in cases when the physician was knowledgeable, although this was
not statistically significant. Conclusion: Physicians should not condemn biological materials brought into
the department after exposure. If possible, they should try to gain more knowledge about
them. If the material is not to be stored, once it is made sure that it is not dangerous,
it should be disposed of in a medical waste bin. Physicians should be knowledgeable toward
the frequency and the types of such agents in their region.
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Affiliation(s)
| | | | | | | | - Tutku Tek
- Emergency Department, Gaziantep University, Turkey
| | - Tufan Alatlı
- Turhal School of Applied Technology and Management, Department of Emergency Aid and Disaster Management, Gaziosmanpaşa University, Turkey
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Abstract
Latrodectus geometricus, also known as the brown widow or brown button spider, is an unrenowned relative of the American black widow. While brown widow envenomation is generally thought of as mild, it does have the potential to lead to moderate or severe features similar to black widow bites. We report a case of brown widow envenomation that led to a moderate reaction including rash, local pain, pain radiating proximally in the extremity and nausea. Poison control was consulted for aid in spider identification. The patient was treated for pain control and muscle relaxation and monitored for eight hours. After proper tetanus prophylaxis, the patient was successfully discharged home with well-controlled, but continued mild symptoms. This case highlights a little-known, but clinically relevant species of widow spider with a wide distribution. Expeditious identification and treatment of brown widow bites can increase patient comfort, satisfaction, and discharge rates.
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Affiliation(s)
- Ryan C Earwood
- Department of Emergency Medicine, Florida State University College of Medicine, Tallahassee, USA
| | - Jay Ladde
- Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, USA
| | - Philip A Giordano
- Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, USA
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16
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Khan A, Al-Kathiri WH, Balkhi B, Samrkandi O, Al-Khalifa MS, Asiri Y. The burden of bites and stings management: Experience of an academic hospital in the Kingdom of Saudi Arabia. Saudi Pharm J 2020; 28:1049-1054. [PMID: 32792849 PMCID: PMC7414059 DOI: 10.1016/j.jsps.2020.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 07/03/2020] [Indexed: 10/25/2022] Open
Abstract
Purpose The main aim of this study is to estimate the economic burden and prevalence of bites and stings injuries in Saudi Arabia. Methods A retrospective, cross-sectional study was conducted at King Saud University Medical City (KSUMC) for all bites and stings cases presented to the Emergency Department (ED) between the period June 2015 and May 2019. Results A total of 1328 bites and stings cases were treated in the ED at KSUMC. There were 886 insect bites and stings cases, 376 animal bites, 22 human bites, 34 scorpion stings, and ten snakebites. Most cases were reported in April - June. Females account for 62% of the reported cases, and the mean age was 24 years old. The total management cost of bite and sting cases during the study period was 3.4 million Saudi Riyal (SR). The spending cost of the management of animal bites was the highest as it cost 1,681,920.76 SR, followed by insect's management costing 1,228,623.68 SR. Conclusion Bites and stings have a considerable health care burden on our society. Although the vast majority of the cases were not associated with a severe life-threatening condition, many were visit ED and associated with high medical costs. Increased awareness of the hazards of animal-related injuries, especially during spring and summer, where most cases take place may lower its incidence and decrease EDs visits.
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Affiliation(s)
- Anas Khan
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Waad H Al-Kathiri
- Department of Clinical Pharmacy Services, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Bander Balkhi
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,Pharmacoeconomic Research Unit, King Saud University, Riyadh, Saudi Arabia
| | - Osama Samrkandi
- Department, Prince Sultan bin Abdulaziz College for EMS, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | | | - Yousef Asiri
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Hareza D, Langley R, Haskell MG, King K. National Estimates of Noncanine Bite and Sting Injuries Treated in US Hospital Emergency Departments, 2011-2015. South Med J 2020; 113:232-239. [PMID: 32358618 DOI: 10.14423/smj.0000000000001091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Injuries resulting from contact with animals are a significant public health concern. This study quantifies and updates nonfatal bite and sting injuries by noncanine sources using the most recent data available (2011-2015) from the National Electronic Injury Surveillance System-All Injury Program with the purpose of using these updates to better understand public health consequences and prevention techniques. Increased rates of bites and stings can be expected in this study's time frame, possibly caused by the increasing human population expanding into animal territories, as well as changes in animal geographic distribution and pet ownership. METHODS The National Electronic Injury Surveillance System-All Injury Program is an ongoing nationally representative surveillance system used to monitor all types and causes of injuries treated in US hospital emergency departments (EDs). Cases were coded by trained hospital coders using information from medical records on animal sources of bite and sting injuries being treated. Data from 2011-2015 were weighted to produce national annualized estimates, percentages, and rates based on the US population. RESULTS An estimated 1.17 million people visited EDs for noncanine bite and sting injuries annually. This translates to a rate of 371.3/100,000 people. Insects accounted for 71.0% of noncanine bite and sting injuries, followed by arachnids (19.2%) and mammals (7.8%). The estimated annual total lifetime medical and work cost of unintentional noncanine injuries was $5,755,581,000. CONCLUSIONS Various sources of bite and sting injuries had an outsized effect on injury rates and identify potential areas of focus for education and prevention programs to reduce the burden of these injuries on health and healthcare costs. The study describes the diversity of animal exposures based on a national sample of EDs. Noncanine bite and sting injuries significantly affect public health and healthcare resources. Priorities can be focused on animal sources with the most impact on bite and sting injury rates, healthcare costs, and disease burden.
