Clinico-epidemiological profile of snake bite in children in a tertiary care centre: a hospital based study


  • Anil Kumar H. Department of Pediatrics, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
  • Mallesh Kariyappa Department of Pediatrics, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
  • Vinutha G. N. Department of Pediatrics, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India



Children, Envenomation, Epidemiology, Snake bite


Background: Snake bite remains major public health problem worldwide, particularly in rural areas with unexpected morbidity and mortality. This study was conducted to evaluate the clinico-epidemiological profile and complications of snake bite in children at our institute.

Methods: This was a retrospective case record based study with records between January 2011 and December 2016 studied. The clinico-epidemiological features and complications were recorded and analysed.

Results: Total of 242 snake bite children were admitted during the study period out of 17512 admissions constituting to 1.38% of admissions. There was male predominance with ratio of 2:1. About 43% of children were in the age group of 7-12 years, followed by 13-18 years. About 43% of bites occurred between March and June months. About 2/3rd of cases were from rural areas, 50% of cases were bitten outdoor. About 3/4th of cases had bite in the lower extremity. In this study 3/4th of children presented to hospital within 6 hours of bite. The major symptoms were pain and swelling at the site of bite. 10% of children had neurotoxic symptoms. Major complications noted were compartment syndrome, DIC, AKI and respiratory paralysis. Four (1.7%) children died, 3 had DIC and 1 died due to uremic encephalopathy.

Conclusions: Snake bite remains a major health problem in children causing significant morbidity and mortality. Children are particularly vulnerable because of their active and explorative nature and they also spend considerable time outdoors particularly male children. Simple preventive measures to be taken and people should be educated about avoiding traditional first aid methods and early presentation to hospital.


Al-Homrany M. Acute renal failure following snake bites: a case report and review of the literature. Saudi J Kidney Dis Transpl. 1996;7:309-12.

Basu J, Majumdar G, Dutta A. Acute renal failure following snake bites (viper). J Assoc Physicians India. 1977;25:883-90.

Bhat RN. Viperine snake bite poisoning in Jammu. J Indian Med Assoc. 1974;63:383-92.

Sundaram MS, Parameswari G, Michael, A, Ramalingam S. Neutralization of the pharmacological effects of Cobra and Krait venoms by chicken egg yolk antibodies. Toxicon. 2008;52:221-7.

Chippaux JP. Snake bites: appraisal of the global situation. Bull World Health Organ. 1998;76:515-24.

Bawaskar HS. Snake venoms and antivenoms: Critical supply issues. J Assoc Physicians India. 2004;52:11-3.

Gaitonde BB, Bhattacharya S. An epidemiological survey of snake-bite cases in India. Snake. 1980;12:129-33.

Hansdak SG, Lallar KS, Pokharel P, Shyangwa P, Karki P, Koirala S. A clinico-epidemiological study of snake bite in Nepal. Tropical Doctor. 1998;28:223-6.

Paul VK. Animal and insect bites. In: Singh M, ed. Medical Emergencies in Children, 2nd ed. New Delhi: Sagar Publications; 1993.

Warrel DA. Venoms, toxins and poisons of animals and plants. In: Wealtherall DJ, Ledingham JGG, Warrell DA, eds. Oxford Textbook of Medicine, 3rd ed. Oxford: Oxford University Press; 1996.

Chandrashekar C, Shariff MA, Gopal K, Ravichander B. Clinical profile of snakebite in children. J Evidence Based Med Healthcare. 2015;2(29):4176-84.

Kshirsagar VY, Ahmed M, Colaco SM. Clinical profile of snake bite in children in rural India. Iranian J Pediatr. 2013; 23(6):632-6.

Krishna VM. Clinical profile and outcome of snake-bite en-venomation in children: a retrospective study in a tertiary care centre kims narketpally. Int J Information Res Rev. 2014;1(11):155-8.

Halesha BR. A Study on the Clinico-epidemiological profile and the outcome of snake bite victims in a tertiary care centre in Southern India. J Clin Diag Res. 2013;7(1):122-6.

Timsinha S, Kar SM, Baral MP. Epidemiology of snake bite cases in Manipal teaching hospital. Int Med J. 2014;1(5):222-6.

Kulkarni ML, Anees S. Snake venom poisoning: an experience with 633 cases. Ind Pediatr 1994;31(10):1239-43.

Koirala DP, Gauchan E, Basnet S, Adhikari S. Clinical features, management and outcome of snake bite in children in Manipal teaching hospital. Nepal J Medl Sci. 2013;2(2):119-24.

Lingayat AM, Wankhade PR. Study of clinical profile complications and outcome in patients of snake bite in pediatric age group. Int J Healthcare Biomed Res.2015;3(3):203-8.

Punde DP. Management of snake-bite in rural Maharashtra: a 10-year experience. Natl Med J India. 2005;18:71-5.

Adhashivam B, Mahadevan S. Snake bite envenomation in India: a rural medical emergency. Indian Pediatr. 2006;43(6):553-4.






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