Welcome to Australia, a land of creatures out to kill you… maybe
WELCOME TO AUSTRALIA, a place that is the focus of regular reports that nearly every creature is ready and waiting to pounce. If it rains, it brings warnings of venomous snakes. If the weather is dry, then giant spiders can set up house in your power box.
But as Australia prepares once again to welcome many new citizens this Australia Day, it seems appropriate to take a closer look at how deadly our creatures really are.
There is no doubt Australia harbours venomous animals and encounters that can be traumatic and need a rapid emergency response.
We must we careful not to understate the impact of any encounters with venomous animals on families and the sufferers themselves. Nor must we play down the highly specialised management, effective treatment and medical care required.
But is this reputation of a land of deadly and aggressive creatures well founded?
Detail in the data
My colleagues and I recently published a review of hospital admissions and deaths caused by venomous animals in the Internal Medical Journal.
We sourced data from 2001-2013 from national hospital admissions and national coronial information, which showed more than 42,000 hospitalisations from venomous sting or bites. Most – not all – are shown in the graph, below.
Over the 12 years that’s an average 3,500 people admitted to hospital every year for a venom-related injury. This can be loosely averaged 0.01% of the Australian population per year, or roughly one in 10,000 Australians.
Allergy or anaphylaxis from insect stings such as bees or wasps were responsible for about one-third (33%) of hospital admissions, followed by spider bites (30%) and snake bites (15%).
Over the 12 years, 64 people were killed by a venomous sting or bite, with more than half of these (34) caused by an allergic reaction to an insect bite that brought on anaphylactic shock.
Of these, 27 deaths were the result of a bee or wasp sting, with only one case of a beekeeper being killed. Anaphylaxis to tick and ant bites combined caused five deaths, the box jellyfish caused three deaths and two deaths were from an unidentified insect.
Given there are 140 species of land snakes in Australia, snake bite fatalities are very rare, at 27 for the study period. To put that in perspective, the World Health Organization estimates that at least 100,000 people die from snake bite globally each year.
While it’s natural to be frightened of snakes, the reality is the number of deaths from snake bites in Australia is very small. In the same time frame, for example, figures from the National Coronial Information System (NCIS) show nearly 5,000 people died from drowning and 1,000 from burns in Australia.
Nevertheless, snake bites do hold the crown as the most common cause of death, with nearly twice as many deaths per hospital admission than any other venomous injury, making snakebite one of the most important issues to address.
Deadly creatures elsewhere
Understandably, living in a country with creatures that can potentially kill us is a daunting prospect. As you can see from the figures, though, they don’t kill as many people as you might think and other countries have their own potentially deadly creatures.
A sturdy Australian would surely quake at the thought of being faced with an offensive grizzly, with no amount of Crocodile Dundee-esk buffalo hypnotism techniques going to get us through that encounter.
Sure Australia also has sharks and crocodiles, but it’s important to note that the majority of our critters do not come after you.
Minimising the minimal risk
Our report, while giving a broad overview of envenoming trends in Australia, does raise more questions than it answers. Questions such as: who is most at risk and how can we support them? Do we need more localised guidelines? And how do we maintain knowledge for such a rare injury?
This work seeks to initiate new conversations in regard to potential gaps in knowledge in both the public and health domains, and find solutions. We’re currently seeking funding to continue this research.
From an individual or national public health perspective, we can’t make informed decisions until we have a much clearer picture of what’s going on. The big question is how can we manage this coexistence with the creatures around us, without being detrimental to people and the creatures themselves.
It comes down to understanding, appreciating and respecting the amazing diversity nature has provided us. We need to learn about prevention methods and understand correct first aid.
This, together with the ongoing research and improvements in clinical care and the accessibility, affordability, effective management and treatment of bites and stings in Australia, actually make it one of the safest places in the world, and certainly not one of the deadliest.