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Affiliation(s)
- Dariusz Hareza
- From the Department of Medicine, University of Chicago, Chicago, Illinois, the North Carolina Department of Health and Human Services, Raleigh, Marilyn Goss Haskell, Innovative One Health Solutions, Raleigh, North Carolina, and the Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ricky Langley
- From the Department of Medicine, University of Chicago, Chicago, Illinois, the North Carolina Department of Health and Human Services, Raleigh, Marilyn Goss Haskell, Innovative One Health Solutions, Raleigh, North Carolina, and the Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Marilyn Goss Haskell
- From the Department of Medicine, University of Chicago, Chicago, Illinois, the North Carolina Department of Health and Human Services, Raleigh, Marilyn Goss Haskell, Innovative One Health Solutions, Raleigh, North Carolina, and the Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Katherine King
- From the Department of Medicine, University of Chicago, Chicago, Illinois, the North Carolina Department of Health and Human Services, Raleigh, Marilyn Goss Haskell, Innovative One Health Solutions, Raleigh, North Carolina, and the Rollins School of Public Health, Emory University, Atlanta, Georgia
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Sheele JM, Hamid O, Chang BF, Luk JH. Knowledge, Experience, and Concerns Regarding Bed Bugs Among Emergency Medical Service Providers. Cureus 2020; 12:e8120. [PMID: 32542172 PMCID: PMC7292720 DOI: 10.7759/cureus.8120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction Bed bugs are commonly encountered by emergency medical service (EMS) providers. The objective of this study was to determine the frequency with which EMS providers encountered bed bugs, assess their knowledge about bed bugs, and analyze the actions they take after finding bed bugs. Methods We anonymously surveyed 407 EMS providers from 180 EMS agencies in northeast Ohio between September 1, 2018, through March 31, 2019. Results Among the providers surveyed, 21% (n = 84) of the EMS providers reported seeing bed bugs at least monthly, and 6% (n = 24) reported seeing bed bugs at least weekly. Being younger, male, and working in an urban environment (vs. rural) were associated with EMS providers reporting more frequent bed bug encounters (p: ≤.05). The mean level of concern for encountering bed bugs among EMS providers was 3.54 (SD: 1.15; scale: 1 = no concern, 5 = very concerned). Among the EMS providers who reported seeing bed bugs at least monthly, 30% took the affected EMS stretcher out of service when they encounter a bed bug, 43% took the EMS rig out of service, 83% cleaned the EMS stretcher with a disinfectant, and 88% notified the ED that their patient has bed bugs. EMS providers scored poorly (mean: 69% correct responses) in a seven-question assessment of basic bed bug biology and public health. Conclusion Based on our findings, we concluded that EMS knowledge and behavior related to bed bugs are suboptimal.
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Affiliation(s)
| | - Osman Hamid
- Emergency Medicine, Mayo Clinic, Jacksonville, USA
| | - Brandon F Chang
- Emergency Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA
| | - Jeffrey H Luk
- Emergency Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA.,Emergency Medicine, Case Western Reserve University School of Medicine, Cleveland, USA
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Curfman KR, Dumire R, Shayesteh K. Complex Wound Closure Following Mysterious and Vicious Animal Attack. Cureus 2020; 12:e7758. [PMID: 32455075 PMCID: PMC7243086 DOI: 10.7759/cureus.7758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Animal attacks are a worrisome and dangerous entity that occur at high volumes and are evaluated frequently by ER physicians, primary care physicians, trauma teams, acute care surgeons, and plastic surgeons. The severity of animal attacks can range from a small insect sting to mauling by large animal, and even death. With animal attacks of high intensity, there is often significant scratching, tearing, shearing, with destruction of the skin, subcutaneous tissues, muscles, and bone. Serious attacks frequently lead to infection, sepsis, pain, loss of sensation or mobility, operative interventions, and amputations of affected limbs. We report herein the traumatic mauling of a woman by a reported unknown animal. Though the entity of animal attacks has been reported in the past, this case dictates presentation given the suspicious circumstances surrounding the attack, the involvement of her care requiring a multidisciplinary surgical approach via trauma surgery and plastic surgery, multiple extensive interventions, and the excellent take of the split thickness skin graft (STSG) after the use of a dermal regeneration template (DRT).
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Affiliation(s)
| | - Russell Dumire
- Surgery, Conemaugh Memorial Medical Center, Johnstown , USA
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20
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A Brief Review on Biting/Stinging of Animals and Its Risk of Infection. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2020. [DOI: 10.5812/archcid.97499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jaramillo JD, Hakes NA, Tennakoon L, Spain D, Forrester JD. The "T's" of snakebite injury in the USA: fact or fiction? Trauma Surg Acute Care Open 2019; 4:e000374. [PMID: 31803846 PMCID: PMC6887492 DOI: 10.1136/tsaco-2019-000374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/02/2019] [Indexed: 11/04/2022] Open
Abstract
Background Venomous snakebites can result in serious morbidity and mortality. In the USA, the "T's of snakebites" (testosterone, teasing, touching, trucks, tattoos & toothless (poverTy), Texas, tequila, teenagers, and tanks) originate from anecdotes used to colloquially highlight venomous snakebite risk factors. We performed an epidemiologic assessment of venomous snakebites in the USA with the objective of evaluating the validity of the "T's of snakebites" at a national level. Methods We performed a retrospective analysis of the National Emergency Department Sample. Data from January 1, 2016 to December 31, 2016 were obtained. All emergency department (ED) encounters corresponding to a venomous snakebite injury were identified using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. Primary outcomes were mortality and inpatient admission. Demographic, injury, and hospital characteristics were assessed. Data were analyzed according to survey methodology. Weighted values are reported. Results In 2016, 11 138 patients presented to an ED with a venomous snakebite. There were 4173 (37%) persons aged 18 to 44, and 7213 (65%) were male. Most snakebites were reported from the South (n=9079; 82%), although snakebites were reported from every region in the USA. Only 3792 (34%) snakebites occurred in rural counties. Persons in the lowest income quartile by zip code were the most heavily represented (n=4337; 39%). The most common site of injury was the distal upper extremity (n=4884; 44%). Multivariate analysis revealed that species of snake (OR=0.81; 95% CI 0.73 to 0.88) and older age (OR=1.42; 95% CI 1.08 to 1.87) were associated with hospital admission. There were <10 inpatient deaths identified, and no variables were predictive of death. Discussion Some of the "T's of snakebites" may be valid colloquial predictors of the risk for venomous snakebites. Based on national data, common demographics of venomous snakebite victims include lower income, Caucasian, and adult men in the South who are bit on the upper extremity. Understanding common demographics of venomous snakebite victims can effectuate targeted public health prevention messaging. Level of evidence IV.
