Injuries Due to Venomous Insects and Plants
in Arizona, 2008

Resources for the development of this report were provided through funding to the
Arizona Department of Health Services from the Centers for Disease and Control and
Prevention, Cooperative Agreement 5U17CE924770-04, Integrated Core Injury
Prevention and Control Program
Permission to quote from or reproduce materials from this publication is granted when
acknowledgment is made.

Prepared by: Alana Shacter, MPH
150 North 18th Avenue, Suite 320
Phoenix, AZ 85007
Injury Prevention Program
Bureau of Women’s and Children’s Health
Arizona Department of Health Services
September 2009

This fact sheet includes mortality data with an underlying cause of death coded to ICD10 codes X20-X29, and hospital discharge data coded to ICD-9 codes 905.0-905.9. The
hospital discharge data only include information from private, acute-care facilities. Data
from rehabilitation hospitals, urgent care centers, or federal facilities, including Indian
Health Services or Veteran’s Administration facilities, are not available.
In 2008, there were no fatalities among Arizona residents due to envenomations by
insects or reptiles. This is in contrast to 2007, in which 4 Arizonans died from such
injuries, and 2006, in which 2 Arizonans died from insect or reptile envenomations.
In 2008, there were 202 non-fatal inpatient hospitalizations among Arizona residents for
treatment of insect or reptile envenomations. Scorpion stings accounted for 29 percent
of non-fatal inpatient hospitalizations (n=59). Bites by venomous snakes and lizards
accounted for the highest percentage of non-fatal inpatient hospitalizations (50 percent,
n=98). Figure 1 shows non-fatal inpatient hospitalizations by type of bite/sting.
Figure 1. Non-Fatal Inpatient Hospitalizations due to
Venomous Animals or Plants, Arizona 2008 (n=202)
Venomous
snakes/lizards
50% (n=98)

Unspecified
venomous animal or
plant
1% (n=2)
Venomous marine
animal/plant
0% (n=1)

Venomous spiders
10% (n=20)

Ants, caterpillars Hornets, wasps, bees
9% (n=19)
1% (n=30

Scorpions
29% (n=59)

Hospital charges for non-fatal inpatient hospitalizations due to venomous animals or
plants totaled $8.1 million, with an average hospital stay lasting 2 days and costing
$39,968. Arizona residents spent a total of 444 days hospitalized, with the longest stay
lasting 25 days. While scorpion stings resulted in 29 percent of inpatient
hospitalizations, they only accounted for 15 percent of the hospital days, and 8 percent
of the total charges.
Between 2004 and 2008, the age-adjusted rates of non-fatal inpatient hospitalizations
decreased 23 percent from 1.96 to 1.51 hospitalizations per 100,000 residents for
injuries from venomous snakes and lizards. The rate of hospitalizations due to
scorpions decreased 49 percent from 1.66 to 0.85 hospitalizations per 100,000
residents. Figure 2 shows the age-adjusted rates of non-fatal inpatient hospitalizations
due to venomous reptiles and scorpions between 2004 and 2008.

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Age-Adjusted Rate per 100,000 Residents

Figure 2. Age-Adjusted Rate of Non-Fatal Inpatient
Hospitalizations Due to Selected Venomous Creatures
by Year, Arizona, 2004-2008
2.5
2.3

2.0

2.2

2

1.5

1.8
1.5

1.7

1.5

1.2

1
0.9

0.9

0.5
Venomous snakes and lizards
Scorpion
0
2004

2005

2006

2007

2008

In 2008, there were 4,977 non-fatal emergency department visits by Arizona residents
for treatment of insect or reptile envenomations. Scorpion stings accounted for a
majority of these visits (55 percent, n=2,694). The second highest number of visits
resulted from stings by hornets, bees, and wasps (27 percent, n=1,335). Figure 3 shows
non-fatal emergency department visits by type of bite/sting.
Figure 3. Non-Fatal Emergency Department Visits due to
Venomous Animals or Plants, Arizona 2008 (n=4,977)
Scorpions
55% (n=2,694)
Hornets, wasps, bees
27% (n=1,335)

Centipede or tropical
millipede
0% (n=17)

Venomous spiders
7% (n=349)
Venomous
snakes/lizards
2% (n=117)

Other/Unspecified
venomous animal or
plant
2% (n=83)

