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Epidemic Poisoning with Snakes in Eastern Sri Lanka; Epidemiological and Clinical Features in Batticaloa District

Selladurai Pirasath, Ariaranee Gnanathasan and Sundaresan Thadchanamoorthy

Introduction: Snake bite is an important health problem causing mortality and morbidity in farming areas of Sri Lanka. Objective: The aim of the study was to determine the epidemiological and clinical features of snake bites in Batticaloa district. Method: Data were collected from all cases with snake bites in Batticaloa district during the period of one year by using interviewed based questionnaires prospectively and were analysed by using SPSS (version 18) analytical package. Result: There were 104 patients [Mean age: 30-32 (±0.43) years], (Male: Female=81:23) with snake bites. Common krait (42, 40.1%), Cobra (18, 17.3%) and Russell’s viper (25, 24%) and Saw scald viper (5, 4.8%) were identified snakes.19 cases were unidentified. Krait bites were observed anywhere from head to toes of victims sleeping on the floor (30, 71.5%) mainly at night related to rainy seasons; high incidence (68.5%) reported in November and December. Cobra bites were below elbow and knee of victims (12, 77.8%) near water reservoirs and inside dwellings. Russell’s viper bites occurred below elbow and knee of victims (20, 80%) working in paddy fields (19, 76%). Fingers, hand, ankle and foot were main sites of Saw scald viper bite. Neurotoxicity (35, 83.3%) was the cardinal feature of krait bite. Local effects and coagulopathy were not observed. Local swelling/tissue necrosis (12, 66.7%) and neurotoxicity (15, 83.3%) were main clinical manifestation of cobra bite. Localized swelling (12, 48%), neurotoxicity (18, 72%) and coagulopathy (22, 88%) were main clinical features of Russell’s viper. Mortality rate was 3.8%. Severe systemic envenomation was significantly associated with mortality and morbidity of victims (P<0.05). Conclusion: Common krait, Cobra and Russell’s viper were identified snake bites in Batticaloa. Neurotoxicity, Localized swelling and Neurotoxicity and Coagulopathy and Neurotoxicity were clinical manifestations of krait, cobra and Russell’s viper bites respectively.