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Affiliation(s)
| | | | | | - David Spain
- Department of Surgery, Stanford University, Stanford, California, USA
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Sheele JM, Ridge G, Li X, Schlatzer D, Lesser E. The Benefit of a Single Oral Dose of Ivermectin in Humans: The Adverse Effects on Cimex lectularius L. Populations and Fecundity. Cureus 2019; 11:e6098. [PMID: 31886039 PMCID: PMC6901371 DOI: 10.7759/cureus.6098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective To measure the population size and fecundity of the common bed bug Cimex lectularius L. (C. lectularius) after feeding it with the blood obtained from human subjects who have consumed a single dose of ivermectin. Methods Serial blood samples were obtained from two human subjects at hour 0 (control) and 4-96 hours after they received a single 0.2 mg/kg dose of ivermectin. The blood samples were then fed to 2,273 bed bugs. Bed bug incapacitation rates, fecundity, and population sizes were recorded over a 54-day period. Whole blood ivermectin levels were measured in the human subjects and the insects. Results The fold change in the size of the control group population over the course of the experiment was found to be 2.16. This was significantly greater (p: <.001) than for all the post-ivermectin feeding groups (range: -11.04-1.43). Two weeks after the experiment, the number of eggs laid per live adult female bed bug per day was 10.74 for controls, which was significantly different (p: <0.001) compared to all the post-ivermectin feeding groups (range: 0-4.28). Conclusions There were significant reductions in C. lectularius population size and fecundity in insects that fed on blood obtained from human study subjects up to 96 hours after they have consumed a single oral dose of ivermectin.
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Affiliation(s)
| | - Gale Ridge
- Entomology, The Connecticut Agricultural Experimental Station, New Haven, USA
| | - Xiaolin Li
- Nutrition Proteomics and Small Molecule Mass Spectrometry, Case Western Reserve University, Cleveland, USA
| | - Danie Schlatzer
- Nutrition Proteomics and Small Molecule Mass Spectrometry, Case Western Reserve University, Cleveland, USA
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Vaughn MG, Holzer KJ, Carbone JT, Salas-Wright CP. Arthropod Bites and Stings Treated in Emergency Departments: Recent Trends and Correlates. Wilderness Environ Med 2019; 30:394-400. [PMID: 31405548 DOI: 10.1016/j.wem.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/15/2019] [Accepted: 05/28/2019] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Despite increasing health effects of arthropod bites and associated costs, research on their frequency is limited, especially at the population level. The aim of this study was to estimate the prevalence, correlates, and recent trends in visits to US emergency departments related to arthropod bites and stings. METHODS The prevalence of arthropod bites, including information regarding location of the bite, was calculated for years 2010 through 2014 using data from the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample. Sex- and age-stratified multivariate logistic regression analyses were conducted with "arthropod bite" as the dependent variable and patient and hospital characteristics as independent variables. RESULTS Overall, there were significant increases in bites over the study period with higher rates of bites in the summer months (June-August), especially among children. Individuals who seek treatment for arthropod bites in the emergency department are more likely to reside in zip codes with lower median household income and to be without insurance coverage or with Medicaid rather than private insurance. The cost of care related to arthropod bites increased approximately 40% over the study period. CONCLUSIONS These results provide updated surveillance on the prevalence and correlates of arthropod bites and stings in the US population.
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Affiliation(s)
- Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO; Yonsei University, Seoul, Republic of Korea
| | - Katherine J Holzer
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO.
| | - Jason T Carbone
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO
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Characteristics of Bed Bug Infested Patients in the Emergency Department. Emerg Med Int 2019; 2019:8721829. [PMID: 31210990 PMCID: PMC6532314 DOI: 10.1155/2019/8721829] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/11/2019] [Accepted: 04/23/2019] [Indexed: 11/17/2022] Open
Abstract
Cimex lectularius L., the common bed bug, is a hematophagous human ectoparasite that has undergone a global resurgence in the past two decades. We surveyed 706 active emergency department (ED) patients about their experiences with bed bugs. We found that 2% of ED patients reported having a current bed bug infestation, significantly more than the historical number of ED patients upon which we find bed bug; 37% of ED patients report previously having been fed on by a bed bug; 15% currently know someone with an active infestation; and 59% know someone that has had an infestation within ≤ 5 years. Only 18% of bed bug infested patients reported their infestation to emergency medicine providers and only 21% were put in isolation precautions. We found that 25% of patients with bed bugs worried about receiving worse healthcare because of their infestation. Persons with bed bugs were more likely compared to those without bed bugs to be older (52 vs. 41 years) and arrive by ambulance (57% vs. 14%) (p < 0.05), but not reporting insomnia (50% vs. 49%) (p = 1.0). Bed bug infested patients can be common in the ED. Most bed bug infested patients are older, arrive to the ED by ambulance, do not report their infestation to healthcare providers, and are not adequately placed into isolation precautions, potentially putting other patients and providers at risk for acquiring the infestation.
