Epidemiology and Clinical Profile of Snakebites in Goa and Surrounding Areas.

Background: Clinico-epidemiological profile of snake envenomation varies in different regions; however, data from India is inadequate. This study was planned to obtain such data from Goa, to help in quick identification of envenomation, prompt treatment and help in building a national database.

Methods: In this prospective observational study,all patients presenting to emergency department between April 2016 to August 2017 with history of snakebite and meeting inclusion and exclusion criteria were enrolled and analysed.

Results: 236 patients were screened, 156 were eligible. Mean age was 39.5±15.6; majority (n=122, 78.2%) were in the age group of 20-59 years; 119 (76.3%) were males. Seasonal variation was noted, highest number being in June, July and between September and December. Bites occurred commonly in housewives, students and retired personnel (n=108, 69.23%). 120 patients (76.9%) had hemotoxicity, 7 (4.5%) had neurotoxicity, 29 (18.6%) had only local reaction. Clinical features seen were bleeding (n= 40, 25.6%) , vomiting (n=15, 9.6%), giddiness/syncope (n=14, 9%), breathlessness (n=5, 3.2%), diplopia (n= 5,3.2%), ptosis (n=7, 4.5%), dysarthria (n=1, 0.6%), altered sensorium (n=7, 4.5%), oliguria (n=2, 1.3%), and chest pain (n=1, 0.6%). Majority (n= 117, 78.5%) received antivenom within 6 hours of bite. 31 patients (20.8%) developed reactions to antivenom, most were febrile reactions (n=12, 8.05%). Anaphylaxis occurred in 4 (2.68%) patients.

Conclusion: Snakebite is a common medical emergency in Goa, with distinct seasonal variation. There was no association between occupation and risk of bite. Hemotoxic and local cytotoxic features predominate in this area. Antivenom reactions though common, are usually mild.