Snakebites in Tamil Nadu, India
Snakebite is prevalent all over India including the state of Tamil Nadu. It is observed in all ages and more among men and women involved in agricultural and plantation works. Often encountered snakebites in Tamil Nadu are in the order of viper group, krait, and cobra. Sea snake bites are extremely rare.
The challenges faced by the state toward the management of snakebite were related to community, policy, transport, governance, and therapy. The government has overcome these challenges through the Tamil Nadu Health Systems Project. The health-care professionals and providers were trained to provide appropriate treatment and care. The success was evidenced by early health-seeking behavior; provision of free transport facilities and specific treatment at primary, secondary, and tertiary health institutions as per guidelines; reduced bite-to-needle time, referral rate, morbidity, and mortality; and increased consumption of anti-snake venom. During the period April 2011 to March 2013, the overall referral rate and death rate were 3–5 and 0.6 % respectively in non-teaching hospitals/health centers, and consumption of anti-snake venom of the state during that period was 435,815 vials (10 ml). The services and supply of materials toward treatment are monitored at district and state level, and difficulties or deficiencies encountered were rectified.
The symptoms, signs, complications, diagnostic aspects, treatment, snakebite in special situations including pregnancy, prevention, community aspects, and futurology are discussed. The political commitment, effective bureaucracies, and good governance at health department have saved the lives of many snakebite victims.
KeywordsVenomous Snake Snake Bite Snake Envenom Tamil Literature Antivenom Therapy
- Al-Hashaykeh N, Al Jundi A, Abuhasna S. Delayed administration of antivenin three days after snake bite saves a life. Anaesth Pain Intens Care. 2011;15(3):167–9. [Cited 2014 April 06]. Available at http://www.apicareonline.com/?p=901. Accessed 02 May 2013.
- Ariaratnam CA, Sheriff MH, Arambepola C, Theakston RD, Warrell DA. Syndromic approach to treatment of snake bite in Sri Lanka based on results of a prospective national hospital-based survey of patients envenomed by identified snakes. Am J Trop Med Hyg. 2009;81(4):725–31.PubMedCrossRefGoogle Scholar
- Chugh KS. Snake-bite-induced acute renal failure in India. Kidney Int. 1989;35:891–907.Google Scholar
- De Silva HA, Pathmeswaran A, Ranasinha CD, Jayamanne S, Samarakoon SB, et al. Low-dose adrenaline, promethazine, and hydrocortisone in the prevention of acute adverse reactions to antivenom following snakebite: a randomised, double-blind, placebo-controlled trial. PLoS Med. 2011;8(5):e1000435.PubMedCentralPubMedCrossRefGoogle Scholar
- DG AFMS medical memorandum No.102 “Snake bite”. [Cited 2013 June 09]. Available http://indianarmy.nic.in/writereaddata/Documents/snake%20bite22.pdf
- Golay V, Roychowdhary A, Dasgupta S, Pandey R. Hypopituitarism in patients with vasculotoxic snake bite envenomation related acute kidney injury: a prospective study on the prevalence and outcomes of this complication. Pituitary. 2013; doi 10.1007/s11102-013-0477-1Google Scholar
- Halesha BR, Harshavardhan L, Lokesh AJ, Channaveerappa PK, Venkatesh KB. A study on the clinico-epidemiological profile and the outcome of snake bite victims in a tertiary care centre in Southern India. J Clin Diagn Res. 2013;7(1):122–6.Google Scholar
- Indian National Snake Bite Protocol 2007. First aid and snake bite prevention. Snake bite treatment support concepts. New Delhi: Health and Family Welfare Department, Government of India. [Cited 2013 May 03]. Available at http://jknrhm.com/Download/Snakebite%20Treatment%20Protocol%202007.doc
- Interventions for snake bites: an overview of current research evidences from South Asia, South Asian Cochrane Network and Centre. Vellore, India: Toxicology special interest group, Department of Medicine, Christian medical college. 2012. [Cited 2013 May 03]. Available at http://www.cochrane-sacn.org/toxicology/files/Summary%20of%20evidence-%20Snake%20envenomation.pdf
- Jacob J. Viper bite with continuous deprivation despite adequate treatment with anti venom. J Assoc Phys India. 2006;54:733–4.Google Scholar
- Jeganathan N. Siddha medicine for poisons, Chapter 31. In: Subramanian SV, Madhavan VR, editors. Heritage of Tamils: Siddha medicine. Taramani: International Institute of Tamil studies, T.T.T.I; 1983. p. 504–22.Google Scholar
- Mahadevan S, Jacobsen I. National snake bite management protocol –2008. Indian J Emer Pediatr. 2009;2:63–84.Google Scholar
- Medical management of severe anaphylactoid and anaphylactic reactions. Aust Prescriber. 2001; 24(5):112. [Cited 2014, April 06]. Available at http://www.australianprescriber.com/magazine/24/5/article/546.pdf.
- Menon V, Tandon R, Sharma T, Gupta A. Optic neuritis following snake bite. Ind J Ophthalmol. 1997;45(4):236–7.Google Scholar
- Mohapatra B, Warrell DA, Suraveera W, Bhatia B, Dhungra N, Jokkar RM, Rodriguez PS, Mishra K, Whitaker R, Jah P, for the million death study collaborators. Snake bite mortality in India. A national representative mortality survey. Plos Negl Trop Dis. 2011;5(4):e1018.PubMedCentralPubMedCrossRefGoogle Scholar
- Mukherjee AK. General medicine as a harmonizing tool to antivenin therapy for the clinical management of snake bite; the road ahead. Ind J Med Res. 2013;136:10–2.Google Scholar
- Punde DP. Management of snake bite in rural Maharashtra; a 10 year experience. National Med J India. 2005;18(2):71–5.Google Scholar
- Simpsom ID. The pediatric management of snakebite: the National protocol. Indian Pediatr. 2007;44(3):173–6.Google Scholar
- Snakebite management in Asia and Africa a guide to snakebite. [Cited 2013 May 03]. Available at http://www.pmrc.org.pk/index_2.htm
- TNHSP (Tamilnadu Health systems project), Handbook on treatment guidelines for snake bite and scorpion sting. 1st ed. Chennai, India: Health and Family welfare Department, Govt of Tamilnadu; 2008. p. 1–118.Google Scholar
- Training module for staff nurse and auxiliary nurse midwife. (Management of snake bite) Basic emergency services for poisoning, State Health Mission, Health and Family Welfare, Government of Tamil Nadu, Chennai; 2007. p. 33–42.Google Scholar
- Vijayaraghavan B, editor. Snakebite: a book for India. 1st ed. Chennai: A Publication of Chennai Snake Park Trust; 2008. p. 1–96.Google Scholar
- Vijayaraghavan B, editor. 400 questions answered about snakes with special reference to snake in India. 1st ed. Chennai: A Publication of Chennai Snake Park Trust; 2010. p. 1–231.Google Scholar
- Warrell DA. Guidelines for the management of snake bite. New Delhi, India: World Health Organisation, Regional Office for South – East Asia; 2010b. p. 1–153. [Cited 2013 May 01]. Available at http://www.toxinology.org/resources/protocols/WHO-SEARO%20Snakebite%20Guidelines%202010%20copy.pdf
- Whitaker R, Whitaker S. Venom, antivenom production and medically important snakes of India. Curr Sci. 2012;103(6):635–43.Google Scholar
- World Health Organization. Guidelines for the production, regulation and control of snake antivenom immunoglobulins. Geneva: WHO; 2010. 141 pp.Google Scholar