Cobra Bite Research Articles

COBRA BITE FOLLOWING IMMUNIZATION AGAINST COBRA VENOM.

THE INDIAN COBRA ( Naja naja ) is considered by most authorities to be one of the most deadly snakes in the world. In India, where the annual mortality from snakebite may reach 25,000 to 30,000, the bite of the cobra is considered one of the prime offenders. Ahuja and Singh 1 and Puranananda 2 have reviewed the symptomatology of cobra bite. The symptoms listed were as follows: pain in and around the bite area, edema extending up the affected limb, numbness, lassitude, drowsiness, and incoordination resembling alcoholic intoxication. The initial symptoms may be followed by a sense of receding consciousness. Breathing becomes difficult, the pulse is weak, heart action is speeded, and speech becomes slurred. There is a dribbling of saliva as well as paralysis of the tongue and laryngeal muscles associated with difficulty of respiration. Coma, respiratory paralysis, and death follow shortly. Convulsions, paralysis of the limbs, and loss of

Successful Management of Cobra Bite

To the Editor:— I was perturbed by the sweeping conclusions of J. Fred Mullins and Don Naylor in their article on Successful Management of Cobra Bite with Cryotherapy inThe Journal, Nov. 26, 1960. There is a vast difference between snake bite and snake envenomization. About 20% of bites result in no envenomization. The percentage of envenomous bites is considerably lower for cobras. Any treatment will result in a high percentage of success if no envenomization occurs. No such bites should be reported without some system of gradation for the Elapidae similar to that of Wood et al. (Virginia Med Monthly 82 :103-135 [March] 1955) for envenomization of the North American Crotalidae. The authors mentioned the use of a tight tourniquet and ice water, always a potentially dangerous combination. This resulted in subsequent gangrenous slough in the finger, a finding not associated with cobra envenomization. Swelling during and after use

Successful management of cobra bite with cryotherapy.

Cryotherapy was used in a case of envenomization by a cobra (Naja naja). The patient, a 17-year-old male snake handler, was bitten on the left index finger. Systemic administration of steroids was also begun at once, but specific antivenin was not obtainable for nine hours. Although death sometimes occurs 8 to 12 hours after cobra envenomization, and in spite of the lack of specific cobra antivenin for 9 hours, no symptoms of systemic intoxication developed. Morbidity was confined to the envenomized arm, which became markedly swollen when cryotherapy was discontinued after 37 hours. Severe local destruction at the site of the bite eventually necessitated amputation of the distal portion of the involved finger.

The Relative Efficiency of Two Types of Anti-Venom Sera in Neutralizing Cobra Venom

DURING the summer of 1945 I was stationed Manila, P.I., with one of the United States Army Medical General Laboratories.1 During the course of the summer two snake antivenins were received at the laboratory for testing against the venom of the Luzon cobra, Naja naja philippinensis. According to Taylor ..... These snakes are poisonous, and probably cause more deaths than any other snake the Philippines. The subspecies is found very commonly Luzon, ... . Up to the time of the study two deaths from cobra bite had already been reported among U.S. military personnel stationed or near Manila and an efficient antivenin was being sought for use by the military forces. The two antivenins to be tested differed mainly the fact that one was a locally prepared (Institute of Hygiene, University of the Philippines) antivenin, specific for the venom of the Philippine cobra. This antivenin was prepared June, 1941, and packaged a 10.0 cubic centimeter hermetically sealed vial. It had an expiration date of June, 1942. The was prepared from horses hyperimmunized against the venom of N. n. philippinensis. The fact that this serum's expiration date was 1942 left its efficacy open to question, since liquid is considered unstable if stored at temperatures above 4? C. (39? F.). The other antivenin received was an Indian polyvalent Anti-snake venom serum prepared from horses hyperimmunized against four snakes: Russell's viper, Vipera russellii; the saw-scaled viper, Echis carinatus; the common krait, Bungarus caeruleus; an Indian cobra, Naja naja (subsp.?). This was desiccated, lyophilized, and packaged with sufficient sterile, distilled water, included a separate vial, to yield 10.0 cc. of reconstituted serum. Date of manufacture was July, 1945. The was prepared by the Haffkine Institute, Bombay, India. Both types of antivenin had been successfully used, but it was desired to check their relative efficiency against cobra venom, under controlled conditions. Since there was only a small quantity of each type of available for testing purposes, it was decided to use white mice for laboratory animals and to run the experiment in reverse, so to speak, order to obtain the most information from a given lot of antivenin. This will be explained more detail later.

Public Health in British India during 1934

THE annual report of the Public Health Commissioner with the Government of India (vol. 1), recently issued, surveys the vital statistics, public health and public health services of British India for the year 1934 (Government of India Press, New Delhi, 1936. Rs. 6 As. 2, or 10s.). The mid-year population is estimated to be, 275,753,570, the births were 9,288,897, a rate per 1,000 of 34, and the deaths numbered 6,856,244, a rate per 1,000 of 25. The infant mortality per 1,000 live births was 187. Of the causes of death, malaria heads the list with 1,319,026 deaths, and this figure does not include the mortality caused indirectly by malaria. Deaths from respiratory diseases numbered 483,018, those from dysentery and diarrhoea 285,110 and from cholera 199,708. Smallpox, with 83,928 deaths, caused a greater mortality than plague, with 80,131 deaths. At the Research Institute, Kasauli, a number of cases of snake-bite have been treated with anti-venomous serum with a high percentage of recoveries -25 out of 29 cases of cobra bite, and 12 out of 13 cases of bite by Russell's viper. Lieut.-Colonel Jolly, the Commissioner, believes that the intensive public health propaganda carried out during the last ten or twelve years is beginning to bear fruit, and that interest is increasing hi such matters as rural reconstruction, nutrition, child welfare and the prevention of epidemics.