A national hospital-based survey of snakes responsible for bites in Thailand

Abstract

Snakes which had been killed and brought to hospital with the patients they had bitten were collected in 80 district and provincial hospitals throughout 67 provinces in Thailand in order to establish the geographical distribution and relative medical importance of the venomous species. Of the 1631 snakes collected, 1145 were venomous: Malayan pit vipers (Calloselasma rhodostoma), green pit vipers (Trimeresurus albolabris) and Russell's vipers (Daboia russelii) were the most numerous, while T. albolabris, C. rhodostoma and spitting cobras ('Naja atra') were the most widely distributed. In 22 cases, non-venomous species were mistaken for venomous ones and antivenom was used unnecessarily. The Malayan krait (Bungarus candidus) was confused with B. fasciatus in 5 cases and B. fasciatus antivenom was used inappropriately. The study extended the known ranges of most of the medically-important venomous species in Thailand. Correct identification of venomous snakes is especially important in Thailand because the locally-produced antivenoms are monospecific. The technique of hospital-based collection, labelling and preservation of dead snakes brought by bitten patients is recommended when rapid assessment of a country's medically important herpetofauna is required.

Syndromic Approach to Treatment of Snake Bite in Sri Lanka Based on Results of a Prospective National Hospital-Based Survey of Patients Envenomed by Identified Snakes

“…This algorithm was based largely on a survey of 762 patients in 10 hospitals in Sri Lanka who brought the snake responsible for biting them to the hospital. This technique, which was used in Thailand, 12 is recommended as a simple means of obtaining information about the relative importance of different species of venomous snakes in a particular geographic region and the effects of envenoming. Dead snakes brought to hospitals are usually discarded by the medical staff after cursory inspection.…”

“…We adopted the technique of Viravan and others, who established the distribution and relative medical importance of 16 taxa of venomous snakes in Thailand by collecting dead snakes brought to hospitals with bitten patients. 12 …”

Venomous snakebites and antivenom treatment according to a protocol for pediatric patients in taiwan

“…Snakebite injuries are not uncommon in Asia (1)(2)(3)(4). However, reports of their clinical features and management in children are scarce, even in countries known to present a high snakebite incidence (5,6).…”

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“…They were responsible for 70% of snakebite cases where the culprit snakes were identifiable in 2008. C. albolabris and C. rhodostoma are widely distributed throughout the country while D. r. siamensis has its major habitat in the central region [1][2][3] . C. albolabris bites usually do not lead to death unlike C. rhodostoma or D. r. siamensis bites whose delayed treatment can be life threatening 3,4 .…”