Haya: The Saudi Journal of Life Sciences

Abbreviated Key Title: Haya Saudi J Life Sci

ISSN 2415-623X (Print) | ISSN 2415-6221 (Online)
Scholars Middle East Publishers, Dubai, United Arab Emirates
Journal homepage: https://saudijournals.com

Review Article

Facts and Perception about Snakes, Snake Bite and Its Management: A
Review
Ajaz A. Wani1*, Younis Rashid2
1Associate Professor and Head Dept. of Zoology Govt. PG College Bhaderwah, J & K
2Assistant professor department of Botany Govt. PG College Bhaderwah, J & K

DOI: 10.36348/sjls.2023.v08i11.006 | Received: 15.11.2023 | Accepted: 18.12.2023 | Published: 25.12.2023

*Corresponding author: Ajaz A. Wani

Associate Professor and Head Dept. of Zoology Govt. PG College Bhaderwah, J & K

Abstract
Snakebites are a serious public health problem in many regions of the world, particularly in rural areas lacking medical
facilities. The World Health Organization (WHO) estimates that 81,000–138,000 people die each year from snakebites
worldwide. Venomous snakebite and its effects are a source of fear for people living in southern Nepal. As a result, people
have developed a negative attitude towards snakes, which can lead to human-snake conflicts that result in killing of snakes.
About 48 People from different walks of life which includes farmers, teachers, businessmen, students and others were
interviewed regarding their perception about snakes. The study reveals that 46/ respondents feared from snakes, 33/
respondents dislike snakes and 25/ like to kill all the snakes particularly venomous snakes.
Keywords: Snakes, Perception, Snake bite, Management, Venomous.
Copyright © 2023 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International
License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original
author and source are credited.

functional lung. Where as on the other hand Lizards have

INTRODUCTION evolved independently have elongate bodies without
Due to a long co-evolutionary history with limbs or with greatly reduced limbs at least twenty-five
snakes, both humans and non-human primates evolved times via convergent evolution as a result leading to
specific neural mechanisms for rapid snake recognition many legless lizards [6]. These limb less lizards
[1-3] Snakes are thought to have evolved from either resembles to snakes, but several legless lizards have
burrowing or aquatic lizards, perhaps during the Jurassic eyelids and external ears, which snakes lack, although
period, with the earliest known fossils dating to between this rule of differentiation is not universal.
143 and 167 Ma ago. However diversity of modern
snakes appeared during Paleocene. Among Snakes are found on every continent except
evolutionarily irrelevant (neutral) stimuli, snake pictures Antarctica and on most smaller land masses; exceptions
act as strong distractors [4], and are detected faster than, include some large islands, such as Ireland, Iceland,
for example, flowers and mushrooms, but not faster than Greenland, the Hawaiian archipelago, and the islands of
stimuli of modern threats such as guns [5]. New Zealand, as well as many small islands of the
Atlantic and central Pacific oceans [7]. Moreover sea
Snakes belongs to class reptiles and is probably snakes are widespread throughout the Indian and Pacific
the most misunderstood and universally disliked animals oceans. There are thirty families of snakes currently
in the world since times immorial. These are elongated, recognized, comprising about 520 genera and about
limbless, carnivorous reptiles of the suborder Serpentes. 3,900 species [8]. The size of snakes ranges from 10.4
Like all other squamates, snakes are ectothermic, cm-long i.e Barbados thread snake to the reticulated
amniote vertebrates covered in overlapping scales. Many python of 7.5 meters (22.8 ft. approximately) in length
species of snakes have skulls with several more joints [9]. Whereas fossil species Titanoboa cerrejonensis was
than their lizard ancestors, enabling them to swallow 12.8 meters (42 ft) long [10].
prey much larger than their heads (cranial kinesis). In
order to accommodate their narrow bodies, their paired The snakes have been generally categorised as
internal organs (such as kidneys) appear one in front of posionous and non poisonous. Venomous and poisonous
the other instead of side by side, and most have only one animals are a considerable origin of global morbidity and

