Snakebite in tropical Australia

a prospective study in the "Top End" of the Northern Territory

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objective: To describe the epidemiology of snakebite in the "Top End" of the Northern Territory, and the envenoming syndromes of individual snake species. Study design: Prospective collection of clinical data and snake identity. Setting: Royal Darwin Hospital (RDH), a 300-bed tertiary hospital servicing a population of 140 000 spread over 522 561 km2. Patients: All patients with bites by confirmed snake species between September 1989 and March 2003, and all suspected snakebite cases between September 1989 and March 1998. Outcome measures: Incidence rates of definite snakebite and envenoming. Clinical features of bites from defined snake species. Results: There were 348 suspected snakebites over 8.6 years, with 114 aerial evacuations to RDH, 216 patients (62%) definitely bitten (23.2/100 000 per year) and 79 (23%) envenomed (7.6/100 000 per year). There were 156 bites from confirmed species over 13.6 years: 31 (20%) from western brown snakes (Pseudonaja nuchalis), with early collapse in 14 (45%), consumptive coagulopathy in 26 (84%) and 25 (81%) given antivenom; 21 from death adders (Acanthophis spp.), with neurotoxicity in 8 (38%) and 6 (29%) given antivenom; and 20 from mulga snakes (Pseudechis australis), with local swelling in 19 (95%), myotoxicity in 12 (60%) and 15 (75%) given antivenom. In 34 bites from less venomous species, there was no life-threatening envenoming. There were no deaths. Conclusions: Snakebite still causes morbidity in tropical Australia, but, with access to hospital and antivenom, deaths are rare. This study has enabled further definition of the envenoming syndromes of three highly venomous Australasian elapids.
    Original languageEnglish
    Pages (from-to)693-697
    Number of pages5
    JournalMedical Journal of Australia
    Volume181
    Issue number11-12
    Publication statusPublished - 2004

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    Northern Territory
    Snake Bites
    Antivenins
    Prospective Studies
    Snakes
    Bites and Stings
    Tertiary Care Centers
    Epidemiology
    Outcome Assessment (Health Care)
    Morbidity
    Incidence

    Cite this

    @article{666c76d8a94f44448772ba2890da47ca,
    title = "Snakebite in tropical Australia: a prospective study in the {"}Top End{"} of the Northern Territory",
    abstract = "Objective: To describe the epidemiology of snakebite in the {"}Top End{"} of the Northern Territory, and the envenoming syndromes of individual snake species. Study design: Prospective collection of clinical data and snake identity. Setting: Royal Darwin Hospital (RDH), a 300-bed tertiary hospital servicing a population of 140 000 spread over 522 561 km2. Patients: All patients with bites by confirmed snake species between September 1989 and March 2003, and all suspected snakebite cases between September 1989 and March 1998. Outcome measures: Incidence rates of definite snakebite and envenoming. Clinical features of bites from defined snake species. Results: There were 348 suspected snakebites over 8.6 years, with 114 aerial evacuations to RDH, 216 patients (62{\%}) definitely bitten (23.2/100 000 per year) and 79 (23{\%}) envenomed (7.6/100 000 per year). There were 156 bites from confirmed species over 13.6 years: 31 (20{\%}) from western brown snakes (Pseudonaja nuchalis), with early collapse in 14 (45{\%}), consumptive coagulopathy in 26 (84{\%}) and 25 (81{\%}) given antivenom; 21 from death adders (Acanthophis spp.), with neurotoxicity in 8 (38{\%}) and 6 (29{\%}) given antivenom; and 20 from mulga snakes (Pseudechis australis), with local swelling in 19 (95{\%}), myotoxicity in 12 (60{\%}) and 15 (75{\%}) given antivenom. In 34 bites from less venomous species, there was no life-threatening envenoming. There were no deaths. Conclusions: Snakebite still causes morbidity in tropical Australia, but, with access to hospital and antivenom, deaths are rare. This study has enabled further definition of the envenoming syndromes of three highly venomous Australasian elapids.",
    keywords = "snake venom antiserum, adult, article, Australia, blood clotting disorder, child, clinical feature, clinical study, collapse, controlled study, death, edema, envenomation, female, health care facility, hospital service, human, incidence, major clinical study, male, neurotoxicity, patient transport, population research, prospective study, snakebite, species difference, tropics, Adolescent, Adult, Age Distribution, Aged, Animals, Antivenins, Child, Child, Preschool, Emergency Treatment, Endemic Diseases, Female, Humans, Incidence, Male, Middle Aged, Northern Territory, Prospective Studies, Risk Assessment, Severity of Illness Index, Sex Distribution, Snake Bites, Survival Rate, Tropical Climate",
    author = "Bart Currie",
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    Snakebite in tropical Australia : a prospective study in the "Top End" of the Northern Territory. / Currie, Bart.

