Local Envenomation and overall Morbidity in Snake Bites - A descriptive study of snake bites in Sri Lanka

Abstract

Abstract Snake bite is an occupational disease that is a major concern in developing countries. Still, research on this subject is limited and a great deal remains to be investigated, especially when it comes to the local manifestations. Sri Lanka is a country in south-east Asia in which snake bites are common. This is a descriptive study with focus on the local manifestations. The aim of this study was to investigate whether severe local envenomation could reduce the systemic symptoms. In total, 82 patients were included in the study. 39% were bitten by Russell’s viper which also gave rise to the most severe envenomations, but mostly moderate swelling (median 4.3%). In comparison, Hump-nosed viper caused 12% of cases, more swelling (median 8.6%) and seldom gave rise to any systemic manifestations. One patient was bitten by a cobra and was the only patient with blistering. Three patients were bitten by kraits, out of one had signs of envenomation. A large group of patients were bitten by unidentified snakes. The results are broadly consistent with the literature, except for the fact that there were no severe local manifestations (blistering and/or necrosis) among the patients bitten by Viperidae spp. The study has several limitations including potential inaccuracies in measurements, a single data collector with limited time, and poor documentation in medical records. The main limitation, however, is small sample size, meaning that it is not possible to draw any definite conclusions on the basis of this study, especially not concerning possible correlations between local and systemic manifestations.