There is a dearth of epidemiologic research on environmental risk factors for snakebites both internationally and domestically. The World Health Organization has identified snakebites as a highest priority neglected tropical disease. In this study, we use data from the Georgia Hospital Association from January 1, 2014 to December 31, 2018 combined with zip code level climate data to analyze the relationship between short-term temperature variation and Emergency Department visits for snakebite. To do this, we performed a case-crossover analysis using conditional logistic regression modeling. We used a time stratified, bi-directional approach where control days were chosen as the same day of the week within the same month and year. With adjustment for dew point and precipitation, we found that across the entire study period, temperature is significantly and positively associated with the snakebite outcome (OR 1.064, CI 1.044 -1.084). Seasonal stratification showed that the association is strongest in the spring (OR 1.106, CI 1.070 -1.144) followed by fall (OR 1.065, CI 1.032 - 1.100). In winter and summer, temperature variation was not significantly (P>0.05) predictive of the snakebite outcome. Our results supported our hypothesis that short-term variation in temperature would be a significant predictor for the odds of experiencing a snakebite, and that the effect would be strongest at moderate temperatures. Because snakebites occurred most frequently in the summer, we speculate that there may be human behaviors that we did not analyze which contribute towards higher snakebite counts in Georgia summers.
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