Injuries and envenomation by exotic pets in Hong Kong

Ng, Vember Ch; Lit, Albert Ch; Wong, OF; Tse, ML; Fung, HT

doi:10.12809/hkmj176984

Cited by 8 publications

(8 citation statements)

References 24 publications

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“…Similar to our data, the UK study reported that 69% of the cases were males with a mean age of 32 years of age. A poison center report from Hong Kong also describes several exotic snakebites [18]. A 34-year-old snake breeder in Switzerland was unknowingly envenomed by a black mamba (Dendroaspis polyepis) while feeding a specimen and a medical helicopter was used to transport antivenom to the treating hospital [19].…”

Section: Discussionmentioning

confidence: 99%

Exotic Snakebites Reported to Pennsylvania Poison Control Centers: Lessons Learned on the Demographics, Clinical Effects, and Treatment of These Cases

Miller

Osterhoudt

Korenoski

et al. 2020

Toxins

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Exotic snakebites (i.e. from non-native species) are a rare occurrence, but they present a unique challenge to clinicians treating these patients. Poison control centers are often contacted to assist in the management and care of these medical emergencies. In this study, we analyzed case records of the two Pennsylvania poison control centers from 2004 to 2018 to describe clinical features reported as a result of exotic snakebite envenomation. For the 15-year period reviewed, 18 exotic snakebites were reported with effects ranging from mild local tissue injury to patients who were treated with mechanical ventilation due to respiratory failure. The mean age of the patients was 35 years and males accounted for 83% of the cases. Antivenom, the only specific treatment, was administered in seven of 18 patients within an average of four h of envenomation. The procurement of antivenom against these exotic species may require substantial logistical efforts due to limited stocking of this rarely used treatment. Newer, targeted, small molecule treatments that are being currently investigated may aid in the treatment of snakebites in general. However, people should be cautious when handling these exotic species, and clinicians should be aware of these bites and relevant clinical effects in order to manage these when reported.

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Section: Discussionmentioning

confidence: 99%

Exotic Snakebites Reported to Pennsylvania Poison Control Centers: Lessons Learned on the Demographics, Clinical Effects, and Treatment of These Cases

Miller

Osterhoudt

Korenoski

et al. 2020

Toxins

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“…In a European Poison Centre study, snakebites accounted for 39% of all bites and stings reported over an 11-year period [4]. Bites by exotic venomous snakes have also been identified as emerging medical challenges in other countries, such as Brazil [16,17], Hong Kong [18] and South Korea [19]. In all these studies, Viperidae or Elapidae were responsible for the most serious cases of envenoming.…”

Section: Introductionmentioning

confidence: 99%

Bites by exotic snakes reported to the UK National Poisons Information Service 2009–2020

Jagpal

Williams

Eddleston³

et al. 2022

Clinical Toxicology

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Introduction: Snakebite is recognised as a neglected tropical disease and a cause of substantial morbidity and mortality. Whilst the most medically important snakes are typically native of Asia, Africa, Latin America and Oceania, the possibility of encountering these snakes is no longer limited by geography due to an increasing number of exotic (non-native) snakes being held in captivity. Methods: A retrospective review of snakebite enquiries to the UK National Poisons Information Service (NPIS) between 2009 and 2020. Enquiries about the European adder (Vipera berus) or where the identity of the snake was unknown were excluded. Results: There were 321 exotic snakebites in 300 patients involving 68 different species during this period. Ten patients were bitten on more than one occasion. The majority of patients (64.5%) were male. Most bites were inflicted by snakes of the family Colubridae (184/321, 57.3%); seventeen bites resulted in moderate symptoms (predominantly swelling of the bitten limb). There were 30 (9.3%) bites by Viperidae and 14 (4.3%) bites by Elapidae. All severe cases (n ¼ 15) resulted from bites by either Viperidae (n ¼ 10) or Elapidae (n ¼ 5). Antivenom was given in 17 cases. One fatality was recorded. Conclusions: Despite their low incidence, exotic snakebites present a substantial challenge for UK healthcare professionals. Although rare, these bites typically occur in individuals (usually male) who keep snakes as part of their occupation or hobby and are therefore at risk of multiple bites. Bites can result in venom hypersensitisation and the risk of venom-induced anaphylaxis. Rapid access to expert clinical advice is available in the UK on a 24-hour basis through the National Poisons Information Service and is strongly recommended in all cases of exotic snakebite.