Citation: Ajaz A. Wani & Younis Rashid (2023). Facts and Perception about Snakes, Snake Bite and Its Management: A Review. 266
Haya Saudi J Life Sci, 8(11): 266-270.
 Ajaz A. Wani & Younis Rashid, Haya Saudi J Life Sci, Dec, 2023; 8(11): 266-270
mortality. There are about 216 species of snakes contains myotoxins that cause myalgias, myopathy and
identifiable in India, of which 52 are known poisonous. rhabdomyolysi [15].
The major families of snakes in India are Elapidae which
includes common cobra (Naja naja), king cobra and Cardiotoxicity
common krait (Bungarus caerulus), viperidae includes Viper and elapid venom can cause direct
Russell’s viper, saw scaled viper (Echis carinatus) and myocardial damage manifesting as arrhythmias,
pit viper and hydrophidae (the sea snakes) [11]. bradycardia, tachycardia or hypotension.

General Features of Posionous Snakes Shock

Poisonous snakes generally possess the following A variety of factors contribute to shock. They
character: include fright, hypovolemia (due to extravasation of
1. Vertically elliptical shaped cat like pupil. fluids and blood loss), myocardial depression,
2. A small depression (termed pit) between the haemorrhage into the adrenals and pituitary and
eyes and nostrils. increased kinin production (as in Viper bite).
3. Triangle shaped head e.g. Copperheads and
rattle snakes, exception- Elapids. Symptoms
4. Underside scales of tail go completely all the Signs or symptoms of a snake bite may vary depending
way across in a single row from the analplate; on the type of snake, but may include:
the very tip of the tail may possess two scale 1. Puncture marks at the wound.
rows. 2. Redness, swelling, bruising, bleeding, or
5. Head and body both are seen during swimming blistering around the bite.
time. 3. Severe pain and tenderness at the site of the bite.
6. Generally of multiple colors. 4. Nausea, vomiting, or diarrhea.
7. Emitting a warning rattle (a dry, whirring 5. Labored breathing (in extreme cases, breathing
sound) may stop altogether).
6. Rapid heart rate, weak pulse, low blood
Classification of Snake Venom: Snake venom can be pressure.
classified into four categories based on their clinical 7. Disturbed vision or blurred vision.
effect. 8. Metallic, mint, or rubber taste in the mouth.
9. Increased salivation and sweating.
Neurotoxins 10. Numbness or tingling around face and/or limbs.
Elapid and sea snake venoms have significant 11. Abnormal blood clotting and bleeding. Severe
neurotoxicity. The toxins that alter the structure and bleeding can lead to a hemorrhage or kidney
function of nervous system. Following an elapid bite, failure.
paralysis is first detectable as ptosis and external 12. Low blood pressure, a faster heart rate and a
ophthalmoplegia appearing as early as 15 minutes after weaker pulse.
the bite. This effect is caused by neurotoxins. These 13. Difficulty breathing, or in serious cases,
toxins can act either pre-synaptically or post-synaptically complete loss of breath.
resulting in blocking transmission at neuromuscular 14. Weakness in your muscles and numbness in the
junctions leading to paralysis of skeletal muscle. It is face or limbs.
important to note that these neurotoxins do not cross
blood brain barrier and do not alter consciousnes [12]. Perception about Snakes
A total of 48 interviews were carried out from
Hemotoxicity September 2023 to Nov.2023.Out of 48 respondents 38
The toxins that effects the blood. Hemotoxicity were male and 10 were female, and both the sexes were
is chiefly caused by anticoagulants, procoagulants, in the age group of 18 to 50 years. The respondents
fibrinolysins, haemorrhagins and haemolysins. These includes 22 agriculturist ( farmers),8 belong to business
hemotoxins produce clinical symptoms such as class,9 were teachers 6 were students and 3 belongs to
haemorrhage and anemia [13]. other professions. The result indicated that 16(33/)
respondents dislike snakes, 12(25/) would like to
Cytotoxicity exterminate all the snakes particularly venomous and 20
