A study of snakebite cases in a tertiary care hospital in South India, Telangana

Sashidhar Reddy Bommineni; K. Rajeshwar; P. Durga Reddy; T. Vindhya; P. Sai Bhargav Reddy; Vamsi Kiran Lakkam

doi:10.18203/2320-6012.ijrms20253949

Authors

Sashidhar Reddy Bommineni Department of Medicine, RVMIMS, Siddipet, Telangana, India
K. Rajeshwar Department of Medicine, RVMIMS, Siddipet, Telangana, India
P. Durga Reddy Department of Medicine, RVMIMS, Siddipet, Telangana, India
T. Vindhya Department of Medicine, RVMIMS, Siddipet, Telangana, India
P. Sai Bhargav Reddy Department of Medicine, RVMIMS, Siddipet, Telangana, India
Vamsi Kiran Lakkam Department of Anesthesia, RVMIMS, Siddipet, Telangana, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20253949

Keywords:

Poisonous snakes, Acute kidney injury, Cellulitis, Polyvalent anti snake venom, Respiratory paralysis

Abstract

Background: Snake bites pose a significant global health threat leading to substantial morbidity and mortality. According to WHO, approximately 11,000 deaths occur due to snake bite per annum in India. This study is done to know about common types of snakes in local areas, identify the clinical features, complications and mortality rates in snakebite victims attending RVM Charitable trust hospital.

Methods: A hospital-based cross sectional study done from 1st January 2024to 31st December 2024. Fifty patients enrolled during this period. Features during presentation and subsequent period were noted, anti-venom was given accordingly and outcome was recorded. Data was collected in a predesigned data sheet form and was analyzed accordingly.

Results: Among 50 snake bite patients, 70% were male and 56% cases were poisonous bites. The common victims were farmers (53%) and the bite was commonly encountered during rural foot walking (32%). Among 28 poisonous cases, 18 Poisonous cases developed neurological manifestations and 3 cases developed breathlessness which required mechanical ventilation support. Rest 10 Poisonous cases developed hematological manifestations and 6 cases developed Acute Kidney Injury of which 3 cases required hemodialysis support. Among the 28 venomous snake bite cases 25 (89%) recovered completely after getting polyvalent antivenom serum and 3 (11%) died after admission. Total 80% cases recovered with 10 vials of polyvalent antivenom serum. No reaction to anti-snake venom was noticed.

Conclusions: Snake bites cases are still a serious health problem for us. Treatment of poisonous snake bite with polyvalent antivenom serum is successful and safe. Awareness should be created among the rural people through mass media regarding the complications of snake bite and the need to visit a hospital as early as possible. Availability of snake venom kits should be made in rural health centres to identify the type of snake bite.

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References

World Health Organization. Snakebite envenoming. 2020. Available at: https://www.who.int/news-room/fact-sheets/detail/snakebite-envenoming. Accessed on 3 August 2025.

Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK, Pathmeswaran A, Premaratna R, et al. The global burden of snakebite: A literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med. 2008;5:218. DOI: https://doi.org/10.1371/journal.pmed.0050218

Abraham SV, Mathew D, Sreekumar A, George AV. Clinical challenges, controversies, and regional strategies in snakebite care in India. Lancet Regional Health-Southeast Asia. 2025;37:758. DOI: https://doi.org/10.1016/j.lansea.2025.100598

Mohapatra B, Warrell DA, Suraweera W, Bhatia P, Dhingra N, Jotkar RM, et al. Snakebite mortality in India: A nationally representative mortality survey. PLoS Negl Trop Dis. 2011;5:1018. DOI: https://doi.org/10.1371/journal.pntd.0001018

Suraweera W, Warrell D, Whitaker R, Menon G, Rodrigues R, Fu SH, et al. Trends in snakebite deaths in India from 2000 to 2019 in a nationally representative mortality study. eLife. 2020;9:5407. DOI: https://doi.org/10.7554/eLife.54076

Bawaskar HS, Bawaskar PH, Parag HB. Premonitory signs and symptoms of envenoming by common krait (Bungarus caeruleus) Trop Doct. 2014;44:82-5. DOI: https://doi.org/10.1177/0049475514521802

World Health Organization. Snake Bite Envenomation. Geneva: World Health Organization. 2019.

