Epidemiological study of snakebites in Nepal

1995 ~ 1996年对尼泊尔特莱地区蛇咬伤病例进行了流行病学调查。死亡29例，死亡率2.5%。然而，有许多患者去医院就诊的无毒蛇咬伤病例。为了澄清这一点，在奇特旺的巴拉特布尔医院进行了一项详细的调查，在那里一年内记录了403例毒蛇咬伤，包括有毒和无毒的。因为毒蛇咬伤的平均数量是11年52次，大约八分之七是无毒的咬伤。在排除了无毒的之后，巴拉特布尔的死亡率是23%。这些事件主要发生在雨季的6月至8月。造成咬伤的蛇主要是印度眼镜蛇（Naja naja）和印度金环蛇（Bungarus caeruleus）。可能会添加暹罗眼镜蛇（Naja kaouthia）。在山林附近，发生了绿色蝰蛇（Trimeressures albolabris）咬伤。被拉塞尔蝰蛇（Daboia russelli）或锯鳞蝰蛇（Echis carinatus）咬伤的情况没有被识别出来。印度多价抗蛇毒血清是进口的，广泛用于治疗。一名患者使用的小瓶数量超过10个，有时为30个。在那些村庄里有一些传统的医生拿着草药或咒语，一些病人去他们那里治疗蛇咬伤。由于非毒蛇咬伤病例众多，因此很难从他们那里获得毒蛇咬伤病例的数据，这样的治疗必须有效。造成无毒蛇咬伤的主要蛇类是鼠蛇（Ptyas mucosus）和水蛇（Xenochrophis piscator），这两种蛇类是白天活动的攻击性蛇类，在该地区数量较多。对蛇也进行了调查，发现了一种新的蛇属物种，一种眼镜蛇，和一种新的游蛇。金环蛇和白狼被添加到尼泊尔动物群。尼泊尔对蛇类的调查仍然不够。

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.