of that deadly bite in the night
Sri Lanka has
the dubious record of having the most number of snake bite victims
in the world according to the Guiness Book of Records. The most
number of deaths from snake bite are reported from the North Central
Of the many
poisonous snakes in Sri Lanka, the common krait is said to be the
most venomous. Many people stung by this snake do not survive. However,
with more people seeking admission to hospital rather than taking
native treatment, the death rate has reduced. Nevertheless the toxicity
of this particularly innocuous looking snake is so high that many
die and the need to be informed about the habits and traits of this
snake is imperative.
Kularatne, a Consultant Physician and lecturer at the Medical Faculty,
University of Peradeniya who was earlier attached to the General
Hospital, Anuradhapura, conducted pioneering research on krait bite
from 1996 to 1998 in the North Central Province. He studied 210
krait bite victims admitted to the Anuradhapura General Hospital
during his period there as Consultant Physician and analyzed the
findings. His original research paper was published in the May 2002
issue of the prestigious Postgraduate Journal of Medicine bringing
honour to Sri Lanka.
research concentrated on the epidemiology of krait bite, the clinical
features, acute complications that manifest as a result and the
treatment of krait bite. This study defined the optimum intensive
care management parameters that are required for krait bite victims
in Sri Lanka. This article is based on the original article by Dr.
Kularatne published in the Postgraduate Journal of Medicine.
krait is found in Sri Lanka, India, Bangladesh and Pakistan. It
is coppery black in colour and is six inches to six feet in length.
Similar to the rat snake, its distinguishing characteristic, however,
is the white bands on the body, from neck downwards.
victims of this snake are farmers who live in open wattle-and-daub
houses and sleep in watch huts in the fields. A significant number
of patients die before reaching hospital. However in recent years
many people have sought the life saving benefits of hospital treatment
and the fatality rate has come down drastically.
The common krait
is a nocturnally active, terrestrial snake, which lives close to
human dwellings but is not vicious by nature. It creeps into houses
over the ground or through the roof and exhibits arboreal tendencies.
Occasional daytime bites and biting on tops of trees have also been
reported. It has also been observed that bites occur at night while
the victims are sleeping. Why the snake prefers to creep into dwellings
and how man becomes a victim is yet to be documented.
krait prefers to feed on small snakes. However, it is attracted
by mice, rats and geckos that are abundant in homes. This may draw
it into houses and while humans are asleep, they may be bitten due
to accidental handling or rolling over the snake. Exposed parts
of the body may be misidentified as prey. These may be possible
provocative factors for a common krait bite even though the snake
remains naturally indolent.
Once a person
is bitten by the common krait, several clinical manifestations occur.
Abdominal pain is common. A patient may wake up in the night with
colicky abdominal pain, unaware that he has been bitten. Thus the
pain has often been misdiagnosed as something not worth taking notice
of and here lies the problem. Internal bleeding from the organs
could occur. Many patients who are bitten by the common krait need
assisted breathing or 'ventilation'. Thus the transfer of the patient
immediately to a hospital that has proper intensive care facilities
is important. Unlike in the case of cobra bite that could kill a
man in 30 minutes, the process of envenoming can be slow in the
case of krait bite. Nevertheless early medical intervention is needed.
The other symptoms
that are manifest after krait bite include a comatose state, memory
loss, autonomic or neuromuscular paralysis and hypokalamia.
treatment for krait bite is not available. Thus victims are given
poiyvalent Haffkine anti-venom in varying doses according to the
severity and the complications are managed.
has identified factors such as poor resuscitation, delay in hospital
admission and resultant complications following krait bite as the
contributory causes for death. Improvement of intensive care facilities
in Sri Lanka, awareness of the clinical course and anticipation
and management of complications can overcome the morbidity. This
means that a person who is bitten must immediately seek the attention
of a qualified medical practitioner in a hospital and not a native
risk populations about the biting pattern of the common krait and
the preventive measures that they can take will no doubt reduce
the incidence of krait related deaths in Sri Lanka. Houses and their
environs should be kept clean and well swept and sleeping in unprotected
open spaces at night should be avoided.
better fighters of SARS
The deadly virus
SARS may have a less serious effect on young children compared with
teenagers and adults, research suggests.
A team from
the Chinese University of Hong Kong have come to the preliminary
conclusion after studying the first 10 children with SARS who received
treatment during the early phase of the epidemic in Hong Kong.
been no childhood deaths from SARS up to 25 April. The researchers
found that teenage patients presented with symptoms similar to adult
cases. All four teenagers examined by the researchers had respiratory
symptoms that were so severe that they had to be given oxygen.
included muscle ache, shivers and a general feeling of being unwell.
However, younger children had much more mild symptoms such as a
cough and runny nose.
the older patients, none of the younger children had shivers or
muscle pains. They also regained full health much more quickly.
Lead researcher Professor Tai Fai Fok said: "Our preliminary
observations suggest that younger children possibly develop a milder
form of disease and tend to run a less aggressive clinical course."
is published on the website of The Lancet medical journal. (BBC