Venomous marine
animal/plant
0% (n=14)

Ants, caterpillars
7% (n=368)

Among the 2,694 non-fatal emergency department visits due to scorpion stings in 2008,
the highest rate of events was among children ages 1 to 4 (94.9 ED visits per 100,000
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residents). Children ages 1 to 4 also had the highest age-specific rate of emergency
department visits due to hornet, wasp, and bee stings, the second leading cause of
emergency department visits due to venomous creatures (30.1 ED visits per 100,000
residents). Figure 4 shows the rate of non-fatal emergency department visits due to
scorpion stings by age group, and Figure 5 shows the rate of non-fatal emergency
department visits due to hornets, wasps, and bee stings by age group.
Figure 4. Rate of Non-Fatal Emergency Department Visits due to
Scorpion Stings per 100,000 Residents, Arizona 2008 (n=2,694)
100

94.9

Rate per 100,000 residents

90
80
70
60
50
40

47.8

47.6

39.4

39.4

33.5

33.7

33.5
30.9

27.0

30
20

11.8

10
0
Under 1
1-4
Year
Years

5-14
Years

15-24
Years

25-34
Years

35-44
Years

45-54
Years

55-64
Years

65-74
Years

75-84 85 Years
Years
and
Older

Figure 5. Rate of Non-Fatal Emergency Department Visits due
to Hornet, Wasp, or Bee Stings per 100,000 Residents,
Arizona 2008 (n=1,335)
Rate per 100,000 residents

35
30.1

30
23.7

25

24.8

23.9
19.3

20

18.7
16.2

15

12.5

12.1

10.4

10

6.4

5
0
Under 1 1-4
Year Years

5-14
Years

15-24
Years

25-34
Years

35-44
Years

45-54
Years

55-64
Years

65-74
Years

75-84
Years

85
Years
and
Older

Hospital charges for non-fatal emergency department visits due to venomous animals or
plants totaled $5.4 million. Visits to treat scorpion stings totaled $2.3 million in hospital
charges. While scorpion stings resulted in 55 percent of the total non-fatal emergency
department visits for venomous animals or plants, they only accounted for 43 percent of
the total hospital charges.

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While the age-adjusted rate of non-fatal emergency department visits declined between
2004 and 2008 for bites from venomous spiders and venomous reptiles (46 percent and
27 percent, respectively), the age-adjusted rates increased for stings from scorpions
and flying insects (29 percent and 18 percent, respectively). Figure 6 shows the ageadjusted rates of non-fatal emergency department visits due to selected venomous
creatures between 2004 and 2008 by year.
Figure 6. Age-Adjusted Rate of Non-Fatal Emergency
Department Visits Due to Selected Venomous Creatures
by Year, Arizona, 2004-2008
Age-Adjusted Rate per 100,000 Residents

45
Venomous snakes and lizards
Scorpion
Venomous spiders
Hornets, wasps, bees

40
35

40.9

36.3

31.8
31.7

30
25
20

41.0

22.4

20.4

19.2

17.3

16.5

15
9.9
10
5

8.9
7.1

2.0

0
2004

2.3
2005

1.7
2006

6.8
2.1
2007

5.4
1.8
2008

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Figure 7: An Arizona Bark Scorpion.
Source: http://phoenix.about.com/od/arizonapicturesandphotos/ig/Arizona-Bark-Scorpions/Scorpion-01.htm

Hospital discharge data do not specify the species of scorpion, so it is not possible to
further classify injuries. Bark scorpions, as shown in Figure 7, are the most venomous
scorpions in North America, and extreme reactions to their stings can cause paralysis
and convulsions, though fatalities are rare. Medical attention is recommended for stings
to pets, young children, older adults, and people with compromised immune systems.

Figure 8: A Striped Scorpion.
Source: http://phoenix.about.com/od/arizonapicturesandphotos/ig/Arizona-Bark-Scorpions/Scorpion-06.htm

Visit the following websites for more information on scorpions and other
venomous creatures in Arizona:
The University of Arizona’s Cooperative Extension website:
http://ag.arizona.edu/pubs/insects/az1223/
The University of Arizona College of Pharmacy Poison and Drug Information Center:
http://www.pharmacy.arizona.edu/outreach/poison/scorpions.php

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