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“…Because keepers in Switzerland are required to register their snakes, they usually know the Latin name of their pet [1]. Reptiles are reported to be the most popular exotic pets worldwide [2]. In the United States it is estimated that 1.5 to 2.0 million households own one or more pet reptiles.…”

Section: Introductionmentioning

confidence: 99%

“…Envenomation by exotic pets is an increasing concern in Europe, the USA and Asia, because physicians are often not used to treating patients after an exotic snakebite [3,[6][7][8][9][10][11][12][13]. In addition, the continuing worldwide antivenom shortage poses a further difficulty for specific treatment, since antivenom is the firstline therapy in patients with severe snakebites [2]. In the US Poisons Center Database 258 cases of exotic snake envenomation were reported between 2005 and 2011, involving at least 61 different exotic species [8].…”

Section: Introductionmentioning

confidence: 99%

Exotic venomous snakebites in Switzerland reported to the National Poisons Information Centre over 22 years

et al. 2022

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OBJECTIVE: The private keeping of exotic venomous snakes is legally permitted in Switzerland. The aim of the present study was to characterise the epidemiological and clinical features of bites by exotic venomous snakes over a period of 22 years in Switzerland. METHODS: We included all calls related to exotic snakebites recorded at the Swiss National Poisons Information Centre (Tox Info Suisse) from 1997 to 2018. Exclusion criteria comprised indigenous snakes, non-venomous exotic snakes such boas or pythons, clinical courses incompatible with a snakebite or calls from abroad. Follow-up information was graded according to the Poisoning Severity Score. RESULTS: Within the study period, 1,364 calls related to snakebites were recorded at Tox Info Suisse; 148 (11%) cases were attributed to exotic venomous snakes and fulfilled the study criteria. A total of 112 (98%) of 114 patients with medical follow-up information exhibited sufficient causality between exposure and clinical effects. Only adult patients were affected. The median age was 40 years (range 16–71) and the male gender was predominant (n = 136, 92%). Viperidae were involved in 87 (78%) and Elapidae in 25 (22%) patients. Overall, the main affected body part was the hand (89 patients, 79%). In the majority of the patients the clinical course was mild (46, 41%) or moderate (40, 36%), in a lower proportion asymptomatic (6, 5%) or with severe symptoms (20, 18%). No fatalities were reported in the study period. Severe symptoms were observed after elapid bites in six patients (24%) and after viper bites in 14 patients (16%). Besides local effects, neurological disorders after elapid bites and haematological disorders after viper bites were most frequently reported. Antivenom was administered in 24% (27 patients: 18 Viperidae, 21% and 9 Elapidae, 36%; 5 patients (4%) required multiple doses), overall, with good resolution of symptoms. CONCLUSION: Exotic snakebite is a rare occurrence in Switzerland but has led to medically relevant morbidity, sometimes requiring antivenom treatment. Over half of the envenomed patients required symptomatic or specific treatment. No fatalities or bites in children were reported.

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Injuries and envenomation by exotic pets in Hong Kong

Cited by 8 publications

References 24 publications

Exotic Snakebites Reported to Pennsylvania Poison Control Centers: Lessons Learned on the Demographics, Clinical Effects, and Treatment of These Cases

Exotic Snakebites Reported to Pennsylvania Poison Control Centers: Lessons Learned on the Demographics, Clinical Effects, and Treatment of These Cases

Bites by exotic snakes reported to the UK National Poisons Information Service 2009–2020

Exotic venomous snakebites in Switzerland reported to the National Poisons Information Centre over 22 years

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