Management of Snake Envenomation in Taiwan

Mao, Yan‐Chiao; Hung, Dong-Zong

doi:10.1007/978-94-007-6288-6_43-1

Cited by 2 publications

(6 citation statements)

References 61 publications

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“…Unlike protein-based antivenom agents, SSC is thermo-stable that can be preserved in room temperature and purchased easily from online shops. In addition, previous studies suggested that 2-4 vials are generally recommended to treat P. mucrosquamatus envenoming [44,45]. A recent study reported that the median dose of antivenom to treat P. mucrosquamatus envenoming is 5.5 vials [33].…”

Section: Discussionmentioning

confidence: 99%

Effects of Sodium Silicate Complex against Hemorrhagic Activities Induced by Protobothrops mucrosquamatus Venom

Chen

Wang

Huang

et al. 2021

Toxins

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Protobothrops mucrosquamatus poses a serious medical threat to humans in Southern and Southeastern Asia. Hemorrhage is one of the conspicuous toxicities related to the pathology of P. mucrosquamatus envenoming. Previous in vitro and in vivo studies showed that a silica-derived reagent, sodium silicate complex (SSC), was able to neutralize hemorrhagic and proteolytic activities induced by pit viper venoms, including Crotalus atrox, Agkistrodoncontortrix contortrix and Agkistrodon piscivorus leucostoma. In this study, we validated that SSC could neutralize enzymatic and toxic effects caused by the venom of P. mucrosquamatus. We found that SSC inhibited the hemolytic and proteolytic activities induced by P. mucrosquamatus venom in vitro. In addition, we demonstrated that SSC could block intradermal hemorrhage caused by P. mucrosquamatus venom in a mouse model. Finally, SSC could neutralize lethal effects of P. mucrosquamatus venom in the mice. Therefore, SSC is a candidate for further development as a potential onsite first-aid treatment for P. mucrosquamatus envenoming.

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Section: Discussionmentioning

confidence: 99%

Effects of Sodium Silicate Complex against Hemorrhagic Activities Induced by Protobothrops mucrosquamatus Venom

Chen

Wang

Huang

et al. 2021

Toxins

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“…acutus (FA); monovalent antivenom for D . siamensis (FD) was not distributed until 2008 [ 25 ]. Patients could only obtain antivenom from the CDC through the NHI system, which is mandatory, and their medical records were detailed in the NHIRD.…”

Section: Methodsmentioning

confidence: 99%

“…The total population was 23,492,074, and the number of people in agriculture was 2,710,680 (11.5%) in 2022, respectively [ 23 , 24 ]. Six venomous snake species with medical importance were found: Trimeresurus stejnegeri stejnegeri , Protobothrops mucrosquamatus , Deinagkistrodon acutus , and Daboia siamensis in the Viperidae family and Naja atra and Bungarus multicinctus multicinctus in the Elapidae family [ 25 ]. The Taiwan Centers for Disease Control (CDC), the only snake antivenom manufacturer, produces four types of antivenom in lyophilized form, which are ammonium sulfate-precipitated F(ab’) 2 fragments [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence rate of SBE decreased from 8.8 cases per 100,000 person-years during 1904–1938 to 4.5 cases per 100,000 person-years during 2005–2009; the case-fatality rate also decreased from 3%–7% to 0.04%–0.08% during the same period, respectively [ 34 , 35 ]. The decline in incidence was related to lifestyle changes, while the large reduction in case-fatality rate might be due to easy access to modern medicine, immediate availability of antivenom in healthcare facilities, and few adverse effects of antivenoms [ 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…In Taiwan, nationwide and long-term epidemiological research on SBE remains lacking after 1940s [ 25 ]. This study aimed to explore the epidemiology of SBE based on the distribution and use of different antivenoms in different parts of Taiwan.…”

Section: Introductionmentioning

confidence: 99%

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Nationwide and long-term epidemiological research of snakebite envenomation in Taiwan during 2002–2014 based on the use of snake antivenoms: A study utilizing National Health Insurance Database

et al. 2023

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Introduction In Taiwan, six venomous snake species with medical importance have been found; however, long-term epidemiological data of snakebite envenomation (SBE) is lacking. This study aimed to explore the epidemiology of SBE based on the distribution and use of different antivenoms in different parts of Taiwan to facilitate the development of prevention strategies and resource allocation. Methods and results This retrospective study was conducted using the Taiwan National Health Insurance Research Database from 2002 to 2014. A total of 12,542 patients were treated with antivenoms. The directly standardized cumulative incidence was 3.6 cases per 100,000 individuals based on the 2000 World Standard Population. The incidence of SBEs peaked in the summer (35.9%). The relative risk (RR) of male patients versus female patients was 2.5 (p < 0.0001). The RRs of patients aged 18–64 and ≥65 years versus those aged <18 years were 6.0 (p < 0.0001) and 14.3 (p < 0.0001), respectively. Furthermore, the RR of eastern Taiwan versus northern Taiwan was 6.8 (p < 0.0001). The RR of agricultural workers versus laborers was 5.5 (p < 0.0001). Compared with patients envenomed by Trimeresurus stejnegeri stejnegeri or Protobothrops mucrosquamatus, those envenomed by Naja atra or Bungarus multicinctus multicinctus were more likely to occur in central (adjusted odds ratio [aOR] = 2.6, p < 0.0001) or southern (aOR = 3.2, p < 0.0001) Taiwan, but less frequently among agricultural workers (aOR = 0.6, p < 0.0001). The overall case-fatality rate was 0.11%. Conclusions Among Asian countries, Taiwan had low incidence and case-fatality rates of SBE. Risk factors included male gender, old age, summer season, being in eastern Taiwan, and being an agricultural worker. Differences of the epidemiological findings between snake species should be focused on when developing strategies for snakebite prevention.

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Management of Snake Envenomation in Taiwan

Cited by 2 publications

References 61 publications

Effects of Sodium Silicate Complex against Hemorrhagic Activities Induced by Protobothrops mucrosquamatus Venom

Effects of Sodium Silicate Complex against Hemorrhagic Activities Induced by Protobothrops mucrosquamatus Venom

Nationwide and long-term epidemiological research of snakebite envenomation in Taiwan during 2002–2014 based on the use of snake antivenoms: A study utilizing National Health Insurance Database

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