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Forrester JD, Forrester JA, Tennakoon L, Staudenmayer K. Mortality, hospital admission, and healthcare cost due to injury from venomous and non-venomous animal encounters in the USA: 5-year analysis of the National Emergency Department Sample. Trauma Surg Acute Care Open 2018; 3:e000250. [PMID: 30623028 PMCID: PMC6307625 DOI: 10.1136/tsaco-2018-000250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background Injuries due to encounters with animals can be serious, but are often discussed anecdotally or only for isolated types of encounters. We sought to characterize animal-related injuries presenting to US emergency departments (ED) to determine the impact of these types of injuries. Methods All ED encounters with diagnosis codes corresponding to animal-related injury were identified using ICD-9-CM codes from the 2010 2014 National Emergency Department Sample (NEDS). Outcomes assessed included inpatient admission, mortality, and healthcare cost. Survey methodology was applied to univariate and multivariate analyses. Weighted numbers are presented. Results There were 6 457 534 ED visits resulting from animal-related injuries identified. Bites from non-venomous arthropods (n=2 648 880; 41%), dog bites (n=1 658 295; 26%) and envenomation from hornets, wasps or bees (n=812 357; 13%) constitute the majority of encounters. There were 210 516 patients (3%) admitted as inpatients. Inpatient admission was most common for those suffering from venomous snakes or lizard bites (24%, n=10 332). Death was infrequent occurring in 1162 patients (0.02% of all ED presentations). The greatest number of deaths was due to bites from non-venomous arthropods (24% of deaths, n=278) whereas rat bites proved the most lethal (6.5 deaths per 10 000 bites). Among persons aged 85 years or greater, odds of hospital admission for any animal-related injury was 6.42 (95% CI 5.57 to 7.40) and the OR for death was 27.71 (95% CI 10.38 to 73.99). Female sex was associated with improved survival (OR 0.55, 95% CI 0.41 to 0.73) and lower rates of hospital admission (OR 0.77, 95% CI 0.75 to 0.79). The total healthcare cost for these animal encounters during the observed time period was $5.96 billion (95% CI $5.43 to $6.50 billion). Conclusion The morbidity, mortality, and healthcare cost due to animal encounters in the USA is considerable. Often overlooked, this particular mechanism of injury warrants further public health prevention efforts. Level of Evidence Level IV.
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Affiliation(s)
| | - Jared A Forrester
- Department of Surgery, Stanford University, Stanford, California, USA
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Ren W, Gries R, McCaughey C, Derstine N, Alamsetti SK, Kurita KL, Tu L, Linington RG, Britton R, Gries G. Maculatic Acids-Sex Attractant Pheromone Components of Bald-Faced Hornets. Angew Chem Int Ed Engl 2018. [DOI: 10.1002/ange.201804666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Weiwu Ren
- Department of Chemistry; Simon Fraser University; Burnaby British Columbia Canada
| | - Regine Gries
- Department of Biological Sciences; Simon Fraser University; Burnaby British Columbia Canada
| | - Catherine McCaughey
- Department of Chemistry; Simon Fraser University; Burnaby British Columbia Canada
| | - Nathan Derstine
- Department of Biological Sciences; Simon Fraser University; Burnaby British Columbia Canada
| | - Santosh K. Alamsetti
- Department of Chemistry; Simon Fraser University; Burnaby British Columbia Canada
- Department of Biological Sciences; Simon Fraser University; Burnaby British Columbia Canada
| | - Kenji L. Kurita
- Department of Chemistry; Simon Fraser University; Burnaby British Columbia Canada
| | - Lorna Tu
- Department of Biological Sciences; Simon Fraser University; Burnaby British Columbia Canada
| | - Roger G. Linington
- Department of Chemistry; Simon Fraser University; Burnaby British Columbia Canada
| | - Robert Britton
- Department of Chemistry; Simon Fraser University; Burnaby British Columbia Canada
| | - Gerhard Gries
- Department of Biological Sciences; Simon Fraser University; Burnaby British Columbia Canada
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Kempema J, Watanabe B, Potter A, Williams M. Bites, Stings, and Envenomations. CURRENT TRAUMA REPORTS 2018. [DOI: 10.1007/s40719-018-0140-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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A new siloxane embedded benzalkonium chloride-based skin protectant (fiteBac Germicidal Skin Softening Gel) for use against insect bites and related dermal infections. REVISTA MÉDICA DEL HOSPITAL GENERAL DE MÉXICO 2018. [DOI: 10.1016/j.hgmx.2018.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Ren W, Gries R, McCaughey C, Derstine N, Alamsetti SK, Kurita KL, Tu L, Linington RG, Britton R, Gries G. Maculatic Acids-Sex Attractant Pheromone Components of Bald-Faced Hornets. Angew Chem Int Ed Engl 2018; 57:11618-11622. [PMID: 29890016 DOI: 10.1002/anie.201804666] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Indexed: 11/06/2022]
Abstract
Yellowjackets in the genera Vespula and Dolichovespula are prevalent eusocial insects of great ecological and economic significance, but the chemical signals of their sexual communication systems have defied structural elucidation. Herein, we report the identification of sex attractant pheromone components of virgin bald-faced hornet queens (Dolichovespula maculata). We analyzed body surface extracts of queens by coupled gas chromatographic-electroantennographic detection (GC-EAD), isolated the compounds that elicited responses from male antennae by high-performance liquid chromatography (HPLC), and identified these components by GC mass spectrometry (MS), HPLC-MS, and NMR spectroscopy. In laboratory olfactometer experiments, synthetic (2Z,7E)-3,7-dimethyldeca-2,7-diendioic acid (termed here maculatic acid A) and (2Z,7E)-10-methoxy-3,7-dimethyldeca-10-oxo-deca-2,7-dienoic acid (termed here maculatic acid C) in binary combination significantly attracted bald-faced hornet males. These are the first sex attractant pheromone components identified in yellowjackets.
