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Venom, antivenom production and the medically important snakes of India

机译:毒液,抗蛇毒药的生产和印度的医学上重要的蛇

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摘要

Snakebite is a medically and socially significant issue in India, but the quality of treatment and reporting protocols need to be upgraded to international standards. There are currently seven pharmaceutical laboratories in India which produce antivenom against four medically important Indian snake species (cobra (Naja sp.), krait (Bungarus sp.), Russell’s viper (Daboia russelii) and sawscaled viper (Echis carinatus sp.), the ‘big four’. Most venom for antivenom production is sourced from Chennai, South India. While the ‘big four’ are responsible for a majority of serious and fatal bites, the situation is actually much more complex. In this article, we review the production of venom and antivenom in India and suggest areas of improvement. We show that several factors complicate the treatment of snakebite in India. The first is geographic, intra-species variation in venoms of cobras and Russell’s vipers. Secondly, there are four species of cobra, eight species of kraits, two distinct sub-species of saw-scaled viper. In view of these observations, it is felt that identifying, evaluating and implementing changes to venom and antivenom production protocols, public education, snakebite treatment and policy in India should be an immediate priority.
机译:蛇咬伤在印度是医学和社会上很重要的问题,但是治疗和报告方案的质量需要升级到国际标准。目前,印度有七个制药实验室,它们针对四种医学上重要的印度蛇种(眼镜蛇(Naja sp。),Krait(Bungarus sp。),罗素的vi蛇(Daboia russelii)和锯鳞蛇(Echis carinatus sp。), “四大毒蛇”用于生产抗蛇毒的毒液大部分来自印度南部的钦奈。“四大蛇毒”造成了大多数严重和致命的咬伤,但情况实际上要复杂得多。在本文中,我们回顾了印度毒液和抗蛇毒的生产,并提出了改进的地方,我们发现印度蛇毒的治疗有几个因素使之复杂化:首先是眼镜蛇和罗素毒蛇毒液的地域,种内差异;其次,有4种眼镜蛇,八种不同种类的锯齿,锯状vi蛇两个不同的亚种,鉴于这些观察,我们认为确定,评估和实施毒液和抗蛇毒草生产方法的变化在印度,公共教育,蛇咬治疗和政策应该是当务之急。

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