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An epidemiological and clinical study of snake‐bites in childhood
Author(s) -
Jamieson Robyn,
Pearn John
Publication year - 1989
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1989.tb136764.x
Subject(s) - antivenom , snake bites , medicine , epidemiology , pediatrics , envenomation , venom , biology , ecology
The last decade has seen major changes in the first‐aid management of elapid snake‐bites and the introduction of a new venom‐detection kit which can identify the genus of medically‐important snakes. In the light of these developments, we report a 10‐year study that comprised 218 consecutive children who were admitted to hospital in southeast Queensland, after a confirmed or a suspected snake‐bite. One‐third (34.9%) of victims were preschool children (zero to five years of age) but the highest “at‐risk” group comprised prepubescent boys. In 70% of cases, the bite was on a single lower limb. Of the 218 children who were admitted to hospital, 42% manifested local or systemic symptoms that were consistent with a confirmed snake‐bite, irrespective of whether or not the species of snake was venomous. A positive identification of the genus of the offending snake was established in 18.8% of cases. In 35.8% of cases, the Commonwealth Serum Laboratories' Venom Detection Kit was used in an attempt to identify the involved snake, with 10 (4.6% of all cases) positive test‐results. We have found that appropriate first aid was applied in the field in a maximum of 18% of cases. Antivenom was administered to 14 children, seven of whom received polyvalent antivenom; one child manifested a severe anaphylactic reaction. There were no fatalities in this series, and no permanent morbidity. An interpretation of our data suggests that the diagnosis of a snake‐bite is confirmed in between 40%‐70% of all children who are admitted to hospital for this reason. From this, we conclude that the age‐specific incidence of snake‐bite is in the range of 2.0‐3.5 cases per 100 000 children annually. (Med J Aust 1989; 150: 698‐702)