Snakebite in northern Cameroon: 134 victims of bites by the saw-scaled orcarpet viper, Echis ocellatus

Abstract

Echis ocellatus is one of the most deadly snakes known to humans, yet the procurement of antivenom forthe treatment of these snakebites in Africa has become increasingly difficult and expensive. There is no consensus for the management of victims, and little is known of actual recent experiences with these cases in ordinary health care settings in Africa. All cases of snakebite reliably identified as bites of E. ocellatus and admitted to Kolofata District Hospital, northern Cameroon, from January 1993 to December 2002 were described retrospectively or prospectively. Of 134 cases admitted, 63% were male, three-quarters were aged < 30 years, and 85% survived. Pasteur polyvalent antivenom for Africa was administered intravenously in all but 1 case, but patients rarely received more than 10 mL. In most cases, appropriate antivenom can be administered effectively at a fraction of the recommended dose (20–60 mL), even in patients with serious complications presenting days after having been bitten; however, death is more likely in late presenters.