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Affiliation(s)
- Weiwu Ren
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Regine Gries
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Catherine McCaughey
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Nathan Derstine
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Santosh K Alamsetti
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia, Canada.,Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Kenji L Kurita
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Lorna Tu
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Roger G Linington
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Robert Britton
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Gerhard Gries
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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Needleman RK, Neylan IP, Erickson T. Potential Environmental and Ecological Effects of Global Climate Change on Venomous Terrestrial Species in the Wilderness. Wilderness Environ Med 2018; 29:226-238. [DOI: 10.1016/j.wem.2017.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 11/08/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022]
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Forrester JA, Weiser TG, Forrester JD. An Update on Fatalities Due to Venomous and Nonvenomous Animals in the United States (2008–2015). Wilderness Environ Med 2018; 29:36-44. [DOI: 10.1016/j.wem.2017.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 09/17/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022]
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Pasmans F, Bogaerts S, Braeckman J, Cunningham AA, Hellebuyck T, Griffiths RA, Sparreboom M, Schmidt BR, Martel A. Future of keeping pet reptiles and amphibians: towards integrating animal welfare, human health and environmental sustainability. Vet Rec 2017; 181:450. [PMID: 29051315 DOI: 10.1136/vr.104296] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 08/12/2017] [Accepted: 08/18/2017] [Indexed: 01/24/2023]
Abstract
The keeping of exotic pets is currently under debate and governments of several countries are increasingly exploring the regulation, or even the banning, of exotic pet keeping. Major concerns are issues of public health and safety, animal welfare and biodiversity conservation. The keeping of reptiles and amphibians in captivity encompasses all the potential issues identified with keeping exotic pets, and many of those relating to traditional domestic pets. Within the context of risks posed by pets in general, the authors argue for the responsible and sustainable keeping of reptile and amphibian pets by private persons, based on scientific evidence and on the authors' own expertise (veterinary medicine, captive husbandry, conservation biology).
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Affiliation(s)
- Frank Pasmans
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Johan Braeckman
- Department of Philosophy, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium
| | | | - Tom Hellebuyck
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Richard A Griffiths
- School of Anthropology and Conservation, Durrell Institute of Conservation and Ecology, University of Kent, Canterbury, Kent, UK
| | | | - Benedikt R Schmidt
- Info Fauna KARCH, Passage Maximilien-de-Meuron, Neuchâtel, Switzerland.,Department of Evolutionary Biology and Environmental Studies, University of Zurich, Zürich, Switzerland
| | - An Martel
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Barros N, Langley R. Fatal and non-fatal animal-related injuries and illnesses to workers, United States, 2011-2014. Am J Ind Med 2017; 60:776-788. [PMID: 28677842 DOI: 10.1002/ajim.22744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND Study provides update of national estimates for work-related fatal injuries and non-fatal injuries and illnesses by animals in US. METHODS Between 2011 and 2014, injuries and illnesses were retrieved from US Department of Labor and were translated to economic losses using National Safety Council estimates. RESULTS Total of 222 fatalities (36% by cattle and other bovines) and 71 460 non-fatal injuries and illnesses (38% by insects, arachnids, mites) were identified from animal sources. For non-fatal injuries and illnesses from primary animal sources, annual incidence rates were 1.5-1.6/10 000 full-time workers and annual median days lost from work were 3-4 days. Work-related costs were $222M for fatalities and $2.8B for non-fatal injuries and illnesses that resulted in at least 1 day lost from work. CONCLUSIONS Study provides evidence of specific animals contributing to more severe injuries and potential for more severe injuries when there is more than one source of injury.
