snake bites - neglected disease
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SNAKE BITES
Distribution & Classification of Venomous Snake Anatomy of Venomous SnakeEpidemiology of SnakebiteClinical Manifestation of SnakebiteDiagnosis Treatment Prevention
OBJECTIVES
DISTRIBUTION OF VENOMOUS SNAKE
Reprinted from Wikimedia Commons, 20091
Viperidae Russell’s viper Saw-scaled viper
(Echis carinatus)Elapidae
Naja Naja Cobra Common Krait
Hydrophidae (Sea snake)
ColubridaeAtractaspididae
CLASSIFICATION OF VENOMOUS SNAKE
Cobra
Russell's viper
Sea SnakeReprinted from Wikimedia
Commons2Reprinted from Wikimedia Commons, 20083
Reprinted from Wikimedia Commons, 20134
ANATOMY OF VENOMOUS SNAKE
Proteroglypha
Solenoglypha
Reprinted from Wikimedia Commons, 20085
OpisthoglyphaReprinted from Wikimedia
Commons, 20086 Reprinted from Wikimedia Commons, 20087
Reprinted from Biology Forums, 20129
ANATOMY
Venom Composition
Venom EnzymeVenom
polypeptide toxins
(neurotoxins)
Zinc metalloprotei
nase haemorrhagi
ns
Procoagulant
enzyme
Phospholipase A2
(lecithinasae)
Acetylcholinesterase
Hyaluronidase
Non-toxic protein
EPIDEMIOLOGY OF SNAKEBITE
Reprinted from Wikimedia Commons, 20099
RISK FACTORS
Characteristics Details
Age 10 – 40 years old
Gender 2:1 male to female ratio
Target Farmers, plantation workers, herders, and fishermen
Time of Bite Diurnal: Viper and CopraNocturnal: Krait
Site of Bite 60%-80% on foot, legs or ankles. Head and trunk (while sleeping)
Transmission TimeReprinted from PMC, 201510
Physical observation (bite marks)
Misidentify snake species Ineffective antivenom
Blood clotting testELISA test
DIAGNOSIS
Puncture of snake bitesReprinted from Wikimedia Commons,189512
CLINICAL MANIFESTATION OF SNAKEBITE
Reprinted from Wikimedia Commons, 200911
ParalysisNecrosisHemostatic AbnormalitiesRenal FailureFatal
COMPLICATIONS
TREATMENTFirst Aid
Traditional First Aid
• Keep the victim calm.• Call for emergency• Remove jewelry and tight
clothing • Position the victim, so the
bite is at or below the victim’s heart level
• Clean the bite, don’t flush it with water
• Cover the bite with dry, clean dressing
Reprinted from PMC, 201013
AntivenomAlbert Calmette
(1890s)Monovalent PolyvalentAdverse effects:
Anaphylactoid (10-180 mins)
Pyrogenic reactions (1-2 hours)
Late serum sickness (4-24 days)
TREATMENT
Venom Extraction
Venom Injection in
Animal Immunization
Blood collection
Antivenom
Wear boots and long pantsStay way from tall grass or brushAvoid sleeping on the floorAvoid climbing on rocks where
snakes may be hidingInform about venomous snake and
health risksUsing flashlight/ torch during night
time
PREVENTION
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2. Kamalnv. Ind ian Cobra . Wik imed ia Commons. h t tps : / /commons .w ik imed ia .org/w ik i / Fi le : Ind iancobra . j pg . Accessed August 10 t h , 2016 .
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4. Gupt .sumeet . Russe l l ’ s Vipe r in Pune Zoo. Wik imed ia Commons . h t tps : / /commons .w ik imed ia .org/w ik i / Fi le :Russe l l s_v ipe r_ in_pune_zoo. jpg. Pub l i shed Apr i l , 2013 . Accessed August 10 t h , 2016 .
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6. Moke le . Crota lus sku l l . Wik imed ia Commons . h t tps : / /commons .w ik imed ia .org/w ik i / Fi le :Crota lus_sku l l . jpg. Pub l i shed February 17 t h , 2008 . Accessed August 10 t h , 2016 .
7. Moke le . He terodon nas icus sku l l . Wik imedia Commons. h t tps : / /en .w ik ipedia .org /w ik i /Fi le :Hete rodon_nas icus_skul l . j pg . Pub l i shed February 17 t h , 2008 . Accessed August 10 t h , 2016 .
8. B iomajor. Snake fangs and venom. B io logy- forums.com. h t tp: / /b io logy- forums.com/ index.php?act ion=gal le ry ;sa=view; id=5309 . Pub l i shed 2012 . Accessed August 10 t h , 2016 .
9. E ightofn ine . Number o f snake envenoming. Wik imedia Commons. h t tps : / /commons .w ik imed ia .org/w ik i / Fi le :Number_of_snake_envenomings .svg . Pub l i shed June 24 t h , 2009 . Accessed August 10 t h , 2016 .
10.Tox ico l Int . Body mapp ing pf the d i s t r i but ion o f snake b i te s i tes . PMC. h t tp: / /www.ncb i .n lm.n ih .gov/pmc /ar t i c l es /PMC4721181/figure /F3 / . Pub l i shed January 2015 . Accessed August 10 t h , 2016 .
11.Mikae l Haggst rom. Snake b i te symptoms. Wik imedia Commons . h t tps : / /commons .w ik imed ia .org/w ik i / Fi le :Snake_b i te_symptoms.png. Publ i shed March 25 t h , 2009 . Publ i shed August 10 t h , 2016 .
12.Punctures or b i tes o f snakes . Wik imedia Commons. h t tps : / /commons .w ik imed ia .org/w ik i / Fi le :PSM_V46_D085_Punctures_or_b i tes_of_snakes . jpg. Pub l i shed 1895 . Accessed August 10 t h , 2016 .
13. PLoS Neglec t Trop ica l D íease . PMC. h t tp: / /www.ncb i .n lm.n ih .gov/pmc /ar t i c l es /PMC2811174/figure /pntd-0000603-g003/ . Pub l i shed January 2010 . Accessed August 10 t h , 2016 .
REFERENCES
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