Animal-Encounter Fatalities, United States, 1999-2016: Cause of Death and Misreporting.

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.

Snakebite during pregnancy: a literature review.

OBJECTIVE: To review reported bites by venomous snakes in pregnant women. METHODS: This is a review of Medline/PubMed articles on venomous snakebites occurring during pregnancy reported in the English literature from 1966 to May 2009. RESULTS: Two hundred thirteen venomous snakebites were reported in pregnant women. The overall case-fatality rate in the pregnant females was approximately 4%, and the fetal loss rate was approximately 20%. CONCLUSIONS: Although rare, venomous bites and stings during pregnancy may have a significant adverse effect on the fetus as well as the mother.

Risk factors associated with fatal animal-vehicle collisions in the United States, 1995-2004.

OBJECTIVE: Animal-vehicle collisions are a significant public health concern in the United States. The annual economic cost currently exceeds $1 billion from injuries and property damage. A recent study by the Centers for Disease Control and Prevention evaluated nonfatal injuries from animal-vehicle collisions, but information on fatal animal-vehicle collisions is limited. This study evaluates risk factors associated with fatal animal-vehicle collisions. METHODS: This study evaluates characteristics of fatal animal-vehicle collisions in the United States from 1995-2004 by using the Fatality Accident Reporting System database of the National Highway Traffic Safety Administration. RESULTS: An average of 165 deaths occurred each year during this 10-year time period. Most deaths occurred in rural areas, during the fall months, on straight roads, and in clear weather, and an increasing trend for deaths was noted over this time period. CONCLUSION: The number of fatal animal-vehicle collisions is increasing. Various methods to reduce such collisions are described, with fencing appearing to be the most effective. The use of personal restraints such as seat belts in passenger vehicles and helmets for motorcycle and all-terrain-vehicle riders may decrease fatalities during a collision.

A review of venomous animal bites and stings in pregnant patients.

This is a review of Medline and PubMed articles on venomous animal bites and stings during pregnancy reported in English literature from 1966 to 2002. Eighty-five venomous snakebites were reported in pregnant women. Although there are frequent anecdotal reports of scorpion stings in pregnant women, few case reports are documented. Other venomous animal bites or stings to pregnant women that have been reported include spiders, jellyfish, and insects, and these are described. Adverse reproductive and teratogenic effects of venoms on gravid animals are also briefly reviewed. Although uncommon, venomous bites and stings during pregnancy may have significant adverse effects on the fetus and the mother.