Snakebite

Dr KABERA Ren
Medical Officer
UNSOS-Beledweyne
Somalia
Plan

Introduction
Clinical presentation
Treatment
Complications

Snakebite/Dr Kabera R
Introduction

Definition

Snakebite is an injury caused by the bite of a snake, especially a venomous

snake.

A common symptom of a bite from a venomous snake is the presence of

two puncture wounds from the animal's fangs.

WHO - neglected public health problem

Most snakebites are innocuous and are delivered by nonpoisonous species

Snakebite/Dr Kabera R
Introduction
Background

Snake : Snakes are elongated, limbless, carnivorous reptiles of the suborder

Serpentes.

Lifespan 9 years. Ectodermic .Length : 10 cm to 9.5 m

Some snakes have a venomous bite and considered dangerous but snakes
attack only when feel threatened

Snakes are misunderstood ,feared but also snakes inspire awe ,reverence
and sometimes worship in some areas

Snakebite/Dr Kabera R
Snakebite/Dr Kabera R
 Introduction
Epidemiology

More than 3000 species.

Only 50% of Venomous snakes will inject the venom during the bite

Snakes commonly involved in poisonings include elapids (such as kraits, cobras and mambas), vipers,

and sea snakes

The majority of Snakes attack by squeezing but are not venomous

World wide :1.8-2.5 million venomous snakebites occur each year and 100,000 to 125,000 annual deaths

MSF South Sudan and CAR 30000 deaths and 8000 amputations per year

Kenya : Vipers, mambas and cobras ,15/100000 snakebites with mortality of 0.5%

Somalia : Cobras, Vipers and Mambas (see the maps)

UN Camp Beledweyne no case of snakebite registered (Level 1 and Level 2 Hospitals )

Snakebite/Dr Kabera R
 Introduction
Elapids
Kraits Mambas Cobras

Snakebite/Dr Kabera R
 Introduction

Vipers most common in sub-Saharan desert (geographic zone of Somalia)

Snakebite/Dr Kabera R
Introduction
Epidemiology

Snakebite/Dr Kabera R
Snakebite/Dr Kabera R
Snakebite/Dr Kabera R
Clinical Presentation

- Snakebite mark
- Presence of two puncture wounds from the animal's fangs

- If there is no venom the wound will just stay the same and heal quickly
Snakebite/Dr Kabera R
 Clinical presentation

Snakebite with Venom

2 puncture wounds with pain

Venomous snakebite has 2 major clinical pictures

Called also Viperidae and Cobraic

Hemorrhagic Syndrome is caused mostly by Vipers

Neuro-cytotoxic Syndrome is caused mostly by Mambas and Cobras

-The mixed clinical feature (hemorrhagic and neurocytotoxic) in some Vipers-

Snakebite/Dr Kabera R
Clinical presentation

Hemorrhagic Syndrome is caused mostly by Vipers :

Bleeding ,bruising, ecchymosis, epistaxis, and hemoptysis

Snakebite/Dr Kabera R
 Clinical presentation

Neurocytotoxic Syndrome Cobraic Syndrome ( Common in Mambas and Cobras)

Swelling, Necrosis, paralysis, paresthesis

Snakebite/Dr Kabera R
Clinical presentation

Spitting cobras

-Skin : mostly harmless

-Eyes : Conjunctivitis to
Blindness

Snakebite/Dr Kabera R
 Treatment

Prevention
Avoid the contact
Rise the bed level, mosquito-net
Avoid livestock (chicken) in house
Dont put hands in holes
Clear the rubbish, keep the grass cut
Listen to wild animals they warn about snakes (Birds, cat)
Strong and closed shoes during the night
Beledweyne UN Camp: Snakes repellent granules

Snakebite/Dr Kabera R
 Treatment

Prehospital Care
Avoid making an incision over the bite, mouth suctioning, tourniquet
use, ice packs, or electric shock.
Snake-stone, viper's stone, black stone, pierre noire ???!!!
Emphasize the basic life support - ABCD
Restrict activity and immobilize the affected area
Do not give antivenin in the field.
Transfer to a Clinic

Snakebite/Dr Kabera R
 Treatment

Hospital care
Snakebite Severity Scale (table)
Severity of Envenomation:
Wound care
Immobilization
Treatment of shock
Antivenin / Beledweyne : ENDF Level 2 hospital -
Surgery debridement, amputation

Snakebite/Dr Kabera R
Complications

Death
Amputation
Blindness
Chronic ulceration
Renal failure
Limb deformities
Osteomyelitis .

Snakebite/Dr Kabera R
Complications

Snakebite/Dr Kabera R
 Reference

Guidelines for Prevention and the Clinical management of Snakebite in Africa.

WHO 2010
Snakebite . Medscape 2017
CDC - Venomous Snakes - NIOSH Workplace Safety and Health Topic
Beledweyne Medical Reports 2017

Snakebite/Dr Kabera R
Thank you

Snakebite/Dr Kabera R