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Snake Bite-The Big Four

Oct 20, 2016

Worldwide, only about 15 % of the more than 2000 species of snakes are considered dangerous to humans, of which 290 are present in India ranging from the 10 cm long worm snake to the 7 meter long python and King Cobra. The best part is that only 52 are venomous and restricted to specific geographical regions. Hence, the chances of a snake bite are highly specific to a few snakes adapted to a particular habitat. This makes identification based on fang markings more reliable.The composition of venom of a single snake species varies from place to place, season to season and between adults and their young. Individual snake venom may even change with its diet.

In this brief article we have highlighted, importantinformation regarding snake bites in India caused by the big four, namely Spectacled Cobra, Common Krait, Russell’s viper and Saw-Scaled Viper. Before reading any further it is desirable to understand the difference between Poison and venom. Poison must be inhaled, ingested, or delivered via touch, while venom is injected into a wound. Hence in our opinion, the term poisonous snake is incorrect. (We also stand to be corrected).

The annual number of cases of snake bite worldwide is about 5 million resulting in 15-200,000 deaths per year. India is estimated to have the highest snake bite mortality in the world.The World Health Organization (WHO) estimates, place the number of bites in India to be 83,000 per annum with approximately, 11,000 deaths.

















Proper first aid is of paramount importance in the life of a snake bite victim, especially in the first hour, also known as the “golden hour”. The facts state that 80 % of the snake bites are by non-venomous snakes. On the other hand,it is very important to understand that 50 % of bites by venomous snakes are dry bites that result in no harm. This is because snakes have complete control over how much venom they inject anytime they bite. So one could get a “DRY BITE”, with no venom at all.

With respect to bites from venomous snakes, 70-80 % of the bites are attributed to Russell’s viper and saw - scaled Viper, which involve hemotoxin/ vasculotoxin. The spectacled Cobra and Common Krait together constitute 30 % of the bite and are neurotoxic in nature.

Statistics show that the snake bite between males and females is in the ratio of 2:1.Majority of the bites being on the lower extremities.It is also important to note that snakes inject the same doze of venom into children and adults. Children must therefore be given exactly the same doze of antivenom as adults.

In India the big four, namely the spectacled Cobra, Common Krait, Russell’s viper and Saw Scaled viper, together, are known to cause more than 90 % of the snake bite deaths. The venom of Krait and Russell’s viper is much more toxic than that of cobra.

Basically snake venom is classified into four types.

Neurotoxic. e.g. Cobra. The venom paralyses the respiratory centre.
Hemotoxic. e.g. Russell's viper. The venom typically affects the blood, resulting in necrosis (death of tissue) and anticoagulant (preventing the blood from clotting).
Myotoxic. e.g. Sea snakes. The venom results in muscle breakdown.
Cardio toxic e.g. S.Cobra. Affects the heart.


(Slide from https://commons.wikimedia.org/)


DIAGNOSIS OF SNAKE BITE


FANG MARKS: Classically, two puncture wounds separated by a distance varying from 8mm to 4cm, depending on the species involved. However a side swipe may produce only a single puncture, while multiple bites could result in numerous fang marks. The Effects of envenomation can be categorized into four distinct types namely,Neurotoxic (Krait &Cobra), Hemotoxic(Russell’s viper)Cardio toxic(Spectacled Cobra &others) andMyotoxic (Sea Snakes).Maximum, with Viper bite, least with Krait bite. Hence krait bite can sometimes go unnoticed.


ANTI-SNAKE VENOM (ASV)

ASV is the main stay of treatment. Antivenom is immunoglobulin purified from the plasma of a horse. Mule, donkey, or sheep that has been immunized with the venoms of one or more species of snake. In India, polyvalent ASV is effective against all the big four.
The following slides have been selected from the power point presentation by Josel Louies.








The website Indiansnakes.org is an ideal reference to learn all about Indian snakes and their conservation. The link below provides a power point presentation by Josel Louies who has provided Snake Bite- Facts, First Aid and prevention.

http://www.slideshare.net/JoseLouies/snake-bite-firstaid-facts-prevention


A NOTE TO READERS:

The Catholic Association of South Kanara (CASK) is a hundred year old organization, based at Mangalore. CASK has initiated a footwear project in rural schools at a place called Badiyar (50 kms from Mangalore).Badiyar records a significant number of snake bites, both venomous and nonvenomous, especially in school children as they walk to school barefoot through the forests. People, interested in knowing more about the project can kindly email at caskmangalore@yahoo.com

 

Acknowledgement

The snake photographs has been kindly provided byJoy Mascarenhas, Ujre. Joy is a herpetologist, a person with interest and expert knowledge on the natural history of reptiles.Joy S Mascarenhas can be contacted at +91 9743432626, Snakejoy1@gmail.com. Joy recently rescued and released the 150th King Cobra.

 

Dr Anand & Geeta Pereira - Archives

Dr Anand & Geeta Pereira

Comment on this article

  • callen dsouza, bendur

    Thu, Nov 3 2016

    thank you DR wonderful article

    Agree

  • Imran, Oman

    Sun, Oct 30 2016

    Thank you Anand for your very informative article the ion of pictures are also very nice.
    Keep writing such type of articles.

