Inadequacy of Present Polyspecific Anti Snakevenom— A Study from Central Kerala

“…[345678] South Indian snakes predominantly cause hemotoxicity or nephrotoxicity in 83.59% of cases (1965 envenomations) [Table 1]. [910111213141516] This trend becomes apparent as we move Southward from Delhi early as Maharashtra, which has thus been included by us in South India. North Indian snakes predominantly cause neurotoxicity in 70.95% of cases (877 envenomations) [Table 2].…”

Section: Introductionmentioning

confidence: 99%

“…[345678] P < 0.05 Our research shows that the Russell's viper is virtually nonexistent in North, and there is enough published evidence to prove this fact. [345678910111213141516] Neurotoxic snake Krait is responsible for high mortality throughout North India. [345678] Hence, the North Indian profile is neurotoxicity predominant (Krait), and South Indian profile is hemonephrotoxicity predominant (Russell's and saw-scaled vipers).…”

Section: Introductionmentioning

confidence: 99%

The North-South divide in snake bite envenomation in India

Chauhan

Thakur

2016

J Emerg Trauma Shock

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Snake bite envenomations are common in rural areas and the incidence peaks during monsoons in India. Prominent venomous species have been traditionally labeled as the ‘big four’ that includes Cobra, Krait, Russel's viper and Saw scaled viper. Systematic attempts for identification and classification of prevalent snakes in various states of India are missing till now and there is no concrete data on this aspect. The published literature however shows that some species of snakes are more prevalent in a particular region than the other parts of India e.g. Saw scaled vipers in Rajasthan. We reviewed the published literature from various parts of India and found that there is a North-South divide in the snake bite profile from India. Neurotoxic envenomations are significantly higher in North India compared to South India where Hematotoxic envenomations are prevalent. Russel's viper causes local necrosis, gangrene and compartment syndrome. These manifestations have never been reported in North Indian snake bite profile in the published literature. Early morning neuroparalysis caused by Krait is a common problem in North India leading to high mortality after snake bite. This review presents supporting evidence for the North-South divide and proposes a way forward in formulation and revision of guidelines for snake bite in India.

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“…In southwestern India (Kerala), in the year 2007, H. hypnale was identified as a common and dangerous source of envenoming, second only to Russell's viper. Deaths have been subsequently recorded in India following HNV envenoming [5,10]. In a prospective multicenter study involving ten hospitals in Sri Lanka, 302 HNV bite victims were identified out of 860 patients with bites by identified snakes (35%).…”

Section: Reviewmentioning

confidence: 99%

Hump-nosed viper bite: an important but under-recognized cause of systemic envenoming

Shivanthan

Yudhishdran

Navinan

et al. 2014

J Venom Anim Toxins incl Trop Dis

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Hump-nosed viper bites are common in the Indian subcontinent. In the past, hump-nosed vipers (Hypnale species) were considered moderately venomous snakes whose bites result mainly in local envenoming. However, a variety of severe local effects, hemostatic dysfunction, microangiopathic hemolysis, kidney injury and death have been reported following envenoming by Hypnale species. We systematically reviewed the medical literature on the epidemiology, toxin profile, diagnosis, and clinical, laboratory and postmortem features of hump-nosed viper envenoming, and highlight the need for development of an effective antivenom.

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Inadequacy of Present Polyspecific Anti Snakevenom— A Study from Central Kerala

Abstract: Hump nosed pit viper envenomation is not rare in Kerala and can cause death, unlike the earlier belief. Available anti snake venoms does not cover pit viper. So, antivenom for this snake is urgently required.

Cited by 15 publications

References 6 publications

Snake bite mortality in children: beyond bite to needle time

Snake bite mortality in children: beyond bite to needle time

The North-South divide in snake bite envenomation in India

Hump-nosed viper bite: an important but under-recognized cause of systemic envenoming

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