Snakebites

Every year in India, thousands of people lose their lives due to snakebite-related accidents every year. With each passing year, snakebite mortality cases have steadily increased. Our ever-expanding need for land and space pushes us to clear, occupy or construct over a greater geographical range, thereby considerably reducing space for other animals and birds. This combined with several other factors results in ever-increasing human-animal conflict.

Snakes do not bite for revenge or fun. They bite only if they are threatened or if we cause any physical injury. We can certainly avoid snakebites most of the time!

SNAKEBITE SCENARIO IN TELANGANA AND ANDHRA PRADESH

We collated snakebite death data from Andhra Pradesh Forensic Science Lab to understand the burden of snakebites in our region. We observed the following trends:

PREVENT SNAKEBITES

Prevention is always better than cure. Avoid snake bites being apprised of the following points –

1. Around 80 % of the people get bitten on their feet. Please look at your path, watch your step and walk slowly, when you are walking in areas where snakes are seen frequently.
2. Do not walk in dark places during the night, if you have to, please ensure that there is proper lighting or use a torch.
3. People living in huts, should ensure that they are not sleeping on the ground. During colder nights, few snakes may slither inside the warmer huts and get under our blankets or beds. In our sleep, when we accidentally place our arm or leg on them, we get bitten. If you have no alternative but o sleep on the ground, ensure that your hut is constructed properly without any holes or gaps.
4. Trim weeds and undergrowth to increase visibility.
5. Do not store materials on the ground. If left, undisturbed for a long time, snakes would have undisturbed space to live. Firewood or other materials should be placed on a platform that is much higher than the ground.
6. While picking up unused material from the ground, ensure that you are not exposing your bare hands near holes or gaps where snakes might be hiding. People have been bitten in the past when they were removing construction bricks or while lifting hay-stacks.
7. Use indoor lavatories. To attend nature calls during wee hours, ensure that you utilize a torch or using proper lighting.
8. Do not try to hold or handle snakes.

SYMPTOMS OF SNAKEBITE

Despite exercising caution, sometimes we fall victim to snakebites. Snakebites are mostly reported on hands & limbs (80%). Depending on the species, symptoms & progression of envenomation may be neurotoxic, hemotoxic, cytotoxin, myotoxic, etc.

Commonly reported symptoms of Cobra & King Cobra bites

• Rupture of skin, bleeding from the bite site
• Immediate, localized pain (sharp & throbbing pain)
• Ecchymosis (discolouration around the bite site) < one hour Localized edema (swelling around the bite site) > one hour
• Nausea & vomiting
• Drowsiness
• Ptosis (drooping eyelids) & ophthalmoplegia (paralysis of eye muscles)
• Dyspnea (respiratory paralysis), etc.
• Necrosis & blistering at the bite site (delayed treatment)

Commonly reported symptoms of Krait & Coral Snake bites

• Rupture of skin, bleeding from the bite site
• Immediate pain due to puncture wound
• Subsequently, pain, discolouration & swelling at the bite is minimal or absent
• Ptosis (drooping eyelids) & ophthalmoplegia (paralysis of eye muscles)
• Nausea & vomiting
• Drowsiness
• Stomach ache or cramping
• Facial & bulbar paralysis
• Respiratory & limb paralysis < 8 hours of the bite
• Neuromuscular paralysis (mimicking coma) & coma

Commonly reported symptoms of Sea Snake bites

Commonly reported symptoms of Viper & Pit viper bites

• Rupture of skin, bleeding from the bite site
• Immediate, localized pain (sharp & throbbing pain)
• Ecchymosis (discolouration around the bite site) < one hour
• Edema (proximal progression of swelling)
• Localized bleeding, oozing from the bite site
• Hypotension
• Systemic bleeding
• Nausea & vomiting
• Drowsiness & disorientation
• Ptosis (drooping eyelids) & ophthalmoplegia (paralysis of eye muscles)
• Dysphagia
• Distant bleeding
• Necrosis & blistering at the bite site (Delayed treatment)

With timely intervention & proper management, snakebites are rarely lethal.

Don’ts

1. Do not panic. Fear leads to the mismanagement of snakebites. Nervousness or panic could increase your heartbeat, thereby felicitating the venom flow in the bloodstream.
2. Do not cut the wound or try to suck the venom out. You must have already figured out that it happens only in the movies, especially with the heroine, and almost always, it is the hero to the rescue. Cutting the wound area could create a new entry site for the venom to pass through the bloodstream. Sucking the venom out could also prove fatal. Fine lacerations in the gum cavity of the rescuer could be the new channel through which the venom from the victim’s body might enter into the rescuer’s!
3. Do not try to kill the snake! The snake bite treatment in India is chiefly symptomatical, i.e., doctors would treat you based on your symptom. Therefore, identifying the snake that bit you might be helpful, but there is no need to produce the defendant!
4. Do not exert yourself after a bite. Physical activity increases the blood flow in the body.
5. Do not waste crucial time by visiting a quack doctor or a faith healer. We do not have any medically proven treatment for snakebites in Ayurveda, Homeopathy, or other alternative medical systems.

Remember, most snakebites are mere accidents. With sufficient awareness & caution, accidents may be averted.