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    7 views18 pages

    Snakes - Bites

    Uploaded by

    2TIN WUELIOT

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    SNAKEBITES WORLDWIDE: CLINICAL MANIFESTATIONS AND DIAGNOSIS wt Ane Marte Gomez J. MD Mac. PRD (o) ropica Medicine Index Introduction Venom properties Clinical Terminology ey Manifestations Epidemiology Diagnosis Geographic distribution INTRODUCTION * Snakebites account for significant morbidity and mortality worldwide, — snake vite: especially in South and Southeast 5.4 million Asia, sub-Saharan Africa, and Latin poopie are estimated io be iten eriees By snakes ovary yoar Venomous snakes are widely 100,000 people die each year as distributed around the world and °°" clinical effects from envenomation tat eerie can overlap to a great degree EVEN ——curce: vos ean oranzaten among different classes of snakes. Ind the world TERMINOLOGY * Out of more than 3000 species of snakes in the world, some 600 are venomous and over 200 are considered to be medically important, * A database and image library has been created by WHO to enable users to easily identify the most important venomous snakes in their country, territory or area; see the distributions of each species; and find information about antivenom products for treating envenoming caused by their bites. * The database is accessible from the Database search option in the left hand site navigation menu. In assessing the relative risk of each species, wo major categories heeps://apps.who.int/bloodproducts/snakeantivenoms/database/ CATEGORY 1: Highest medical importance CATEGORY 2: Secondary medical importance Definition: Highly venomous snakes that are common or | Definition: Highly venomous snakes capable of causing widespread and cause numerous snakebites, resulting in | morbidity, disability or death, for which exact epidemiological high levels of morbidity, disability or mortality. ‘or clinical data may be lacking; and/or are less frequently implicated (due to their activity cycles, behavior, habitat references or occurrence in areas remote to large human populations). ‘Some medically important venomous snakes found in Central and South America* Consult a regional poison control center (www: who int/ipcs/porsons/centre/ or Ginioan wah expertise in treating bes caused by Central or South American sakes for medial therapy including indications for ging antwenom, specie entwenom to use, and dosing, ‘Common name Scientific name Additional effects Antivenom ‘Snakes causing paralysis EPIDEMIOLOGY Oo * The Global Burden of Disease regions are defined according to regions that are epidemiologically homogeneous sothat estimates in one country within a region can be reasonably used by other countries e within that region. x ¢ However, this method may produce some inaccuracies in regions, (eg. the Carribean) where land masses arediscreet (eg, islands) or are separated by geographical barriers such as mountain ranges or large bodies of water. Cee] ‘ ke envenomations by world regions (G80 regions er GEO region per veer | asa racine, high income 12 Latin America, Central aa vases ee iaeeer scenes ‘ome a B00 Ss be ceeenia te Peocaet a heirs te GEOGRAPHIC DISTRIBUTION O Approximately 600 distinct species of venomous snakes have been described. Venomous snakes are widely distributed on every continent except Antarctica. Increased numbers of species are located in warm, tropical regions. A comprehensive listing of venomous sakes by geographical region: and estimated geographical distribution for individual species may be obtained by searching the following databases: . © World Health Organization: WHO snake venoms database. © Clinical toxinology resources, The University of Adelaide, Auscralia Toxinology snakes search. GEOGRAPHIC DISTRIBUTION Oo Most venomous snakes routinely dangerous for humans belong to one of two families, Elapidae and Viperidae. However, the “classic” literature suggesting that elapids cause neurotoxic effects and vipers cause local and hemorrhagic effects is misleading and inaccurate. ‘A number of Elapid snakes cause predominantly local effects, rather than systemic effects (typically the "spitting" cobras), while others cause predominantly coagulopathic rather than neurotoxic systemic effects (eg, Australian brown snakes). Similarly, some Viperid snakes cause minimal local effects and predominantly systemic effects, including paralysis, coagulopathy, and/or thabdomyolysis (eg South American rattlesnakes). Te DISTRIBUTION (CHARACTERISTICS FIGURE Elapida lapid snakes are found widely shorter fangs (compared to ‘emmen Ina aba ej a throughout tropical and subtropical body size), regions of Asia, Africa, Central and a less triangular head with a South America, the Middle East, and subtle: transition from het Australia. Common names include body (but with exceptions, Cobras, kat, mamas, coral snakes, such as Australian death Talpans, tiger snakes, copperheads adders), (Australian), death adders (Australia. and a larger scale pattern on ‘and New Guinea), black snakes the head. (Australi), and brown snakes (Australia). Sea snakes are also Elapic snakes. Viperidae Viperid snakes have a broad Folding, long fangs, triangular | Sass rer ona coe stnbution that encompasses many heads with an abrupt ragions that contain elapid snakes: {transition tothe body, and but also includes Europe and North smaller scales on the head. ‘America. Pit vipors (Crotalinae) also havo hoat-sensing pits ‘towards the front ofthe head (for infra-red “vison”) and eliptical pupils for nocturnal species) TE DISTRIBUTION ‘CHARACTERISTICS FigURE ‘Other snake | These are generally grouped under the “The fang position in these familes with | heading "non-ront-fanged colubrid" snakes is variable but generally dangerously | (NFFC) snakos. classified as “rear fangod," a venomous. ‘Some species in

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