Clinical features and response to antivenom of Russell's viper bite cases of Myinmu, Sagaing Division

ABSTRACT

A total of 43 Russell's viper bite cases were studied during 1995-96. The median age of the victim is 27 years (7-71 yr) and the time interval between the bite and admission to the hospital is 1.50 hours (20 min-8.15 h). Sixty per cent of the bites occurred in lower limb and 86 per cent were bitten while at work in the field. Length of the dead snakes brought varied from 23 to 50 cm (median 29 cm). Eighty-six per cent applied tourniquets and 67 per cent carried out immobilisation. Fourteen per cent of the bites developed systemic, 72 per cent local and 14 per cent no features of envenoming. Out of 6 systemic cases, only one presented with a spectrum of spontaneous systemic bleeding. One to 4 ampoules of antivenom was given to all cases irrespective of the state of envenoming. Six antigen negative cases were also given antivenom. Antivenom reactions were present in 21 per cent of the cases. Venom levels of the cases with local and systemic manifestations were 10-45 ng/ml and 50-70 ng/ml respectively. there was no fatality in this study. Vomiting (32 per cent) was observed in non systemic cases as well.