Edema, blisters and necrosis are frequently seen (46) feared from snakes.
at the site of bites caused by Viperidae or Elapidae. These
are due to local effects of cytotoxic components [14]. It was further observed that farmers were most
negative towards snakes and teachers were most
Myotoxicity ambivalent towards them, where as other shows mixed
Skeletal muscle damage caused by snake reactions.
venom myotoxins can be local or systemic leading to
skeletal muscle breakdown, muscle weakness, pain,
tenderness, and myoglobinuria. Sea snake venom
© 2023 | Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 267
 Ajaz A. Wani & Younis Rashid, Haya Saudi J Life Sci, Dec, 2023; 8(11): 266-270
Management of Snake Bite enough to occlude the lymphatic and venous flow but not
First Aid the arterial flow. A useful guide is that it should be loose
1. Person should take these steps if a snake bites enough to permit a finger to slip under it. The tourniquet
them: should be released for 30 seconds every 15 minutes to
2. Seek medical attention as soon as possible (call allow slow release of venom into circulation, thereby
local Emergency Medical Services). enabling its neutralization. The tourniquet should only be
3. Antivenom is the treatment for serious snake released after the first dose of antivenom is given [16].
envenomation. The sooner antivenom can be The bite wound should be gently wiped with sterile
started, the sooner irreversible damage from cotton gauze. In case of incoagulable blood or oozing
venom can be stopped. from puncture wounds only use the intravenous route for
4. Driving oneself to the hospital is not advised medication.
because people with snakebites can become
dizzy or pass out. Treatment/ Evaluation in Hospitals
5. Take a photograph of the snake from a safe A bite is considered to have been poisonous in case any
distance if possible. Identifying the snake can of the following features are present:
help with treatment of the snakebite. 1. Swelling, blistering or necrosis at the site of the
6. Keep calm. bite and its extension.
7. Apply first aid while waiting for EMS staff to 2. Hypotension / shock
get you to the hospital. 3. Haemorrhage
8. Lay or sit down with the bite in a neutral 4. Laboratory evidence of coagulation defect.
position of comfort. 5. Neuroparalytic manifestations.
9. Remove rings and watches before swelling 6. Arrhythmias / bradycardia / tachycardia.
starts. 7. Myoglobinuria.
10. Wash the bite with soap and water.
11. Cover the bite with a clean, dry dressing. Monitor pulse, blood pressure, respiratory rate,
12. Mark the leading edge of tenderness/swelling and muscle weakness hourly. Local swelling and
on the skin and write the time alongside it. necrosis should also be charted hourly. Examine gingival
sulci carefully for bleeding. Monitor ECG and CPK,
Do Not Do Any of The Following serum transaminases, blood urea and serum creatinine
1. Do not pick up the snake or try to trap it. daily. Serum electrolytes, especially potassium, should
NEVER handle a venomous snake, not even a be estimated 6 hourly in case of sea snakebite.
dead one or its decapitated head.
2. Do not wait for symptoms to appear if bitten, Coagulation profile should be tested 6 hourly
get medical help right away. (especially for viper bites). A useful test for venom-
3. Do not apply a tourniquet. induced defibrinogenation is the 20-minute whole blood
4. Do not slash the wound with a knife or cut it in clotting time. A few milliliters of venous blood is put in
any way. a clean test tube and kept aside for 20 minutes. It is then
5. Do not try to suck out the venom. tipped to see if it has clotted or not. Incoagulability
6. Do not apply ice or immerse the wound in indicates systemic envenomation by Vipera or Echis
water. species. Other sensitive tests are plasma prothrombin
7. Do not drink alcohol as a painkiller. time and fibrinogen degradation product estimation.
8. Do not take pain relievers (such as aspirin, Platelet count should be estimated twice daily.
ibuprofen, naproxen).