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Affiliation(s)
- Nirmalla Barros
- Division of Public Health; North Carolina Department of Health and Human Services; Raleigh North Carolina
| | - Ricky Langley
- Division of Public Health; North Carolina Department of Health and Human Services; Raleigh North Carolina
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Babcock T, Gries R, Borden J, Palmero L, Mattiacci A, Masciocchi M, Corley J, Gries G. Brewer's Yeast, Saccharomyces cerevisiae, Enhances Attraction of Two Invasive Yellowjackets (Hymenoptera: Vespidae) to Dried Fruit and Fruit Powder. JOURNAL OF INSECT SCIENCE (ONLINE) 2017; 17:4098124. [PMID: 28922898 PMCID: PMC5581402 DOI: 10.1093/jisesa/iex065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Indexed: 06/07/2023]
Abstract
The German yellowjacket, Vespula germanica F., and common yellowjacket, Vespula vulgaris L. (Hymenoptera: Vespidae), are pests of significant economic, environmental, and medical importance in many countries. There is a need for the development and improvement of attractive baits that can be deployed in traps to capture and kill these wasps in areas where they are a problem. Yellowjackets are known to feed on fermenting fruit, but this resource is seldom considered as a bait due to its ephemeral nature and its potential attractiveness to nontarget species. We analyzed the headspace volatiles of dried fruit and fruit powder baits with and without Brewer's yeast, Saccharomyces cerevisiae, using gas chromatography-mass spectrometry, and we field tested these baits for their attractiveness to yellowjackets in Argentina. The addition of yeast to dried fruit and fruit powder changed the volatile compositions, increasing the number of alcohols and acids and decreasing the number of aldehydes. Dried fruit and fruit powder baits on their own were hardly attractive to yellowjackets, but the addition of yeast improved their attractiveness by 9- to 50-fold and surpassed the attractiveness of a commercial heptyl butyrate-based wasp lure. We suggest that further research be done to test additional varieties and species of yeasts. A dried fruit or fruit powder bait in combination with yeast could become a useful tool in the management of yellowjackets.
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Affiliation(s)
- Tamara Babcock
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, CanadaV5A 1S6
| | - Regine Gries
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, CanadaV5A 1S6
| | - John Borden
- Scotts Canada Ltd., 7572 Progress Way, Delta, BC, CanadaV4G 1E9
| | - Luis Palmero
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, CanadaV5A 1S6
| | - Analía Mattiacci
- Grupo de Ecología de Poblaciones de Insectos, CONICET—INTA EEA Bariloche, Bariloche, Argentina, and
| | - Maité Masciocchi
- Grupo de Ecología de Poblaciones de Insectos, CONICET—INTA EEA Bariloche, Bariloche, Argentina, and
| | - Juan Corley
- Grupo de Ecología de Poblaciones de Insectos, CONICET—INTA EEA Bariloche, Bariloche, Argentina, and
| | - Gerhard Gries
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, CanadaV5A 1S6
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Abstract
BACKGROUND Better knowledge of the epidemiological characteristics of snakebites could help to take measures to improve their management. The incidence and mortality of snakebites in the Americas are most often estimated from medical and scientific literature, which generally lack precision and representativeness. METHODOLOGY/PRINCIPAL FINDINGS Authors used the notifications of snakebites treated in health centers collected by the Ministries of Health of the American countries to estimate their incidence and mortality. Data were obtained from official reports available on-line at government sites, including those of the Ministry of Health in each country and was sustained by recent literature obtained from PubMed. The average annual incidence is about 57,500 snake bites (6.2 per 100,000 population) and mortality is close to 370 deaths (0.04 per 100,000 population), that is, between one third and half of the previous estimates. The incidence of snakebites is influenced by the abundance of snakes, which is related to (i) climate and altitude, (ii) specific preferences of the snake for environments suitable for their development, and (iii) human population density. Recent literature allowed to notice that the severity of the bites depends mainly on (i) the snake responsible for the bite (species and size) and (ii) accessibility of health care, including availability of antivenoms. CONCLUSIONS/SIGNIFICANCES The main limitation of this study could be the reliability and accuracy of the notifications by national health services. However, the data seemed consistent considering the similarity of the incidences on each side of national boundaries while the sources are distinct. However, snakebite incidence could be underestimated due to the use of traditional medicine by the patients who escaped the reporting of cases. However, gathered data corresponded to the actual use of the health facilities, and therefore to the actual demand for antivenoms, which should make it possible to improve their management.
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Affiliation(s)
- Jean-Philippe Chippaux
- CERPAGE, Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Bénin
- UMR216, Mère et enfant face aux infections tropicales and PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
- * E-mail:
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Sheele JM, Ridge GE, Coppolino K, Bonfield T, Young AB, Gaines SL, McCormick TS. Antibody and cytokine levels in humans fed on by the common bedbug,Cimex lectulariusL. Parasite Immunol 2017; 39. [DOI: 10.1111/pim.12411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/06/2017] [Indexed: 11/30/2022]
Affiliation(s)
- J. M. Sheele
- Department of Emergency Medicine; University Hospitals Cleveland Medical Center & Case Western Reserve University; Cleveland OH USA
| | - G. E. Ridge
- The Connecticut Agricultural Experiment Station; New Haven CT USA
| | - K. Coppolino
- Case Western Reserve University; Cleveland OH USA
| | - T. Bonfield
- Department of Pediatrics; Case Western Reserve University; Cleveland OH USA
| | - A. B. Young
- Department of Dermatology; Case Western Reserve University; Cleveland OH USA
| | - S. L. Gaines
- Department of Emergency Medicine; University Hospitals Cleveland Medical Center & Case Western Reserve University; Cleveland OH USA
| | - T. S. McCormick
- Department of Dermatology; Case Western Reserve University; Cleveland OH USA
