General Context of Scorpionism in Mexico
In Mexico, between 200,000 and 300,000 scorpion stings are recorded annually, concentrated mainly in rural areas with warm climates, with a significant increase in cases between the months of April and July (Murillo-Godínez, 2020; Secretaría de Salud, 2023). This situation makes scorpionism a persistent and underestimated public health problem, particularly in marginalized regions.
Scorpion Sting Envenomation (SSE) constitutes an acute toxic syndrome that can affect multiple organs and systems, with neuromuscular, cardiovascular, and respiratory effects, depending on the type of venom involved and the general condition of the patient (Secretaría de Salud, 2016).
In Mexico, approximately 190 scorpion species have been identified, grouped into seven families, of which Buthidae represents the greatest risk to human health. Within this family, the genus Centruroides is the most relevant from a medical standpoint, because its venom possesses high toxicity and rapid systemic action (Murillo-Godínez, 2020; De Roodt et al., 2017).
At-Risk Groups and Epidemiological Data
The most severe clinical cases occur in:
- Children under 15 years old, especially under 5
- Older adults
- People with comorbidities (diabetes, cardiovascular diseases)
- Patients who receive delayed treatment
(Murillo-Godínez, 2020; PAHO, 2022).
During the period 2018–2022, the states with the highest incidence of stings were Morelos, Puebla, and Jalisco, while the entities with the most deaths associated with this cause were Guerrero, Jalisco, Nayarit, and Michoacán (Secretaría de Salud, 2023).
SSE ranks among the leading causes of mortality subject to epidemiological surveillance in children under 14 years old (Epidemiological Bulletin, Secretaría de Salud, 2021).
In epidemiological week 13 of 2025, 50,561 cases of scorpion sting envenomation were reported throughout the country, and by epidemiological week 37 (which concluded on September 20), there were 212,590 recorded cases of SSE (Secretaría de Salud, 2025).
Factors that Hinder Timely and Effective Treatment
Various social, cultural, structural, and economic factors complicate adequate care for SSE cases, especially in marginalized communities:
- Use of home remedies: Many people resort to traditional practices without scientific support, such as ingesting scorpion tails, infusions of epazote with garlic, milk, or lemon, which delays seeking medical attention (Murillo-Godínez, 2020).
- Application of inadequate techniques: Practices such as the use of tourniquets, cryotherapy, or venom suction are not only ineffective but can worsen the patient's condition (PAHO, 2022).
- Deficit in medical training: In many regions, medical personnel do not have the necessary training to effectively identify and treat scorpion envenomation cases (Manual de Procedimientos de Ponzoña, Secretaría de Salud, 2024).
- Limited production and availability of antivenoms: The lack of precise statistical information about the actual demand for antivenoms has led to their underproduction or market withdrawal in some cases (WHO, 2021). Additionally, the limited shelf life of antivenoms requires constant inventory rotation, something that is not always adequately managed (Specific Action Program 2013–2018).
- Socioeconomic and structural factors: Poverty, deficient health infrastructure, distance from medical centers, and low educational level hinder timely care. In marginalized communities, homes are often constructed with materials that facilitate scorpion proliferation, increasing risk (CONAPO, 2022).
Target Community
State of Morelos
The state of Morelos represents one of the most alarming cases due to its high incidence of scorpion stings.
Figure 1 showing epidemiological behavior of envenomations caused by scorpion stings in men and women in the state of Morelos over the last six years (2014-2021).
The most common barriers in these regions include:
- Distant health centers or those without available antivenoms
- Lack of trained medical personnel
- Transportation difficulties
- Severe economic limitations
- Misinformation about the correct way to act when stung
According to the List of Municipalities with high and very high degrees of marginalization, Morelos has a High level of marginalization, which places it in a community that meets the characteristics for evaluation.
In 2020, it was estimated that 627,800 inhabitants of Morelos did not have access to public health services, and by 2023, 1 in 3 people in Mexico remained in this condition. Morelos ranked as the 8th entity with the greatest deficit in access to health services (INEGI, 2023; Coneval, 2023).
Surveys and Interviews
To analyze the community diagnosis regarding perception, incidence, and care of scorpionism in Morelos communities and identify the level of knowledge, prevention and care practices, as well as the main problems related to access to antidotes against scorpion stings in Morelos communities, a survey was conducted along with some interviews with community members, covering a highly diverse demographic, as ages range from 14 to 79 years with a mean of 50 years, thus covering multiple generations with different levels of access to education (Figure 2).
Figure 2. Scatter plot showing age distribution of respondents, number of samples vs age
It is also observed that there is a gap regarding knowledge of scorpion species present in the municipality, where those minimally informed or directly misinformed predominate, as shown in the following graph (Figure 3).
Figure 3: Dispersion sample regarding knowledge of scorpion species present in the municipality of Morelos.
Regarding the perception of danger from scorpion stings at the municipal level, the statistics strongly lean toward recognizing the danger they represent, as a strong 77.8% of respondents agree that they are a serious problem at the municipal level, while 18.5% attribute slight severity, compared to the minimally representative 3.7% who do not recognize it as a dangerous situation, as presented in the figure 4.
Figure 4: Dispersion sample regarding the perception of scorpion stings as a problem present in the municipality of Morelos.
Regarding adequate access to treatment against venom administered by a scorpion, we return to divided opinion, as the majority considers that there is not good access to this tool (44.4%), while 37% considers that there is good access to the resource, also considering 18.5% who remain neutral, maintaining a "maybe" as they do not have sufficient information to make a judgment (figure 5).