9. Do not apply electric shock or folk therapies. Urine should be examined for microscopic
10. Management of snake bite haematuria and active sediments. Output should be
monitored in case of renal failure.
The patient should be reassured and moved to
the nearest hospital as quickly as possible. Active The most important decision in managing a case
movements should be as minimal as possible. The bitten of snakebite is to decide whether to administer
part should be immobilized with a splint or sling. antivenom or not. There is evidence that in patients with
Tourniquets and compression bandages are potentially severe envenomation, the benefits of this therapy far
dangerous as they can cause gangrene, increased outweigh the risk of reactions [17].
fibrinolysis and bleeding in the occluded limb, peripheral
nerve palsies and intensification of local envenomation. Haemostatic abnormalities such as spontaneous
The only indication for their use is in case of severe systemic bleeding, incoagulable blood, or thrombo-
elapid or sea snake bites where the delay in reaching a cytopaenia.It is almost never too late to give anti-venom
medical centre is likely to be more than 0.5 hours but less as long as systemic signs of envenoming persist.
than 2-3 hours. Here compression / tourniquet delay Antivenom has been shown to be effective up to 2 days
absorption of the venom and so help retard onset of after sea snake bite and in patients still defibrinated
respiratory muscle paralysis. Tourniquet should be tight weeks after viper bite. anti-venom available in the
© 2023 | Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 268
 Ajaz A. Wani & Younis Rashid, Haya Saudi J Life Sci, Dec, 2023; 8(11): 266-270
Armed Forces is a polyvalent equine antiserum. This is snake populations will decline, and rare and endangered
effective against the 4 most important venomous snakes snake species may even become locally extirpated.
in India, namely, Cobra, Common Krait, Russell's viper Moreover, inappropriate perception and knowledge
and saw-scaled viper. The antiserum is available in a about snakes and snakebites may put BZ people at
lyophilized form and has to be reconstituted with 10 ml increased risk of venomous snakebite. Therefore,
sterile water for injection. The dose required depends on intensive, pragmatic educational efforts focused on
the clinical state of victim. natural history and ecology of snakes and prevention of
snakebite should be undertaken in communities and at
The antivenom is diluted in approximately 5ml schools and universities.
/ Kg body weight of isotonic saline or 5% Dextrose and
is administered as a slow intravenous infusion over 1-2 REFERENCES
hours. This method is preferred over the ‘push’ technique 1. Isbell, L. A. (2006). Snakes as agents of
where the undiluted serum is pushed intravenously at a evolutionary change in primate brains. Journal of
rate of 4 ml/minute. Response to antivenom is dramatic human evolution, 51(1), 1-35. doi:
and rapid. Neurotoxic signs may improve within 30 10.1016/j.jhevol.2005.12.012.
minutes but usually take several hours. Spontaneous 2. Van Le, Q., Isbell, L. A., Matsumoto, J., Nguyen,
systemic bleeding usually stops within 15 - 30 minutes M., Hori, E., Maior, R. S., ... & Nishijo, H. (2013).
and blood coagulability is restored within 6 hours of Pulvinar neurons reveal neurobiological evidence of
antivenom provided a neutralizing dose has been given. past selection for rapid detection of
Antivenom therapy should be repeated if severe signs snakes. Proceedings of the National Academy of
persist after 1 - 2 hours or if blood coagulability is not Sciences, 110(47), 19000-19005. doi:
restored within 6 hours. In case of severe neurotoxicity, 10.1073/pnas.1312648110.
the dose may have to be repeated half hourly till 3. Baynes-Rock, M. (2017). Human perceptual and
progression of weakness stops. In viper bites the phobic biases for snakes: a review of the
antivenom should be repeated every 6 hours till clotting experimental evidence. Anthrozoös, 30(1), 5-18.
profile returns to normal and progression of local doi: 10.1080/08927936.2017.1270584.
