Rediscovery of Severe Saw-Scaled Viper (Echis sochureki) Envenoming in the Thar Desert Region of Rajasthan, India

Kochar, Dhanpat Kumar; Tanwar, Parul; Norris, Robert L.; Mohammed, Sabir; Nayak, Kailash Chandra; Agrawal, T.D.; Purohit, Vinay; Kochar, Anju; Simpson, Ian D.

doi:10.1580/06-weme-or-078r.1

Cited by 48 publications

(35 citation statements)

References 9 publications

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“…Saw-scaled vipers ( Echis carinatus and E. sochureki ) are other very important viperine species that inhabit open and dry environments. E. sochureki causes numerous bites in northern India and has long been regarded as one of Pakistan's deadliest snakes [17],[23]; E. carinatus is regionally highly abundant and causes many bites in parts of western and southern India [18] and in arid coastal areas of northern Sri Lanka [24]. Three other species of true vipers that occur in the west of South Asia are the Levantine viper ( Macrovipera lebetina ) and two species of desert vipers ( Eristicophis macmahoni and Pseudocerastes persicus ).…”

Section: Venomous Snakes In South Asiamentioning

confidence: 99%

Snake Bite in South Asia: A Review

Alirol

Sharma

Bawaskar³

et al. 2010

PLoS Negl Trop Dis

385

380

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Snake bite is one of the most neglected public health issues in poor rural communities living in the tropics. Because of serious misreporting, the true worldwide burden of snake bite is not known. South Asia is the world's most heavily affected region, due to its high population density, widespread agricultural activities, numerous venomous snake species and lack of functional snake bite control programs. Despite increasing knowledge of snake venoms' composition and mode of action, good understanding of clinical features of envenoming and sufficient production of antivenom by Indian manufacturers, snake bite management remains unsatisfactory in this region. Field diagnostic tests for snake species identification do not exist and treatment mainly relies on the administration of antivenoms that do not cover all of the important venomous snakes of the region. Care-givers need better training and supervision, and national guidelines should be fed by evidence-based data generated by well-designed research studies. Poorly informed rural populations often apply inappropriate first-aid measures and vital time is lost before the victim is transported to a treatment centre, where cost of treatment can constitute an additional hurdle. The deficiency of snake bite management in South Asia is multi-causal and requires joint collaborative efforts from researchers, antivenom manufacturers, policy makers, public health authorities and international funders.

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Section: Venomous Snakes In South Asiamentioning

confidence: 99%

Snake Bite in South Asia: A Review

Alirol

Sharma

Bawaskar³

et al. 2010

PLoS Negl Trop Dis

385

380

View full text Add to dashboard Cite

show abstract

“…E. c. sochureki causes numerous deadly bites especially in Asia [1, 2]. Generally envenoming by Echis snake vipers is responsible for several clinical complications of severe systemic and local pathology.…”

Section: Introductionmentioning

confidence: 99%

Neutralisation of Local Haemorrhage Induced by the Saw-Scaled ViperEchis carinatus sochurekiVenom Using Ethanolic Extract ofHibiscus aethiopicusL.

Hasson

Al-Balushi

Said

et al. 2012

Evidence-Based Complementary and Alternative Medicine

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The objective of the study is to investigate the anti-snake venom activities of a local plant, Hibiscus aethiopicus L. The H. aethiopicus was dried and extracted with ethanol. Different assays were performed according to standard techniques, to evaluate the plant's acute toxicity and its antivenom activities. The results of evaluating the systemic acute toxicity of the H. aethiopicus extract using “oral and intra-peritoneal” route were normal even at the highest dose (24 g/kg) tested. All guinea pigs (n = 3) when treated with venoms E. c. sochureki (75 μg) alone induced acute skin haemorrhage. In contrast, all guinea pigs (n = 18) treated with both venom and the plant extract at a concentration between 500 and 1000 mg/kg showed no signs of haemorrhage. Moreover, all guinea pigs (n = 18) treated with venom and the plant extract below 400 mg/kg showed acute skin haemorrhage. All guinea pigs treated with venom E. c. sochureki (75 μg) alone induced acute skin haemorrhage after both 24 and 32 hours. In contrast, all guinea pigs treated with both venom and the plant extract (administered independently) at concentrations between 500 and 1000 mg/kg showed no signs of haemorrhage after 32 hours. However, after 24 hours all tested guinea pigs showed less inhibition (<60%) compared to that obtained after 32 hours. The outcome of this study reflects that the extract of H. aethiopicus plant may contain an endogenous inhibitor of venom induced local haemorrhage.

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“…9 The common clinical experience is that it carries venom with high fatality with mainly hemotoxic manifestations. 10,11 In fact, SSV venom inflicts four different ill effects on its victims; local tissue swelling, local tissue necrosis, consumptive caogulopathy, and spontaneous bleeding. The phospholipase A2 component in venom causes local tissue necrosis.…”

Section: Discussionmentioning

confidence: 99%

“…The local SSV venom though having hemotoxic manifestations does not seem to be fatal to man as its counterpart's venom in some parts of India (Jammu, Rajasthan) and West Africa. 9,17,[21][22][23][24] This needs to be confirmed by appropriate venom profiling of the Sri Lankan species that may be erroneously classified as a highly venomous snake.…”

Section: Discussionmentioning

confidence: 99%

Saw-Scaled Viper Bites in Sri Lanka: Is It a Different Subspecies? Clinical Evidence from an Authenticated Case Series

Gnanathasan¹,

Rodrigo²,

Peranantharajah³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. The saw-scaled viper (SSV) (Echis carinatus) is considered to be a highly venomous snake in Sri Lanka despite any published clinical justification. Being a rarity, the clinical profile of SSV bites is not well established in Sri Lanka. We report a series of 48 (n-48) SSV bites from the Northern Province of Sri Lanka. The majority (65%) of victims had evidence of local envenoming at the site of the bite; however, 29% showed spontaneous bleeding and 71% had coagulopathy. There were no deaths in the series. The envenoming was mild in contrast to the mortality and significant morbidity associated with SSV bites in West Africa and some parts of India. These observations need to be further explored with laboratory studies to identify the venom components, study of morphological characteristics, and genetic profiling of the Sri Lankan SSV to see if it is different from the subspecies found elsewhere.

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Rediscovery of Severe Saw-Scaled Viper (Echis sochureki) Envenoming in the Thar Desert Region of Rajasthan, India

Abstract: Echis sochureki causes severe bites in Rajasthan. Work needs to be done to alter the first aid practices used for snakebites in this area, to encourage more rapid presentation to hospital, and to develop antivenom that is more effective against E sochureki.

Cited by 48 publications

References 9 publications

Snake Bite in South Asia: A Review

Snake Bite in South Asia: A Review

Neutralisation of Local Haemorrhage Induced by the Saw-Scaled ViperEchis carinatus sochurekiVenom Using Ethanolic Extract ofHibiscus aethiopicusL.

Saw-Scaled Viper Bites in Sri Lanka: Is It a Different Subspecies? Clinical Evidence from an Authenticated Case Series

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