Animal attacks really aren’t that bad after all

At least, not according to the CDC WONDER database. When you take 9 years of data from said database, you get a whopping 1802 deaths. That comes out to just a hair over 200 deaths per year. Now, the article says they used ICD-10 codes W53-59 and X20-29 as their inclusion criteria, so take from that what you will.


Of the 1802 deaths, 1088 (60%) were from nonvenomous species, and specifically, 655 (36% of the total) were from farm animals. Thus, farm animals account for nearly as many deaths as venomous animals. Guess which one we spend more time on with teaching. When’s the last time you saw a board question that involved cattle?

The authors also break down the statistics by gender, race, age, and regional geography. The gender and race of the most commonly injured shouldn’t surprise anyone (white, male), but the ages might. We are taught that often it is young, intoxicated men are on the receiving end of most bites, but this data shows the overwhelming majority of those killed are >35 years old. The only group with more deaths at a young age(<9) is those killed by dogs, sadly. Children under 9 make up 46% of dog related deaths, despite making up only 10% of the total deaths.

Now, the question is, is this an example of the problems with ICD-10, or just a problem with reporting in general? Clearly more than 200 people are killed per year by animals, so how do we accurately assess the true risks? Based on this data we should put as much emphasis on agricultural education as we do on venomous species. Now, a significant majority of the farm animal injuries occur in rural areas, but so do most of the venomous animal injuries that don’t involve hymenoptera (~28% of the total). And yet we clearly devote a larger proportion of our teaching towards exotic, venomous animals. This even differs from the perceived over-emphasis on critical care, as knowing the exact thing to do in a time stressed situation can have a mortality benefit. Rarely is that true in the case of a venomous species, apart from anaphylaxis.

As the authors propose, we should as a specialty spend more effort on teaching agricultural safety as well as dog safety in homes with children. We already do a fair amount of teaching and community outreach with regards to anaphylaxis and hymenoptera, which is another significant cause of mortality. However, we could always do more with regards to preventable deaths.


  • Forrester JA, Holstege CP, Forrester JD. Fatalities from venomous and nonvenomous animals in the United States (1999-2007). Wilderness Environ Med. 2012 Jun;23(2):146-52. [PMID 22656661]

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EBM Gone Wild

Wilderness Medicine

Emergency physician with interests in wilderness and prehospital medicine. Medical Director of the Texas State Aquarium, Padre Island National Seashore, Robstown EMS, and Code 3 ER | EBM gone Wild | @EBMGoneWild |

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