Warrell DA. Guidelines for the Management of Snake-Bites. Geneva: World Health Organization. 2010.

Avau B, Borra V, Vandekerckhove P, De Buck E. The treatment of snake bites in a first aid setting: A systematic review. PLoS Negl Trop Dis. 2016;10:5079. DOI: https://doi.org/10.1371/journal.pntd.0005079

Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's Principles of Internal Medicine (20th ed). New York: McGraw-Hill Education. 2018.

Standard Treatment Guidelines. Management of Snake Bite, Quick Reference Guide. India: Ministry of Health and Family Welfare, Government of India. 2016.

Bhagyalakshmi, Kumar S, Sunder A, Kumari S. Clinical and epidemiological profile of snakebite cases – A study from an industrial teaching hospital at Jamshedpur, Jharkhand, India. J Family Med Prim Care. 2023;11(12):7652–6. DOI: https://doi.org/10.4103/jfmpc.jfmpc_890_22

Shine Stephen, Chitta Ranjan Mohanty, Rakesh VR, Alwin I. Clinico-epidemiological profile, trends, and health-related outcomes of snakebite victims: a one-year prospective study from eastern India. Wilderness Environ Med. 2024;35(2):155-65. DOI: https://doi.org/10.1177/10806032241239628

Pusparaj S. A comprehensive epidemiological study of Snake bites in a tertiary care hospital in Bhubaneswar, India. Int J Forensic Med. 2020;2(1);31-5. DOI: https://doi.org/10.33545/27074447.2020.v2.i1a.72

Silva A, Maduwage K, Sedgwick M, Pilapitiya S, Weerawansa P, Dahanayaka NJ, et al. Neurotoxicity in Russells viper (Daboia russelii) envenoming in Sri Lanka: A clinical and neurophysiological study. Clin Toxicol. 2016;54(5):411–9. DOI: https://doi.org/10.3109/15563650.2016.1143556

Phillips RE, Theakston RDG, Warrell DA, Galigedara Y, Abeysekera DTDJ, Dissanayaka P, et al. Paralysis, rhabdomyolysis and haemolysis caused by bites of Russell’s viper (Vipera russelli pulchella) in Sri Lanka: Failure of Indian (Haffkine) antivenom. QJM. 1988;68(4):691–715.

Johnston CI, Ryan NM, O’Leary MA, Brown SGA, Isbister GK. Australian taipan (Oxyuranus spp.) envenoming: clinical effects and potential benefits of early antivenom therapy–Australian Snakebite Project (ASP-25). Clin Toxicol. 2017;55(2):115–22. DOI: https://doi.org/10.1080/15563650.2016.1250903

Kularatne SAM, Silva A, Weerakoon K, Maduwage K, Walathara C, Paranagama R, et al. Revisiting Russell’s Viper (Daboia russelii) bite in Sri Lanka: Is abdominal pain an early feature of systemic envenoming? PLoS One. 2014;9(2):1–8. DOI: https://doi.org/10.1371/journal.pone.0090198

Suhita R, Begum I, Rashid M, Chandran V, Shastri S, Kantamneni R, et al. Systematic review and meta-analysis of global prevalence of neurotoxic and hemotoxic snakebite envenomation. East Mediterr Health J. 2022;28(12):909–16. DOI: https://doi.org/10.26719/emhj.22.090

Sasidharan P, Kaeley N, Mahala P, Jose JR, Shankar T. Clinical and demographic profiling of snakebite envenomation in a tertiary care centre in northern India. Int J Emerg Med. 2025;18(1):50. DOI: https://doi.org/10.1186/s12245-024-00796-x