    In: Medical Journal of Australia, Vol. 181, No. 11-12, 2004, p. 693-697.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Snakebite in tropical Australia

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    AU - Currie, Bart

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    N2 - Objective: To describe the epidemiology of snakebite in the "Top End" of the Northern Territory, and the envenoming syndromes of individual snake species. Study design: Prospective collection of clinical data and snake identity. Setting: Royal Darwin Hospital (RDH), a 300-bed tertiary hospital servicing a population of 140 000 spread over 522 561 km2. Patients: All patients with bites by confirmed snake species between September 1989 and March 2003, and all suspected snakebite cases between September 1989 and March 1998. Outcome measures: Incidence rates of definite snakebite and envenoming. Clinical features of bites from defined snake species. Results: There were 348 suspected snakebites over 8.6 years, with 114 aerial evacuations to RDH, 216 patients (62%) definitely bitten (23.2/100 000 per year) and 79 (23%) envenomed (7.6/100 000 per year). There were 156 bites from confirmed species over 13.6 years: 31 (20%) from western brown snakes (Pseudonaja nuchalis), with early collapse in 14 (45%), consumptive coagulopathy in 26 (84%) and 25 (81%) given antivenom; 21 from death adders (Acanthophis spp.), with neurotoxicity in 8 (38%) and 6 (29%) given antivenom; and 20 from mulga snakes (Pseudechis australis), with local swelling in 19 (95%), myotoxicity in 12 (60%) and 15 (75%) given antivenom. In 34 bites from less venomous species, there was no life-threatening envenoming. There were no deaths. Conclusions: Snakebite still causes morbidity in tropical Australia, but, with access to hospital and antivenom, deaths are rare. This study has enabled further definition of the envenoming syndromes of three highly venomous Australasian elapids.

    AB - Objective: To describe the epidemiology of snakebite in the "Top End" of the Northern Territory, and the envenoming syndromes of individual snake species. Study design: Prospective collection of clinical data and snake identity. Setting: Royal Darwin Hospital (RDH), a 300-bed tertiary hospital servicing a population of 140 000 spread over 522 561 km2. Patients: All patients with bites by confirmed snake species between September 1989 and March 2003, and all suspected snakebite cases between September 1989 and March 1998. Outcome measures: Incidence rates of definite snakebite and envenoming. Clinical features of bites from defined snake species. Results: There were 348 suspected snakebites over 8.6 years, with 114 aerial evacuations to RDH, 216 patients (62%) definitely bitten (23.2/100 000 per year) and 79 (23%) envenomed (7.6/100 000 per year). There were 156 bites from confirmed species over 13.6 years: 31 (20%) from western brown snakes (Pseudonaja nuchalis), with early collapse in 14 (45%), consumptive coagulopathy in 26 (84%) and 25 (81%) given antivenom; 21 from death adders (Acanthophis spp.), with neurotoxicity in 8 (38%) and 6 (29%) given antivenom; and 20 from mulga snakes (Pseudechis australis), with local swelling in 19 (95%), myotoxicity in 12 (60%) and 15 (75%) given antivenom. In 34 bites from less venomous species, there was no life-threatening envenoming. There were no deaths. Conclusions: Snakebite still causes morbidity in tropical Australia, but, with access to hospital and antivenom, deaths are rare. This study has enabled further definition of the envenoming syndromes of three highly venomous Australasian elapids.

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