    Agree

  • Leona Pais, Brisbane

    Thu, Oct 27 2016

    Dear Dr Anand & Geeta. I just wanted to say thanks for the nice write-up & lovely pictures,The information about 2000 species of snakes that are considered dangerous to humans. I really appreciate the extra mile that you both take each time & every time,more over you both WALK THE TALK. Sincerely appreciate both of you & your contribution to our Environment. Leona Pais (Brisbane)

    Agree

  • Liza Pais, Brisbane

    Wed, Oct 26 2016

    Dear Uncle Anand & Aunty Geeta.

    There is so much of depth in this article & lot of knowledge shared to protect our environment.

    Excellent work must always be recognized and differentiated as such. High performers are intrinsically motivated by doing excellent work and producing something that impresses others. When that credit is not given, over time they will redirect their effort and contributions towards work that does meet that need for high achievement.

    But i always see you both have never given up contributing to the community.

    Love your work-Liza Pais (Brisbane)

    Agree [4]

  • Louis, Udupi

    Wed, Oct 26 2016

    Need more information on why not every village is not provided with snake treatment medicines .Is this is costly , as it is called first hour is golden hour during snake bite then mostly snake bites are in viilages and these villagers has to go to their main city.

    Agree [2]

  • Leander Pais, Briabane

    Tue, Oct 25 2016

    Dear Dr Anand & Geeta.

    I can imagine the time & efforts you have drained into capturing & compiling these informative eclectic images,Good on you.

    Leander Pais-Brisbane.

    Agree [1]

  • Joe Britto, Nakre/Bangalore

    Sun, Oct 23 2016

    Thanks so much for this great article on snakes .A very tricky subject .
    Most useful informative article, practical and could save many a life. Just as snakes shed their skin, we welcome you Dr Geetha & Dr Anand in your new Avatar and look ahead to your articles in the days ahead.

    Agree [4]

  • k b r, Mangluru

    Sun, Oct 23 2016

    this couple is outstanding....
    great work...may you be blessed...

    Agree [2]

  • Ophelia Lazarus, Pune/ Muscat

    Sat, Oct 22 2016

    Dear Dr.Anand & Geeta Pereira
    Thank you for this educative and informative article on snake bites. Alot of knowledge gained and mis conceptions dispelled.
    The illustrative pictures are excellent and well explained.
    Awesome pics by Joy.
    Appreciate the time, effort and study gone into this article to let the common man know more about the environment.

    Agree [2]

  • mustafa, mangalore

    Sat, Oct 22 2016

    nice article... keep writing..God bless you

    Agree [3]

  • Balkrishna, Belman

    Sat, Oct 22 2016

    Thank you Dr. Anand & Geeta and Joy for the nice pics. As always very informative. Keep writing more.

    Agree [2]

  • anita britto, Mangalore/Auckland

    Sat, Oct 22 2016

    Dear Dr. Anand & Geeta, Thank you for the interesting informative article which helps dispel so many pre-conceived notions and the inherent fear that many of us have when it comes to snakes. The pictures are amazing and the effort you make to simplify your knowledge and impart it in such a systematic manner is phenomenal. I hope this can be circulated to as many younger students as possible so that they learn so many fascinating as well as useful facts early on as opposed to people from my generation who panic at the very mention of the word “ snake”.

    Very nicely presented about the Dos and Don’ts in case of a snake bite which would help people react calmly instead of letting fear and paranoia take over and thereby suffer a greater reaction because of the consequences of the system going into a shock mode.

    No snakes in New Zealand however I remember encountering several snakes while growing up in Vikhroli and being very excited about finding an intact snake skin that was shed.

    Congratulations on this wonderful article – beautiful picture of a lovely couple who share a common love in protecting the environment and have such a passion for Nature.

    Agree [4]

  • sudhir, Mangalore Muscat

    Sat, Oct 22 2016

    Wonderful article Dr.Anand/Geeta Pereira, a lot of my questions got answered.lovely photos too. Pls keep writing more such articles which will help us all to understand these wonderful reptiles more.

    Agree [3]

  • Allen Pais, Brisbane

    Fri, Oct 21 2016

    Dear Dr Anand & Geeta. The pictures are excellent & the information shared has great value,Good on you both for the time & efforts to make this Country a peaceful place to stay with "Environment" the main factor for survival. Kind Regards-Allen Pais

    Agree [6]

  • Ivan frank & Fly, Mangalore

    Fri, Oct 21 2016

    Snake bite-the big four is very informative with good photographs and lucid illustrations. Definitely a considerable amount of time and effort has been spent in bringing out this educative article.Thank you Anand and Geeta

    Agree [7]

  • urv, Mangalore

    Thu, Oct 20 2016

    Thank You Sir! very happy to see this article on Big Four. indeed very informative.Such attempts by you and madam is a bolster to save lives, and the nature. Hats-off to snake joy for his services as a herpetologist. wonderful photography by joy sir. Kudos to the lovely couple for the great article.

    Agree [7]

  • Dr. Ethihas, mangalore

    Thu, Oct 20 2016

    Thank you Dr. Anand & Geeta for the wonderful article.
    very informative.

    Agree [13]

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