Management of Snakebite and Research Management of Snakebite ...

Management of Snakebite and Research
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Time of bite
Most bites occur at work in the field while ploughing and harvesting crops and on the
road, on the way home or to work. Seventy-five per cent of the bites occur during the day
(6 a.m-6 p.m) and 25% after dark (6 p.m-6 a.m). The number of bites occurring during
forenoon and afternoon of day and in late evening is approximately the same. Most farmers
start their work before dawn and work the whole day. That may explain the high incidence
of bites during the day because of the long hours of exposure to risk. The work involved is:
reaping grass, harvesting crops, paddy and minding livestock. Ninety-three per cent of late
evening bites occurred on the way home from work after dark, attending livestock in the
sheds in insufficient light, guarding harvested crops in the field and visiting friends. Seven
per cent of the bites occurred early in the morning among those who have to tend paddy
fields when tide comes in at night, for example, night watchman.
Site of bite
Eighty-eight percent of the bites occur in the lower limbs and 12% in the upper limbs.
Bites occur in those engaged in plugging corn, reaping grass, harvesting crops, sesame and
groundnut, chopping grass, and also in those engaged in activities like: ploughing, minding
and feeding livestock, night watchman, cutting trees for firewood.
Biting habit
Russell’s vipers in the paddy fields or in the bundled crops or hay are responsible for most
bites during the harvesting season. Bites also occur during ploughing when snakes are dug
up. Cobra bite is few compared to Russell’s viper bite and occurs among firewood fetchers.
Chinese krait bite usually occurs at night while persons are sleeping on the ground. Sea
snakebite occurs among fish sorters.
Venomous snake survey
Species of snakes
A total of 375 dead snakes brought by the snakebite victims from 28 hospitals (including
those sent by basic health staffs)of 7 divisions (Yangon, Bago, Mandalay, Magwe, Sagaing,
Ayerawaddy and Tanintharyi) and 2 states (Kachin and Shan) were studied. Ten were nonvenomous
and 365 were venomous. Of the venomous species, 322 were Russell’s viper
(Daboia russelii siamensis), 28 Cobra (Naja kaouthia), four B. multicinctus, one B.candidus,
one B. fasciatus, four Tr. erythrurus, two Tr. purpureomaculatus, two Tr. monticola and one
Tr. stegnegeri. Among the non- venomous were two Elaphidae radiata, two Ptyas mucosus,
one Chrysopelia ornata and five Homolopsis buccata.
Snakebite occurs in all geographical regions but Russell’s viper bite is endemic in rice
growing areas namely Mandalay, Sagaing, Yangon, Bago, Magwe and Ayerawaddy divisions.
Cobra bite occurs in Shan State, Mandalay, Bago, Magwe, Yangon and Rakhine divisions.
Although green pit vipers are found elsewhere, only 4 species were collected namely