Ninety-five cases of adder bite that have occurred in Britain over the past 100 years are reviewed. Most bites occurred in men who foolishly picked up the adder. Three-quarters of the victims reached hospital within two hours of the bite. When venom is injected the early symptoms include local swelling and discoloration, vomiting, diarrhoea, and early collapse, which often resolves spontaneously. In severe poisoning persistent or recurrent shock is the main feature. Children recover quickly but adults may take weeks or months to recover, during which there may be considerable disability in the bitten limb. Deaths are rare: only 14 deaths from poisoning were recorded in the past 100 years. In England and Wales only one death from adder bite was recorded in 1950-72, but there were 61 deaths from bee or wasp stings. In most cases simple symptomatic treatment is enough, but all patients should be carefully monitored. With persistent or recurrent shock Zagreb antivenom is indicated; and it should also be considered in adults seen within two hours of the bite to minimise morbidity from local effects. (+info)
Snakebite mortality in the world.
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In examining the relative importance of snakebite mortality in different parts of the world, the authors review the information collected concerning both snakebite mortality and the species of snake incriminated. Available statistical data are known to be unreliable and at best can serve to provide only an approximate and highly conservative estimate of the relative magnitude of the snakebite problem. The sources of error inherent in the data are discussed, and estimates are made of the probable mortality from snakebite in various areas of the world. (+info)
Snake venom poisoning in Southern California.
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The annual incidence of rattlesnake bite in Southern California is approximately 1 per 75,000 population. The case fatality rate is 1.5 per cent. The snakes implicated in the greatest number of injuries are the southern Pacific rattlesnake, the red diamond rattlesnake and the sidewinder. Rattlesnake venom produces deleterious changes in the blood cells, defects in blood coagulation, injury to the intimal linings of vessels, damage to the heart muscle, alterations in the respiratory cycle and, to a lesser extent, changes in neuromuscular conduction. The most frequently observed symptoms and signs following ophidiasis in this area are swelling and edema, pain, ecchymosis, swelling of the regional lymph nodes, weakness, sweating, increased body temperature, faintness, and hemorrhagic vesiculations. First aid treatment consists of immobilization of the affected part, application of a constriction band, incision and suction with subsequent local application of ice packs. Treatment in hospital consists of administration of antivenin, antitetanus agent and antibiotic. Transfusions, oxygen and a corticosteroid may be indicated in some cases. (+info)
NATURE AND TREATMENT OF BITES OF VENOMOUS SNAKES IN CANADA: A REVIEW.
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A review of literature on snakebites was undertaken to evaluate the various recommended and practised methods of treatment used over the years, and to choose the most effective and least mutilating therapy for snakebite victims. Descriptions and photographs of pit vipers indigenous to Canada are included for identification purposes. The only proved adequate treatment of snakebite was shown to be Antivenin administration. A complete description of the use of this substance, which is prepared from horse serum, is given, as well as precautions to be taken prior to its administration, in the event of sensitivity to the serum. Supporting therapy is described and brief comments are made on less satisfactory means of treatment. (+info)
COUNTING CALIFORNIA'S SNAKEBITES.
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Poisonous snakebites happen in all sections of California, but they are especially frequent in Southern California. An estimated 221 (138 in-patients and 83 out-patients) people were bitten by snakes annually, an incidence of 1.41 bites per 100,000 people. However, the estimated case-fatality rate was less than one-half of one per cent. Of 135 in-patients reported in detail by California hospitals during 1958 and 1959, 123 (91 per cent) were bitten by rattlesnakes, one (1 per cent) by a foreign snake, and 11 (8 per cent) by unidentified poisonous snakes. "Seasonal epidemics" of snakebites occurred, 90 per cent of the bites being inflicted from April through October. Males had higher bite rates than females and Caucasians had higher rates than non-whites. Fifty per cent of the cases were among children and young adults less than 20 years of age. Ninety-nine per cent of the bites were on the extremities-65 per cent on the upper extremities and 34 per cent on the lower extremities. The recommended treatment of poisonous snakebites included incision and suction and the 3 A's (antivenin, antibiotics and antitetanus treatment). (+info)
Characteristics of venomous snakebites in Herzegovina.
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AIM: To investigate the degree to which primary and secondary care physicians in the Herzegovina region follow the protocols recommended in the literature for treatment of patients bitten by a venomous snake. METHOD: We retrospectively examined hospital records of all patients treated at the Department of Infectious Diseases, Mostar University Hospital, for intoxication following a venomous snakebite in the 1997-2002 period. The data on demographic characteristics, clinical presentation, therapy protocols, and final outcome were collected for each patient. RESULTS: From 1997 to 2002, 43 men (60.5%) and 28 women (33.4%) were treated at our Department for a venomous snakebite. The greatest number of snakebites occurred in persons older than 60 (chi-square=12.44, df=3, p=0.006) and during the summer months (chi-square=8.12, df=1, p=0.004). More than half of the patients (38, or 53.5%) were bitten on the hand. The commonest symptoms and signs of the local envenomation were pain (97.1%) and swelling (87.3%), whereas general symptoms were tachycardia (39.4%), nausea (33.8%), and vomiting (28.1%). Also, 56 patients (78.8%) experienced anxiety and fear. The primary care protocol recommended in the literature (antibiotics, tetanus antitoxin, snakebite antiserum, and immobilization) was given to only 2 patients (2%). However, there were no lethal outcomes. CONCLUSION: Development of a precise evidence-based protocol for prehospital management of venomous snakebite is needed in the Herzegovina region, followed by educational efforts targeted at primary care physicians. (+info)
Impact of snake bites and determinants of fatal outcomes in southeastern Nepal.
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Current available data on snake bites in Nepal are based solely on hospital statistics. This community-based study aimed at evaluating the impact of snake bites and determining the risk factors associated with a fatal outcome in southeastern Nepal. A total of 1,817 households, selected by a random proportionate sampling method, were visited by trained field workers in five villages. Extensive data from snake bite victims during the 14 previous months were recorded and analyzed. One hundred forty-three snake bites including 75 bites with signs of envenoming were reported (annual incidence = 1,162/100,000 and 604/100,000, respectively), resulting in 20 deaths (annual mortality rate = 162/100,000). Characteristics of krait bites such as bites occurring inside the house, while resting, and between midnight and 6:00 am were all factors associated with an increased risk of death, as were an initial consultation with a traditional healer, a long delay before transport, and a lack of available transport. An initial transfer to a specialized treatment center and transport by motorcycle were strong protective factors. Among the 123 survivors, wounds required dressing and surgery in 30 (24%) and 10 (8%) victims, respectively, the mean working incapacity period was 15 days, and the mean out-of-pocket expense was 69 U.S. dollars. Snake bite is a major but neglected public health problem in southeastern Nepal. Public health interventions should focus on improving victims' rapid access to anti-snake venom serum by promoting immediate and fast transport to adequate treatment centers, particularly for bites occurring at night. (+info)
Anticholinesterase therapy for patients with ophthalmoplegia following snake bites: report of two cases.
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Although ophthalmoplegia following snake bites is not indicative of a serious neurotoxic complication, symptoms of diplopia, dizziness and ocular discomfort can be emotionally devastating for patients. The authors experienced two cases of ophthalmoplegia following snake bites in Korea. The patients complained of diplopia that had developed several hours after the snake bites. The diplopia did not improve with antivenom treatment, but resolved completely after several injections of neostigmine. (+info)