Neurotoxic Snakebite In Jammu Region: Is It Cobra Or Krait

ABSTRACT

Background: The aim of this study is to analyze the clinical profile and outcome of the neurotoxic envenomation in children inJammu region and to identify the species based on the syndromic approach developed by WHO.Materials and Methods: A retrospective hospital record based descriptive study which analyses the case records of childrenreporting to pediatric emergency with signs and symptoms of neurotoxic envenomation.Results: A total of 22 cases of the neurotoxic envenomation reported between April 15 and October 15. These included 14males and 8 females between the age group of 2.5 years and 16 years. The highest incidence of snakebite was observed inthe age group of 4–8 years. A total of seven cases presented neuroparalytic symptoms and local signs suggesting cobra bite.Bite was reported in the afternoon or evening hours between 12.30 pm and 10.30 pm and 83% bites were outdoors. A total of15 children presented with neuroparalytic symptoms with no local signs suggesting krait bite. 86% of the bites were indoor withonset of symptoms between 12 am and 7 am.Conclusion: Both cobra and krait cause neurotoxic envenomation in children in Jammu region with krait bite accounting for 68%of the total cases. Most of these cases are brought to the pediatric emergency late. Training of the peripheral doctors regardingearly recognition of neurotoxic snakebite, species diagnosis as per the WHO syndromic approach, prompt institution of initialmanagement with neostigmine and after visit summary, endotracheal intubations and AMBU bag ventilation, and quick referralto a center with ventilator facility should help in reducing the morbidity and mortality due to krait and cobra bite in children.