My 2 year old and the Scorpion - What parents should know about scorpion stings

Scorpion on the beach

We recently headed to Franskraal for a nice weekend with my family. The hope was to just relax but, as always, there was a bit of drama.

The drama started when a scorpion tried to get acquainted with our 2 year old.

"Make sure to always save the emergency contact numbers for the areas you travel to. I have now made sure that I have the private ambulance service opering in Franskraal area's number saved on my phone."

We were getting ready for the day on Saturday morning, luckily our daughter was already dressed and wearing boots. She was standing between my husband and I, when she suddenly bent over, pointed at something on the ground and started saying; "Mamma, bee, Mamma, bee!".

I thought she must be pointing to a bug or fluff, thinking a bee wouldn't have gotten into the room (I hadn't opened any windows yet). When I bent over her to see what she was pointing at, I saw a scorpion on its way to her feet and it had luckily not reached her yet.

I immediately picked her up and tried to tell my husband there's a scorpion, but all I got out while running to the other side of the room was some strange noises and then "aaa thing, get it, scorpion!".

I checked her over while my husband left the room to quickly find something to put the scorpion in. I was on scorpion duty while he was gone so one eye was tracking the scorpion and the other was checking her for any wounds. She didn't cry at all or seem unwell so we were fairly certain she hadn't been stung. There was also no puncture wounds on her.

My husband returned with some tissue paper, it was the only thing he could find on short notice and I thought he was going to catch it and release it outside, like the previous times we had found scorpions in Franskraal (I once almost showered with one, it was the fastest I had ever gotten out of a shower).

Luckily my husband remembered that we need to keep the scorpion for in case our daughter had been stung, so that we could take it along to the hospital but in his efforts to grab the got squished. So we ended up keeping the remains. (Sorry if this is traumatic for scorpion lovers, it was an accident)

Once my husband had the scorpion, I put our daughter down and she followed Daddy out the door, but this is where the confusion comes. When she reached the door she started crying about her finger hurting and the finger had some blood on it, but we were 99% certain that either my husband closed the door on her finger or she scraped it on the edge. The crying lasted all of 30 seconds before she got distracted by our cat.

There was still that 1% of parental paranoia of "what if it was the scorpion". So we started looking up symptoms and information on scorpions.

But the fact that she hadn't cried when she pointed at the "bee" (don't know how close her finger got) and she hadn't even cried at all up until that point, had us thinking it was just the door, since scorpion stings are extremely sore from the moment of the sting and it lasts for hours and days without relief. She also had no other symptoms or any sign of that scrape/blood when I had initially checked her.

She was acting normal, running around and eating rusks so we monitored her. (Fast forward to today: She is still perfectly fine so it was just a scrape from the door)

That evening she started crying in her sleep and had some reflux from a post nasal drip she was developing. My mom brain obviously started worrying and I kept asking my husband, "do you think this is respiratory issues? Is it the scorpion?" and I sat up the rest of the night watching her sleep and reading up on scorpions. I share what you need to know about scorpions and scorpionism in children below.

Our case is obviously not just straight forward and had she not scraped her finger at the door, letting doubt slip in, we would have been assured that the scorpion was no where near her. If she had immediately started crying before I picked her up, I would have called the ambulance to have her checked over.

Family at the beach

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South African Scorpions:

From my reading I learned that there are about 160 species of scorpions in South Africa. Only two types of scorpions in South Africa have been
associated with serious envenomings.

Envenoming is what you call it when you have been stung by a scorpion and the venom inters you and then they also refer to is as scorpionism. The two potentially lethal scorpions in South Africa are P. granulatus and P. transvaalicus.

Of these two, P. granulatus is the more deadly. Both have thick tails and slender pincers and both are considered large scorpions, measuring 60 to 150mm.

The rule of thumb is usually that scorpions with thick tails and slender pincers are more dangerous (venomous) than those with slender tails and large pincers.

P. granulatus is light to dark brown in colour and P. transvaalicus is dark brown to uniformally black.

It's important to catch the specimen (where possible) and take it to the hospital with the envenomed person so that the species can be identified.

Scorpions are mostly active during the summer months and most species are nocturnal.

Parabuthus granulatus and P. transvaalicus - Image Credit:
Parabuthus granulatus and P. transvaalicus - Image Credit:

How will you know if your child has been stung by a scorpion:

The symptoms displayed by children under 13 years old differs from the symptoms displayed by older patients.

Young children and babies may only cry uncontrollably while others will develop a unique form of restlessness.
The restlessness is not only caused by pain but is due to the severe form of systemic envenomation and the child will be unable to control his movements. There will be crying, screaming, jerking around, uncontrollable flailing of the arms and legs, strange positions, pulling of the face and making chewing motions etc.

"The restlessness caused by scorpionism in children has been described as ‘extraordinary and duplicated by little else in medicine’."

You may be able to see the sting site but it won't have a bad reaction or look like much.

Adults display symptoms within 1 to 4 hours but some of the symptoms only appear after 8. When someone is treated in hospital, they will be monitored for up to 12 hours to be sure.

Symptoms to watch out for in children:

  • The severity of envenomation is usually visible within 15 to 60 minutes.
  • Look for the sting site.
  • Uncontrollable crying.
  • The restlessness described above.
  • Bulbar paralysis affecting the lower cranial nerves that control speech, saliva, swallowing etc.
  • Respiratory distress / Trouble breathing. It is more frequent in children than in adults and tends to be more severe. Respiratory failure is the most dangerous feature of severe scorpionism and is usually the primary cause of death.

What to do if your child has been stung by a scorpion:

  • Call an ambulance immediately. Respiratory distress are the most serious complications of scorpionism and most children die on route to hospital due to insufficient respiratory support. Rather call an ambulance than drive them yourself. (Patients, especially children, may develop respiratory failure within 1 - 2 hours.)
  • Catch the scorpion to take to hospital with your child.
  • Identifying a scorpion down to species level is difficult and it can only be done by an expert. The hospital will likely call someone in to help.
  • You can apply ice to the sting site but most patients don't tolerate the cold well.

Make sure to always save the emergency contact numbers for the areas you travel to. I have now made sure that I have the private ambulance service opering in Franskraal area's number saved on my phone.

Here's a link to a very detailed article on South African scorpions and the treatment of scorpionism. It also lists all the symptoms that adults display:

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