Editing Snakebite (section)

{{short description|Injury caused by bite from snakes}}
{{other uses}}
{{cs1 config|name-list-style=vanc}}
{{Use dmy dates|date=January 2014}}
{{Infobox medical condition (new)
| name          = Snakebite
| image         = Cobra bite in Thailand (image, 2023).jpg
| caption       = A [[cobra]] bite on the foot of a girl in [[Thailand]]
| field         = [[Emergency medicine]]
| symptoms      = Two [[puncture wound]]s, [[redness]], [[Edema|swelling]], severe pain at the area<ref name=CDC2012/><ref name=Gold2002/>
| complications = [[hemorrhage|Bleeding]], [[kidney failure]], [[anaphylaxis|severe allergic reaction]], [[necrosis|tissue death]] around the bite, breathing problems, [[amputation]], [[envenomation]]<ref name=CDC2012/><ref name=WHO2015/>
| onset         =
| duration      =
| types         =
| causes        = [[Snakes]]<ref name=CDC2012/>
| risks         = Working outside with one's hands ([[farming]], [[forestry]], construction);<ref name=CDC2012/><ref name=WHO2015/> harassment;<ref>{{cite web|url=https://www.fs.usda.gov/detail/eldorado/learning/safety-ethics/?cid=STELPRDB5259659|title=Eldorado - Outdoor Safety & Ethics}}</ref><ref>{{cite web | url=https://wildlife.utah.gov/news/utah-wildlife-news/1202-rattlesnake-encounter-what-to-do.html | title=What to do if you encounter a rattlesnake}}</ref> [[drunkenness]]<ref>{{cite web | url=https://reptilesmagazine.com/alcohol-and-snake-bites/ |title=Alcohol and Snake Bites – Reptiles Magazine | date=December 2011}}</ref>
| diagnosis     =
| differential  =
| prevention    = [[Protective footwear]], avoiding areas where snakes live, not handling snakes<ref name=CDC2012/>
| treatment     = Washing the wound with soap and water, [[antivenom]]<ref name=CDC2012/><ref name=WHONeg/>
| medication    =
| prognosis     = Depends on type of snake<ref name=Marx2010/>
| frequency     = Up to 5 million a year<ref name=WHO2015/>
| deaths        = 94,000–125,000 per year<ref name=WHO2015/>
}}
<!-- Definition and symptoms -->

A '''snakebite''' is an injury caused by the bite of a snake, especially a [[venomous snake]].<ref>{{cite web |title=Definition of Snakebite |url=https://www.merriam-webster.com/dictionary/snakebite |website=www.merriam-webster.com |access-date=17 June 2019 |language=en}}</ref> A common sign of a bite from a venomous snake is the presence of two [[puncture wound]]s from the animal's [[fang]]s.<ref name=CDC2012/> Sometimes [[envenomation|venom injection from the bite]] may occur.<ref name=WHO2015>{{cite web |title=Animal bites: Fact sheet N°373 |url=https://www.who.int/mediacentre/factsheets/fs373/en/ |publisher=[[World Health Organization]] |access-date=19 May 2015 |date=February 2015 |url-status=live |archive-url=https://web.archive.org/web/20150504100257/http://www.who.int/mediacentre/factsheets/fs373/en/ |archive-date=4 May 2015}}</ref> This may result in redness, swelling, and severe pain at the area, which may take up to an hour to appear.<ref name=CDC2012/><ref name=Gold2002/> [[Vomiting]], blurred vision, tingling of the limbs, and sweating may result.<ref name=CDC2012/><ref name=Gold2002/> Most bites are on the hands, arms, or legs.<ref name=Gold2002>{{cite journal | vauthors = Gold BS, Dart RC, Barish RA | title = Bites of venomous snakes | journal = The New England Journal of Medicine | volume = 347 | issue = 5 | pages = 347–356 | date = August 2002 | pmid = 12151473 | doi = 10.1056/NEJMra013477}}</ref><ref>{{cite journal | vauthors = Daley BJ, Torres J | title = Venomous snakebites | journal = Journal of Emergency Medical Services| volume = 39 | issue = 6 | pages = 58–62 | date = June 2014 | pmid = 25109149}}</ref> [[Fear]] following a bite is common with symptoms of a [[Tachycardia|racing heart]] and [[Dizziness|feeling faint]].<ref name=Gold2002/> The [[venom]] may cause [[hemorrhage|bleeding]], [[kidney failure]], a [[anaphylaxis|severe allergic reaction]], [[necrosis|tissue death]] around the bite, or breathing problems.<ref name=CDC2012>{{cite web|title=Venomous Snakes|url=https://www.cdc.gov/niosh/topics/snakes/|publisher=[[U.S. National Institute for Occupational Safety and Health]]|access-date=19 May 2015|date=24 February 2012|url-status=live|archive-url= https://web.archive.org/web/20150429051901/http://www.cdc.gov/niosh/topics/snakes/|archive-date=29 April 2015}}</ref><ref name=WHO2015/> Bites may result in the [[amputation|loss of a limb]] or other [[Chronic condition|chronic problems]] or even death.<ref name="Healthline Media UK Ltd">{{cite web |last1=Eske |first1=Jamie |last2=Biggers |first2=Alana |title=How to identify and treat snake bites |url=https://www.medicalnewstoday.com/articles/324007 |website=Medical News Today |publisher=Healthline Media UK Ltd |access-date=4 May 2022 |language=English |date=14 December 2018}}</ref><ref name=WHO2015/>

