Epidemiological study of snakebites in Nepal

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Epidemiological survey of snakebite cases was undertaken in Terai area, Nepal during 1995-1996.1180 cases were recorded in recent 1 year from 22 major hospitals. The fatal cases were 29 with 2.5% of mortality rate. However, there were many non-venomous snakebite cases in which patients visited hospitals. To clarify this, a detailed survey was made in Bharatpur Hospital, Chitwan, where 403 cases of snakebites including both venomous and non-venomous ones were recorded in a year. Because the average number of venomous snakebites was 52 in 11 years, about seven eighths were non-venomous bites. After excluding non-venomous one the mortality rate was 23% at Bharatpur. The incidents occurred mainly June to August, a rainy season. The snakes responsible for bites were mainly Indian cobra (Naja naja) and Indian krait (Bungarus caeruleus). Siamese cobra (Naja kaouthia) may be added. Near the mountain forests, green pit-viper (Trimeresures albolabris) bites occurred. Bites by Russell's viper (Daboia russelli) or saw-scaled viper (Echis carinatus) were not recognized. Indian polyvalent antivenins were imported and extensively used for treatment. Number of vials used for one patient exceeded 10, sometimes 30. There were some traditional physicians with herbal medicines or mantra in the villages, and some patients visited them for treatment of snakebites. It was difficult to obtain the data of snakebite cases from them Because non-venomous snakebites were numerous, such a treatment must be effective. The main snakes responsible for non-venomous snakebites were rat snake (Ptyas mucosus) and water snake (Xenochrophis piscator) which were aggressive diurnal snakes and abundant in the area. A survey of snakes was also made and a new species of the genus Calliophis (sensu lato), an elapid snake, and a new colubrid snake were discovered. Bungarus bungaroides and Lycodon jara were added to Nepali fauna. The survey of snake fauna is still insufficient in Nepal.