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Decontamination Work and the Long-term Increase in Hospital Visits for Hymenoptera Stings Following the Fukushima Nuclear Disaster. Disaster Med Public Health Prep 2017; 11:545-551. [DOI: 10.1017/dmp.2016.194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveAnimals, including arthropods, are one health threat that can be affected by disasters. This institution-based study aimed to assess trends in Hymenoptera stings following the 2011 Fukushima nuclear disaster.MethodsWe reviewed the medical records of patients with hymenopteran stings who visited Minamisoma Municipal General Hospital, located 23 km from Fukushima Daiichi Nuclear Power Plant, from March 2005 to March 2016. Patient and sting characteristics of post-disaster patients were examined, and the annual incidence of hospital visits for hymenopteran stings was compared with the pre-disaster baseline, calculating an incidence rate ratio (IRR) for each year.ResultsWe identified 152 pre-disaster patients (2005-2011) and 222 post-disaster patients (2011-2016). In the post-disaster period, 160 males (72.1%) were identified, with a median age of 59 years (range: 2-89 years). A total of 45 patients (20.3%) were decontamination workers. Post-disaster increases were found in the IRR for hymenopteran stings, peaking first in 2011 (IRR: 2.8; 95% confidence interval [CI]: 1.9-4.2) and later in 2014 (IRR: 3.2; 95% CI: 2.4-4.3) and 2015 (IRR 3.3; 95% CI: 2.5-4.4).ConclusionsLong-term increases were found in the IRR of hospital visits for hymenopteran stings in an institution affected by the Fukushima nuclear disaster. Decontamination workers appear to have been particularly affected by this phenomenon. Better disaster field worker monitoring and education about potential environmental health hazards may help to identify and prevent worker exposure to insect stings and other vectors in these settings. (Disaster Med Public Health Preparedness. 2017;11:545–551)
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Enhanced Trapping of Yellowjacket Wasps (Hymenoptera: Vespidae) via Spatial Partitioning of Attractants. INSECTS 2017; 8:insects8010017. [PMID: 28178183 PMCID: PMC5371945 DOI: 10.3390/insects8010017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 01/12/2017] [Accepted: 01/24/2017] [Indexed: 12/04/2022]
Abstract
Several yellowjacket species are important pests in both their native habitat and in areas where they are invasive. Traps that contain one or more chemical attractants to lure insects inside are commonly used to combat these yellowjackets in urban environments. Usually, attractants are placed within the trap and combined indiscriminately, though little is known about how this design influences trap attractiveness or efficacy. Here, using the common attractant heptyl butyrate in combination with chicken extract, we demonstrate that spatial partitioning of attractants results in increased capture of the western yellowjacket Vespula pensylvanica—a widespread pestiferous species. Specifically, we show that partitioning of these attractants results in increased visitation of yellowjackets to a trap while also leading to more individuals entering the trap. Further, we provide evidence that this effect is driven by the ability of heptyl butyrate to function as an attractant to the general location of the trap while also blocking the effects of meat extract as a trap-entering stimulus. Thus, our data challenge the current paradigm of combining attractants inside yellowjacket traps, and suggest that these methods can be improved through the consideration of spatial variables and interactions. Our results not only provide novel insight into the mechanisms of yellowjacket attraction, but are also likely to be applicable to the control of other insects for which attractant-based traps are used.
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Cockrell M, Swanson K, Sanders A, Prater S, von Wenckstern T, Mick J. Safe Handling of Snakes in an ED Setting. J Emerg Nurs 2016; 43:21-23. [PMID: 27842799 DOI: 10.1016/j.jen.2016.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 07/12/2016] [Accepted: 07/21/2016] [Indexed: 11/24/2022]
Abstract
Efforts to improve consistency in management of snakes and venomous snake bites in the emergency department (ED) can improve patient and staff safety and outcomes, as well as improve surveillance data accuracy. The emergency department at a large academic medical center identified an opportunity to implement a standardized process for snake disposal and identification to reduce staff risk exposure to snake venom from snakes patients brought with them to the ED. METHODS A local snake consultation vendor and zoo Herpetologist assisted with development of a process for snake identification and disposal. RESULTS All snakes have been identified and securely disposed of using the newly implemented process and no safety incidents have been reported. IMPLICATIONS FOR PRACTICE Other emergency department settings may consider developing a standardized process for snake disposal using listed specialized consultants combined with local resources and suppliers to promote employee and patient safety.
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FMC Verifi traps are not effective for quantifying the burden of bed bugs in an emergency department. Am J Infect Control 2016; 44:1078-80. [PMID: 27061255 DOI: 10.1016/j.ajic.2016.02.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 02/01/2016] [Indexed: 11/20/2022]
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Hojjat H, Svider PF, Lin HS, Folbe AJ, Shkoukani MA, Eloy JA, Zuliani G. Adding Injury to Insult: A National Analysis of Combat Sport-Related Facial Injury. Ann Otol Rhinol Laryngol 2016; 125:652-9. [PMID: 27189152 DOI: 10.1177/0003489416644617] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES/HYPOTHESIS To estimate the incidence of patients presenting to emergency departments (EDs) for facial trauma sustained from participation in combat sports and evaluate injury patterns and patient demographics. METHODS The National Electronic Injury Surveillance System (NEISS) was evaluated for facial injuries from wrestling, boxing, and martial arts leading to ED visits from 2008 to 2013. Relevant entries were examined for injury mechanism, location, type, as well as other patient characteristics. RESULTS There were 1143 entries extrapolating to an estimated 42 395 ED visits from 2008 to 2013. Injury rates for boxing, marital arts, and wrestling were, respectively, 44, 56, and 120 injuries per 100 000 participants. Males comprised the majority (93.7%). A plurality of injuries involved lacerations (46.0%), followed by fractures (26.2%) and contusions/abrasions (19.3%). The proportion of fractures was highest among boxers (36.9%). Overall, the most common mechanisms of injury were punching, kicking, and head butting. CONCLUSIONS The significant number of ED visits resulted from combat sports facial trauma, reinforcing the importance of familiarity with injury patterns among practitioners managing facial trauma. As most injuries involve individuals younger than 19 despite guidelines suggesting children and adolescents avoid combat sports, these findings may be used for patient education and encouragement of the use of personal protective equipment. Furthermore, injury patterns reported in this analysis may serve as an adjunct for enhancing clinical history taking and physical examination.