The outcome depends on the type of snake, the area of the body bitten, the amount of [[snake venom]] injected, the general health of the person bitten, and whether or not anti-venom serum has been administered by a doctor in a timely manner.<ref name="Healthline Media UK Ltd"/><ref name=Marx2010>{{cite book| vauthors = Marx JA |title=Rosen's emergency medicine: concepts and clinical practice |date=2010 |publisher=Mosby/Elsevier |location=Philadelphia |isbn=978-0-323-05472-0|page=746|edition=7|url=https://books.google.com/books?id=u7TNcpCeqx8C&pg=PA746|url-status=live|archive-url= https://web.archive.org/web/20150521114649/https://books.google.com/books?id=u7TNcpCeqx8C&pg=PA746|archive-date=21 May 2015}}</ref> Problems are often more severe in children than adults, due to their smaller size.<ref name=WHO2015/><ref>{{cite book| vauthors = Peden MM |title=World Report on Child Injury Prevention|date=2008|publisher=[[World Health Organization]]|isbn=978-92-4-156357-4|page=128|url=https://books.google.com/books?id=UeXwoNh8sbwC&pg=PA128|language=en|url-status=live|archive-url=https://web.archive.org/web/20170202050637/https://books.google.com/books?id=UeXwoNh8sbwC&pg=PA128|archive-date=2 February 2017}}</ref><ref name=WHOantivenoms/> Allergic reactions to snake venom can further complicate outcomes and can include [[anaphylaxis]], requiring additional treatment and in some cases resulting in death.<ref name="Healthline Media UK Ltd"/>

<!-- Cause -->
Snakes bite both as a method of hunting and as a means of protection.<ref name=Kast2008/> [[Risk factor]]s for bites include working outside with one's hands such as in [[farming]], [[forestry]], and construction.<ref name="CDC2012" /><ref name="WHO2015" /> Snakes commonly involved in envenomations include [[elapid]]s (such as [[krait]]s, [[cobra]]s and [[mamba]]s), [[viper]]s, and [[sea snake]]s.<ref name=WHONeg>{{cite web|publisher=[[World Health Organization]] |title=Neglected tropical diseases: Snakebite|url=https://www.who.int/neglected_diseases/diseases/snakebites/en/|access-date=19 May 2015|archive-url=https://web.archive.org/web/20150930063057/http://www.who.int/neglected_diseases/diseases/snakebites/en/|archive-date=30 September 2015}}</ref> The majority of snake species do not have venom and kill their prey by [[constriction]] (squeezing them).<ref name=Gold2002/> Venomous snakes can be found on every continent except [[Antarctica]].<ref name=Kast2008/> Determining the type of snake that caused a bite is often not possible.<ref name=WHONeg/> The [[World Health Organization]] says snakebites are a "neglected [[public health issue]] in many tropical and subtropical countries",<ref name=WHOantivenoms>{{cite web |publisher=[[World Health Organization]] |title=Snake antivenoms: Fact sheet N°337 |url=https://www.who.int/mediacentre/factsheets/fs337/en/ |date=February 2015 |access-date=16 May 2017 |url-status=live |archive-url=https://web.archive.org/web/20170418105431/http://www.who.int/mediacentre/factsheets/fs337/en/ |archive-date=18 April 2017}}</ref> and in 2017, the WHO categorized snakebite envenomation as a [[Neglected tropical diseases|Neglected Tropical Disease]] (Category A). The WHO also estimates that between 4.5 and 5.4 million people are bitten each year, and of those figures, 40–50% develop some kind of clinical illness as a result.<ref name=Langley2020>{{cite journal |last1=Langley |first1=Ricky |last2=Haskell |first2=Marilyn Goss |last3=Hareza |first3=Dariusz |last4=King |first4=Katherine |title=Fatal and Nonfatal Snakebite Injuries Reported in the United States |journal=Southern Medical Journal |date=October 2020 |volume=113 |issue=10 |pages=514–519 |doi=10.14423/SMJ.0000000000001156|pmid=33005969 |s2cid=222070778}}</ref> Furthermore, the death toll from such an injury could range between 80,000 and 130,000 people per year.<ref>World Health Organization. Prevalence of snakebite envenoming. <nowiki>[https://web.archive.org/web/20170922113845/http://www.who.int/snakebites/epidemiology/en/ ]</nowiki>. Accessed April 15, 2019</ref><ref name=Langley2020/> The purpose was to encourage research, expand the accessibility of antivenoms, and improve snakebite management in "[[Developing country|developing countries]]".<ref>{{cite web|url=https://www.who.int/snakebites/resources/s40409-017-0127-6/en/|archive-url=https://web.archive.org/web/20170922115522/http://www.who.int/snakebites/resources/s40409-017-0127-6/en/|archive-date=22 September 2017|title=WHO &#124; Snakebite envenomation turns again into a neglected tropical disease!|website=WHO}}</ref>