swelling ceases. 4. Soares, S. C., Lindström, B., Esteves, F., & Öhman,
A. (2014). The hidden snake in the grass: superior
Supportive Treatment/ Theraphy detection of snakes in challenging attentional
1. Tetanus prophylaxis conditions. PLoS one, 9(12), e114724. doi:
2. Antibiotics are indicated only in cases of severe 10.1371/journal.pone.0114724.
envenomation with significant local reaction 5. Zsido, A. N., Deak, A., & Bernath, L. (2018b). Is a
3. Surgical debridement of dead tissue snake scarier than a gun? The ontogenetic–
4. Fasciotomy for compartment syndromes phylogenetic dispute from a new perspective: the
5. Management of respiratory paralysis: Airway role of arousal. Emotion [Epub ahead of print].
patency and toilet should be ensured. 6. Wiens, J. J., Brandley, M. C., & Reeder, T. W.
Ventilatory support must be considered and (2006). Why does a trait evolve multiple times
instituted early. The “Tensilon test” should be within a clade? Repeated evolution of snakeline
done as follows: Atropine sulphate (0.6 mg for body form in squamate reptiles. Evolution, 60(1),
adults and 0.02-0.05 mg/Kg for children) 123-141. doi:10.1554/05-328.1. PMID 16568638.
should be given I/V followed by Edrophonium S2CID 17688691.
chloride (10mg for adults and 0.25 mg for 7. Bauchot, R. (1994). Snakes: A Natural History. New
children) I/V. Patients who respond York: Sterling Publishing Co., Inc, 220. ISBN 978-
convincingly can be maintained on neostigmine 1-4027-3181-5.
methyl sulphate (50 - 100 µg/Kg body weight) 8. Search results for Higher taxa: snake". reptile-
and atropine four hourly or by continuous database.org. Retrieved 7 March 2021.
infusion. 9. Fredriksson, G. M. (2005). Predation on sun bears
6. Hemostatic disturbances usually respond well by reticulated python in East Kalimantan,
to antivenom treatment. In case of severe Indonesian Borneo. The raffles bulletin of
bleeding fresh frozen plasma, cryoprecipitates, zoology, 53(1), 165-168.
& platelet concentrates may be required. There 10. Head, J. J., Bloch, J. I., Hastings, A. K., Bourque, J.
is no role for heparin. R., Cadena, E. A., Herrera, F. A., ... & Jaramillo, C.
A. (2009). Giant boid snake from the Palaeocene
CONCLUSION neotropics reveals hotter past equatorial
People with predisposed negativity towards temperatures. Nature, 457(7230), 715-717.
snakes were not proponents of snake conservation. Fear, doi:10.1038/nature07671. PMID 19194448. S2CID
negativity, ambivalence towards, and ignorance about, 4381423.
snakes and the need for snake conservation were strong 11. Warrell, D. A., Gutiérrez, J. M., Calvete, J. J., &
indicators of the propensity to harm or kill snakes. It Williams, D. (2013). New approaches &
seems that if wanton killing of snakes continues, local technologies of venomics to meet the challenge of
© 2023 | Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 269
 Ajaz A. Wani & Younis Rashid, Haya Saudi J Life Sci, Dec, 2023; 8(11): 266-270
human envenoming by snakebites in India. The and skin cancer (A-375) cell
Indian journal of medical research, 138(1), 38. lines. Cytotechnology, 68, 687-700.
12. Nirthanan, S., Awal, W., & Niranjan, N. R. (2017). 15. Alok, K., Yuen, R., Gopalakrishnakone, P., & Gwee,
Snake a-Neurotoxins and the Nicotinic M. C. E. (1997). A myotoxic fraction from the venom
Acetylcholine Receptor. Snake Venoms, 215. of Bungarus caeruleus. Toxicon, 4(35), 491.
13. Kini, R. M. (2019). Toxins for decoding interface 16. Parikh, C. K. (1985). Parikh's Textbook of Medical
selectivity in nicotinic acetylcholine Jurisprudence, 780–802.
receptors. Biochemical Journal, 476(10), 1515-1520. 17. Grenvik, A. K. E., Ayers, S. M., Holbrook, P. R., &
14. Bradshaw, M. J., Saviola, A. J., Fesler, E., & Shoemaker, W. C (2000). (editors). Injuries by
Mackessy, S. P. (2016). Evaluation of cytotoxic venomous and poisonous animals. In: Textbook of
activities of snake venoms toward breast (MCF-7) Critical Care 4th ed, I, 224-233.

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