Toxicity and symptomatic identification of species involved in snakebites in the Indian subcontinent

Abstract

Snakebites, being the major occupational hazard for farm workers, claim a large number of lives in the Indian subcontinent. During the course of medical management, identification of the biting species is given a low priority, resorting to prescription of polyvalent anti-snake venom. Whereas the World Health Organization (WHO) recommends monospecific anti-snake venom instead of polyvalent anti-snake venom. Thus, it is essential to identify the aggressor species either by a visual inspection or by the symptoms of the victim. Along with the four deadly venomous species (cobra, krait, Russell's viper, and saw-scaled viper), there are a number of other species of medical importance, whose venoms and bites have not been paid much attention. Thus, a misclassification resulting into erroneous treatment cannot be ruled out. This paper discusses the nature, constitution, and toxicity of venoms and their possible toxic effects on victims of snakebites. An attempt has also been made to categorize the distinctive symptoms due to the bites of the four major venomous species and their severity grading

Clinical profile, species-specific severity grading, and outcome determinants of snake envenomation: An Indian tertiary care hospital-based prospective study

“…2006,[11] we attempted to identify the species of the snake and found viper as the most common species identified in 73.68% of the cases [Table 1]. Hemotoxic (defined as prolongation of PT, INR, and APTT, reversal was considered with normalization of PT, INR, and APTT) and neurotoxic nature of envenomation were observed in 56 (73.68%) and 15 (19.73%) cases respectively, whereas 4 (5.26%) cases had both hemotoxic and neurotoxic manifestations.…”

“…[11] Two viperidae species were combined for analysis purpose because of inability to differentiate from history or laboratory data. The average quantity of ASV required in each grade of severity was estimated.…”

Parotid swelling after Russell's viper envenomation: an unusual and poor prognostic sign

“…Thus, the numbers of deaths reported by government agencies are thought to underestimate the true toll of death and disability by snakebite . The common venomous snake species in India are Spectacled cobra ( Naja naja ), Saw‐scaled viper ( Echis carinatus ), Russell's viper ( Daboia russelii ), and Common Krait ( Bungarus caeruleus ) , and are the target of commercially available polyvalent antivenoms of varying quality. Unfortunately, only 70–85% of bites are by these species and with the large number of bites, many patients cannot receive either specific or appropriately effective polyvalent antivenom therapy even if they reach a hospital.…”

Biochemical Evaluation of a Potentially Ubiquitous Element in Snake Bite: Myths and Facts-A Tertiary Rural Hospital Study in India

“…Russell"s viper and Saw scaled viper possess hemotoxic venoms. Following viper bite hemorrhagic manifestations and bleeding leads to shock, tachycardia, myocarditis and cardiac failure [15]. One of complications of snake envenomation is acute renal failure.…”