Epidemiology of Scorpion Envenomation
Scorpionism, the pathology of scorpion envenomation, is a problem that occurs across five continents. Because of its frequency and severity, it represents a serious concern for public health on a worrying scale in many countries of North Africa, the Middle East, India and South America (Lourenço, 1988). Epidemiological studies report that more than 5,000 people worldwide die each year (Stockmann and Ythier, 2010). According to Chippaux (2009), the incidence of scorpion envenomation is essentially limited to four highly endemic regions: Mexico, South America to the East of the Andes, North Africa, Near and Middle East.
In North Africa, A. australis, Leiurus quinquestriatus and Androctonus mauritanicus (last endemic in Morocco) are considered the most dangerous. However, Androctonus aeneas, Buthus occitanus and Hottentota gentili, especially in the Saharan zone (Goyffon and Guette, 2005), can also cause serious, sometimes fatal envenomations. Thus the main North African countries affected by this scourge are Algeria Morocco and Tunisia with an incidence that exceeds 29,900 cases / year.
In the Near- and Middle-East, scorpion stings, mainly due to species belonging to Androctonus, Buthus and Leiurus such as L. quinquestriatus, A. crassicauda and B. occitanus and P. liosoma. The annual incidence of scorpion envenomation in this region varies according to the countries from 16 scorpion stings per 100,000 inhabitants in Oman to 90 scorpion stings per 100,000 inhabitants in Saudi Arabia. While the annual mortality is about 0.0013 death to .01 per 100,000 inhabitants recorded respectively in Saudi Arabia and Turkey (Ozkan et al., 2008; El-Aminn and Berair, 1995).
In Asia, Iran and India are the main countries affected by scorpion envenomation. The total annual incidence is about 140 per 100,000 inhabitants. The most dangerous species are Hemiscorpius lepturus, Androctonus crassicauda and Hottentota tamulus (Pipelzadeh et al., 2007).
In Latin America, although there is a wide geographical variations in scorpion envenomation incidence. Scorpion stings incidence is high and could reach 1350 scorpion stings per 100,000 inhabitants in some states of Mexico. Scorpion species such as Centruroides limpidus, C. sufussus, C. gracilisTityus pachyurus, Tityus serrulatus, T. bahiensis, T. stigmurus and T. brazilae are responsible for most of the severe scorpion envenomations (Otero et al., 2004).