- Email: [email protected]
Clinical aspects of snakebite in southern Africa
To,ffcon. VoL 23. No. 4, pp. 621-629. 1985, Primed in Great Britain.
0041-0101/85 $3.00+ .00 Pergamon Press Ltd.
ABSTRACTS CONCERNING SNAKEBITES PRESENTED AT THE XITH INTERNATIONAL CONGRESS FOR TROPICAL MEDICINE A N D MALARIA, 1 6 - 2 2 SEPTEMBER 1984, CALGARY, C A N A D A INCLUDED in this triennial Congress were one symposium and f i v e workshops on cfinical aspects of snakebites. Twenty-seven papers were presented from 15 countries. Topics included the objective assessment of intracompartmentai pressure in snakebitten limbs, a critical re.assessment of ELISA for detection of venom antigens and antibodies, application of monoclonal antibodies to investigation of clinical aspects of snakebite and the use of venoms incorporated into stabilised liposomes for immunisation and the improvement of antivenoms. Such strong representation of snakebite in a general congress on tropical medicine re-establishes the speciality as an important and reputable part of clinical tropical medicine, in accord with the ambitions of such distinguished proponents as the late H. Alistair Reid. The XIIth Congress will be held in Amsterdam in September 1987 and will contain sessions on snakebite. DAVID A . WARRELL
BLAYLOCKR. S. (Somerset Hospital, Green Point, South Africa 8001) Clinical aspects of snakebite in southern Africa. Two RECENT series of snakebites from peripheral hospitals are compared (Bt~YLOCK, 1982; COETZER and TILBURY 1982). Clinical envenomation occurred in 79.1% and 93.3% of cases, respectively. This accords well with 81% and 95.5% of snakes that were positively identified as being poisonous. Almost all bites by poisonous snakes lead to clinical envenomation. Allergy to snake venom was not reported. Psychological reactions were rare. The time of onset of clinical envenomadon occurs within 1 hr in all cases and within minutes in most. This has an important clinical application. Further elucidation of the natural history of snakebite will lead to its more logical manasement. EAPEN, C. K., CrIAt~V, N. and JOSEPH, J. K. (L. F. Hospital, Angamally, Kerala, India) A study of 1000 cases of snake envenomation. ONE THOUSANDCI[UR~of snake envenomation seen at Little Flower Hospital, An~amally, Kerala, S. India, during 1976-1983 have been studied. Occurrence of snakebite has been ~rmlysed according to age and sex of victims and the period of year in which it occurs. The clinical presentation, laboratory data, method of man~ement, progress with treatment and end result have been presented. Kidney failure and its management with fresh blood exchange transfusions and haemodlalysis is discussed. Death and their probable causes are discussed. Unusual compfications of snakebites seen immediately and later, such a panhypopituitarism, focal epilepsy, probable diabetes insipidus, exfoliative dermatitis and eczematons dermatitis, have been dealt with.
GAIt.FIN, S. R. (Division of Orthopaedics & Rehabilitation, University of California Medical Centre, San Diego, CA 92103, U.S.A.) The role of tissue pressure measurements in the treatment of rattlesnake bites. TIlE TRP.ATMP.NTof rattlesnake bites varies and is controversial. Many physicians advocate the primary use of intravenous antivenin and feel that surgery is seldom, if ever, necessary. Others recommend early and extensive 621
0041-0101/85 $3.00+ .00 Pergamon Press Ltd.
ABSTRACTS CONCERNING SNAKEBITES PRESENTED AT THE XITH INTERNATIONAL CONGRESS FOR TROPICAL MEDICINE A N D MALARIA, 1 6 - 2 2 SEPTEMBER 1984, CALGARY, C A N A D A INCLUDED in this triennial Congress were one symposium and f i v e workshops on cfinical aspects of snakebites. Twenty-seven papers were presented from 15 countries. Topics included the objective assessment of intracompartmentai pressure in snakebitten limbs, a critical re.assessment of ELISA for detection of venom antigens and antibodies, application of monoclonal antibodies to investigation of clinical aspects of snakebite and the use of venoms incorporated into stabilised liposomes for immunisation and the improvement of antivenoms. Such strong representation of snakebite in a general congress on tropical medicine re-establishes the speciality as an important and reputable part of clinical tropical medicine, in accord with the ambitions of such distinguished proponents as the late H. Alistair Reid. The XIIth Congress will be held in Amsterdam in September 1987 and will contain sessions on snakebite. DAVID A . WARRELL
BLAYLOCKR. S. (Somerset Hospital, Green Point, South Africa 8001) Clinical aspects of snakebite in southern Africa. Two RECENT series of snakebites from peripheral hospitals are compared (Bt~YLOCK, 1982; COETZER and TILBURY 1982). Clinical envenomation occurred in 79.1% and 93.3% of cases, respectively. This accords well with 81% and 95.5% of snakes that were positively identified as being poisonous. Almost all bites by poisonous snakes lead to clinical envenomation. Allergy to snake venom was not reported. Psychological reactions were rare. The time of onset of clinical envenomadon occurs within 1 hr in all cases and within minutes in most. This has an important clinical application. Further elucidation of the natural history of snakebite will lead to its more logical manasement. EAPEN, C. K., CrIAt~V, N. and JOSEPH, J. K. (L. F. Hospital, Angamally, Kerala, India) A study of 1000 cases of snake envenomation. ONE THOUSANDCI[UR~of snake envenomation seen at Little Flower Hospital, An~amally, Kerala, S. India, during 1976-1983 have been studied. Occurrence of snakebite has been ~rmlysed according to age and sex of victims and the period of year in which it occurs. The clinical presentation, laboratory data, method of man~ement, progress with treatment and end result have been presented. Kidney failure and its management with fresh blood exchange transfusions and haemodlalysis is discussed. Death and their probable causes are discussed. Unusual compfications of snakebites seen immediately and later, such a panhypopituitarism, focal epilepsy, probable diabetes insipidus, exfoliative dermatitis and eczematons dermatitis, have been dealt with.
GAIt.FIN, S. R. (Division of Orthopaedics & Rehabilitation, University of California Medical Centre, San Diego, CA 92103, U.S.A.) The role of tissue pressure measurements in the treatment of rattlesnake bites. TIlE TRP.ATMP.NTof rattlesnake bites varies and is controversial. Many physicians advocate the primary use of intravenous antivenin and feel that surgery is seldom, if ever, necessary. Others recommend early and extensive 621