B4.5 | VENOMOUS SNAKES OF NEPAL
Snakebite envenoming is one of the most neglected diseases of the 21st century and affects several million people every year. It is most common in tropical and subtropical regions where it is an occupational disease of the young rural poor population and a disaster-related health hazard (e.g., after extreme weather events like floods). Children are highly vulnerable and especially severely envenomed. The morbidity and mortality or long-term disability of young people that is caused by snakebite envenoming has profound socio-economic consequences for these developing nations. In many countries, snakebite envenoming is also a true disease of poverty in the sense that it mostly affects the poorest of the poor, and further perpetuates poverty by causing treatment costs, loss of income during illness or due to disability, or the death of a family's bread-earner.
One of the most fundamental impediments to improving the management of snakebite envenoming is ignorance of the species of snake that cause bites. This has, for example, resulted in the production of therapeutic immunoglobulin preparations (antivenoms) that cover an insufficient number of species, or regionally irrelevant species. Ignorance of the local venomous and non-venomous snake species is also at the root of the indiscriminate killing of any snake that is widespread in countries where snakebite is a problem. This in turn can lead to ecological problems such as growing populations of rodents that eat crops and transmit diseases but are normally controlled by predators like snakes. Finally, most people do not know what to do if they are bitten by a snake, or believe in ineffective and often harmful "first aid" measures.
As part of Swiss and German cooperation with Nepal, a team of biologists and physicians from the three countries has prepared a book on the venomous snakes of Nepal that is the first to help identify these dangerous reptiles based on photographs and text in separate Nepali and English editions. The book also contains information on snakebite first aid and treatment. This information is country-specific and reflects the present state of scientific evidence on this topic in the Nepali context. While part of the information and recommendations given have general validity, readers should bear in mind that others may apply to the situation in Nepal only, or may change over time as new evidence becomes available.
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Alirol, E., Sharma, S.K., Bawaskar, H.S., Kuch, U. & F. Chappuis (2010)
Snake Bite in South Asia: A Review. - PLoS Neglected Tropical Diseases 4(1): e603.
Jansen, M. & A. Schulze (2012) : Molecular, morphology and bioacoustic data suggest Bolivian distribution of a large species of the Leptodactylus pentadactylus group (Amphibia: Anura: Leptodactylidae). - Zootaxa 3307: 35-47.
Kuch, U., Sharma, S.K., Alirol, E. & F. Chappuis (2011) : Fatal neurotoxic envenomation from the bite of a Lesser Black Krait (Bungarus lividus) in Nepal. - Southeast Asian Journal of Tropical Medicine and Public Health 42(4): 960-964.
Sharma, S.K., Pandey, D.P., Shah, K.B., Tillack, F., CHappuis, F., Thapa, C.L., Alirol, E. & U. Kuch (2013) : Venomous Snakes of Nepal. A photographic guide. - Published by: B.P. Koirala Institute of Health Sciences, Dharan, Nepal (English Version) (Nepali Version)
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