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Affiliation(s)
- Houmehr Hojjat
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Peter F Svider
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Ho-Sheng Lin
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA Section of Otolaryngology, Department of Surgery, John D. Dingell VA Medical Center, Detroit, Michigan, USA
| | - Adam J Folbe
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Mahdi A Shkoukani
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA Section of Otolaryngology, Department of Surgery, John D. Dingell VA Medical Center, Detroit, Michigan, USA Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Newark, New Jersey, USA
| | - Giancarlo Zuliani
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA Section of Otolaryngology, Department of Surgery, John D. Dingell VA Medical Center, Detroit, Michigan, USA Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
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Toxicity and potential utility of ivermectin and moxidectin as xenointoxicants against the common bed bug, Cimex lectularius L. Parasitol Res 2016; 115:3071-81. [DOI: 10.1007/s00436-016-5062-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/08/2016] [Indexed: 12/30/2022]
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Totten V, Charbonneau H, Hoch W, Shah S, Sheele JM. The cost of decontaminating an ED after finding a bed bug: results from a single academic medical center. Am J Emerg Med 2016; 34:649. [DOI: 10.1016/j.ajem.2015.12.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 12/11/2015] [Accepted: 12/11/2015] [Indexed: 11/15/2022] Open
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de Oliveira Vieira C, Bernardes Filho F, Azulay-Abulafia L. Capybara Bites: Report of Human Injury Caused by a Hydrochoerus hydrochaeris. J Emerg Med 2015; 49:e179-82. [PMID: 26432078 DOI: 10.1016/j.jemermed.2015.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 07/28/2015] [Accepted: 08/08/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Health care demand due to animal bites is frequent, especially in the emergency department (ED). In addition to the physical trauma caused by bites, one should be concerned with infectious diseases that can be transmitted. The range of the lesions depends on the animal species. Bites of Hydrochoerus hydrochaeris (capybaras) in humans are relatively uncommon. Capybaras are docile animals; however, their large rodent incisive teeth could cause serious injury. Localized care, antibiotic therapy when necessary, careful examination of the structures, tetanus and rabies immunization as indicated, and follow-up are recommended for wild animal bites. The authors hereby describe and discuss the medical management of a case of multiple lesions from capybara bites on the right thigh of a man. CASE REPORT A 54-year-old male patient was admitted to the ED with a compression bandage soaked with blood after being bitten by a capybara. At the clinical examination, the patient had two lacerating wounds and multiple abrasions on the anterior face of the right thigh. Rabies prophylaxis was administered and the wounds were irrigated and closed with sterile dressings. Oral amoxicillin/clavulanate potassium for 7 days was administered to the patient. The patient was followed up; 3 months after the attack he returned to his previous level of activity without any complication. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We recommend that practitioners and physicians should provide prompt attention due to potentially significant morbidities, particularly rabies. The adequate care of the wound will allow better aesthetic and functional results to victims of wild animal bites.
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Affiliation(s)
| | - Fred Bernardes Filho
- Emergency Department, Policlínica Regional do Largo da Batalha, Niterói (RJ), Brazil; Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luna Azulay-Abulafia
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
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Abstract
Snake envenomation is a global problem and often a matter of life or death. Emergency treatment is not always readily available or effective. There are numerous neurotoxic snakes in the Americas, chiefly elapids; some crotalids have also evolved neurotoxic venom. The variability of neurotoxins found in snake venom within the same species makes development and choice of proper antivenom a major challenge that has not been completely addressed. This article reviews the epidemiology, clinical effects, and current treatment of neurotoxic snake envenomation in the Americas.
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Affiliation(s)
- Terry D Rolan
- Harry S. Truman Memorial Veterans Hospital, Columbia, MO
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49
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Gries R, Britton R, Holmes M, Zhai H, Draper J, Gries G. Bed Bug Aggregation Pheromone Finally Identified. Angew Chem Int Ed Engl 2014. [DOI: 10.1002/ange.201409890] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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50
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Gries R, Britton R, Holmes M, Zhai H, Draper J, Gries G. Bed bug aggregation pheromone finally identified. Angew Chem Int Ed Engl 2014; 54:1135-8. [PMID: 25529634 DOI: 10.1002/anie.201409890] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Indexed: 11/10/2022]
Abstract
Bed bugs have become a global epidemic and current detection tools are poorly suited for routine surveillance. Despite intense research on bed bug aggregation behavior and the aggregation pheromone, which could be used as a chemical lure, the complete composition of this pheromone has thus far proven elusive. Here, we report that the bed bug aggregation pheromone comprises five volatile components (dimethyl disulfide, dimethyl trisulfide, (E)-2-hexenal, (E)-2-octenal, 2-hexanone), which attract bed bugs to safe shelters, and one less-volatile component (histamine), which causes their arrestment upon contact. In infested premises, a blend of all six components is highly effective at luring bed bugs into traps. The trapping of juvenile and adult bed bugs, with or without recent blood meals, provides strong evidence that this unique pheromone bait could become an effective and inexpensive tool for bed bug detection and potentially their control.
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Affiliation(s)
- Regine Gries
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia (Canada)
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