Figure 5: Dispersion sample regarding adequate access to treatment against scorpion venom.
Regarding knowledge about the existence of an antidote or antivenom in case of a sting, a strong positive opinion was obtained, as 72.2% recognize its existence, reducing the opposing opinion since only 16.7% acknowledge not knowing of its existence, while 11.1% of respondents are not sure about its existence, as shown in the figure 6.
Figure 6: Dispersion sample representative of the existence of an antidote or antivenom in case of scorpion sting.
Although a quite significant portion recognizes the existence of this antidote, it was found that the majority does not know how it works, as 51% are unaware of the fundamental mechanism of the antidote, while only 30.6% of respondents know how it works, and the neutral statistic remains significant with 18.4% recognizing that they know it somewhat, as represented in figure 7.
Figure 7: Dispersion sample regarding the functioning of the antivenom.
When respondents were asked about where they would go in case of a sting, an interesting result was obtained, as the majority recognizes the importance of going to a Hospital/Medical Center, while the minority falls into the decision not to seek treatment or not knowing what to do; however, there is a presence that cannot be overlooked of those who still resort to home remedies or holistic resources (healers) to alleviate this situation. The dispersion of responses is presented below, recognizing that there is no absolute percentage as multiple responses were allowed (Figure 8).
Figure 8: Dispersion table of places to go in the event of a scorpion sting.
* The bar chart is showing: hospital, medical center, healer, home remedies, would not go for treatment and would not know what to do.
When asking respondents if they have directly suffered a scorpion sting, we find a truly representative response, as 57.4% confirm having suffered one, while 22.2% have also experienced it indirectly as a family member received the sting, while the minority has not suffered such a sting with 20.4% of the sample. These results are evidenced in figure 9.
Figure 9: Dispersion sample representative of those who have suffered a scorpion sting directly or indirectly.
When asking what method they resorted to to remedy the sting event, the vast majority went directly to medical attention, while others combined home remedies with medical attention, which recognizes the importance of having remedies efficiently available to the population, as in case of emergency, the majority seeks public health services to receive care. Some share the experience of requiring the antivenom and not being able to access it comfortably, having to travel considerable distances to access it, putting at risk the health and integrity of those who received the sting, evidencing a deficiency in the public health system, as in most cases, access to the resource does not manage to cover the needs of the population as represented in figure 10.
Figure 10: Representation of dispersion regarding access to adequate treatment for a scorpion sting.
*Bar chart showing various responses with frequencies, including statements about treatment accessibility, with responses ranging from "Yes, they injected me" to situations where treatment was delayed or adequate.
When asking respondents (Figure 11) about using the alternative antivenom RSAV presented to them during the survey, the majority finds it interesting and a useful tool to have available in the area, especially as an accessible alternative that awakens the interest of respondents. As shown in the following graph, 63% would use the antivenom, while 22.2% would not use it directly, also considering that 14.8% decide to remain neutral with a "maybe." Among the reasons for obtaining a negative response, the popular belief that a scorpion sting has no adverse health effects is found, as well as doubting its veracity by not having the backing of a governmental organization for its management and distribution, as well as doubting its capacity and veracity since there is no confirmation of experimental phases, communicating the general concern of the population regarding diverse capacity to have a solution to scorpion stings.
Figure 11: Dispersion sample representative regarding the use of the antivenom presented herein.
The 77.8% of respondents consider it a serious problem, which justifies the need to reinforce prevention and community education campaigns, since there is awareness of the danger, but it does not always translate into adequate care practices.
Misinformation increases family vulnerability, especially because many still resort to home remedies or healers before reaching the hospital.
Access to treatment is another critical point: 44.4% perceive that there is no adequate access to the antidote, and several respondents reported experiences where they had to travel long distances to obtain it, and some people mentioned difficulty being able to travel to those places. This implies a failure in the distribution of medical supplies, which puts the lives of those who suffer a sting at risk, as treatment time is determinant to avoid serious complications.
More than half of respondents (57.4%) have directly suffered a sting and another 22.2% have experienced it through a family member. This data confirms that scorpionism is not a hypothetical risk, but a frequent problem that directly impacts the daily life of Morelos communities. The high incidence justifies the need to implement permanent prevention strategies and not only reactive ones.
Finally, 63% of respondents expressed interest in having the antidote available in the community, which reflects a clear social demand for local and accessible solutions. However, the distrust of part of the population toward the efficacy or legitimacy of the antidote underscores the importance of accompanying distribution with awareness campaigns backed by the health system, to guarantee credibility and acceptance.
The results show that SSE continues to be a real and frequent threat in many regions of Mexico, especially in states like Morelos. The figures show that vulnerability is not only biological, but social and structural. Addressing this problem requires comprehensive public policies, timely medical care, and community commitment based on education, organization, and recognition of local knowledge.
Beyond the Antivenom: The Need for a Comprehensive Approach
Combating scorpionism requires more than distributing antidotes. A multidisciplinary and community approach is needed, including:
- Continuous training for medical personnel in clinical management of SSE.
- Improvement in rural health infrastructure.
- Efficient management of antivenom stock.
- Prevention and community education strategies, adapted to local contexts.
The surveys were accompanied by environmental education tools, such as an illustrative infographic accompanied by an outreach talk about the creation and functioning of antivenoms, actions in case of an encounter, and prevention.
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