Parallels between Russell's viper ( Daboia russelii) and hump–nosed viper ( Hypnale species) bites in the central hills of Sri Lanka amidst the heavy burden of unidentified snake bites

Abstract

Objective To describe the epidemiology of snake bite in the region and attempt to compare proven Russell's viper with hump-nosed viper bites. Methods All snake bite admissions to the Toxicology Unit of Teaching Hospital Peradeniya over three year from 2006 were included. Results Of the 776 snakebites, 665(86%) were unidentified and non-envenomed. Hump-nosed viper and Russell's viper accounted for 55(7%) and 40(5%) bites respectively, of them, incriminated snakes were found in 36(65%) and 19(48%) cases. The cobra bites-5, krait bites-0. The median ages: Russell's viper bites-41(range 16-66), hump-nosed viper bites-42(range 15-75). The gender incidence, time of bite (>58% daytime) were similar. In hump-nosed viper bite; upper limb involved in 13(36%), happened at home garden in 22(61%), none in paddy fields. In Russell's viper bite; 6(33%) occurred in paddy fields. Dry bites were similar at 5%. In hump-nosed viper bite: local effects 94%, coagulopathy 3%, acute renal failure 3% and one patient died. In Russell's viper bite; local effects 84%, coagulopathy 53%, neurotoxicity 21%. Abdominal pain occurred only in Russell's viper bites 10(53%). Conclusions Overwhelming numbers of unidentified, non-envenomed snakebites are common in the central hills. Some distinctive differences were observed between Russell's viper and hump-nosed viper bites.