<!-- Prevention and treatment -->
Prevention of snake bites can involve wearing protective footwear, avoiding areas where snakes live, and not handling snakes.<ref name=CDC2012/> Treatment partly depends on the type of snake.<ref name=CDC2012/> Washing the wound with soap and water and holding the limb still is recommended.<ref name=CDC2012/><ref name=WHONeg/> Trying to suck out the venom, cutting the wound with a knife, or using a [[tourniquet]] is not recommended.<ref name=CDC2012/> [[Antivenom]] is effective at preventing death from bites; however, antivenoms frequently have [[side effect]]s.<ref name=WHO2015/><ref name=Gutierrez2007/> The type of antivenom needed depends on the type of snake involved.<ref name=WHONeg/> When the type of snake is unknown, antivenom is often given based on the types known to be in the area.<ref name=WHONeg/> In some areas of the world, getting the right type of antivenom is difficult and this partly contributes to why they sometimes do not work.<ref name=WHO2015/> An additional issue is the cost of these medications.<ref name=WHO2015/> Antivenom has little effect on the area around the bite itself.<ref name=WHONeg/> [[Mechanical ventilation|Supporting the person's breathing]] is sometimes also required.<ref name=WHONeg/>

<!-- Epidemiology -->
The number of venomous snakebites that occur each year may be as high as five million.<ref name=WHO2015 /> They result in about 2.5 million envenomations and 20,000 to 125,000 deaths.<ref name=WHO2015/><ref name=Kast2008/> The frequency and severity of bites vary greatly among different parts of the world.<ref name=Kast2008>{{cite journal | vauthors = Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK, Pathmeswaran A, Premaratna R, Savioli L, Lalloo DG, de Silva HJ | display-authors = 6 | title = The global burden of snakebite: a literature analysis and modelling based on regional estimates of envenoming and deaths | journal = PLOS Medicine | volume = 5 | issue = 11 | pages = e218 | date = November 2008 | pmid = 18986210 | pmc = 2577696 | doi = 10.1371/journal.pmed.0050218 | doi-access = free}}</ref> They occur most commonly in [[Africa]], [[Asia]], and [[Latin America]],<ref name=WHO2015/> with rural areas more greatly affected.<ref name=WHO2015/><ref name=WHOantivenoms/> Deaths are relatively rare in [[Australia]], [[Europe]] and [[North America]].<ref name=Kast2008/><ref name=Gutierrez2007>{{cite journal | vauthors = Gutiérrez JM, Lomonte B, León G, Rucavado A, Chaves F, Angulo Y | title = Trends in snakebite envenomation therapy: scientific, technological and public health considerations | journal = Current Pharmaceutical Design | volume = 13 | issue = 28 | pages = 2935–2950 | year = 2007 | pmid = 17979738 | doi = 10.2174/138161207782023784}}</ref><ref name=Chippaux1998>{{cite journal | vauthors = Chippaux JP | title = Snake-bites: appraisal of the global situation | journal = Bulletin of the World Health Organization | volume = 76 | issue = 5 | pages = 515–524 | year = 1998 | pmid = 9868843 | pmc = 2305789}}</ref> For example, in the United States, about seven to eight thousand people per year are bitten by venomous snakes (about one in 40 thousand people) and about five people die (about one death per 65 million people).<ref name=CDC2012 />
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