A global accounting of medically significant scorpions: Epidemiology, major toxins, and comparative resources in harmless counterparts

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Scorpions are an ancient and diverse venomous lineage, with over 2200 currently recognized species. Only a small fraction of scorpion species are considered harmful to humans, but the often life-threatening symptoms caused by a single sting are significant enough to recognize scorpionism as a global health problem. The continued discovery and classification of new species has led to a steady increase in the number of both harmful and harmless scorpion species. The purpose of this review is to update the global record of medically significant scorpion species, assigning each to a recognized sting class based on reported symptoms, and provide the major toxin classes identified in their venoms. We also aim to shed light on the harmless species that, although not a threat to human health, should still be considered medically relevant for their potential in therapeutic development. Included in our review is discussion of the many contributing factors that may cause error in epidemiological estimations and in the determination of medically significant scorpion species, and we provide suggestions for future scorpion research that will aid in overcoming these errors.HighlightsAn up-to-date review of medically significant scorpion species around the world.Geography, major toxins, and epidemiology for medically significant scorpions.104 scorpions identified as medically significant, 32 confirmed as causing severe human harm, 68 with unverifiable symptoms.Harmless scorpion venoms are also rich in toxins with potential in therapeutic development.Future work should include proper scorpion identification, larger case studies, and extensive venom characterizations.

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