Panbari (Assam): An animal keeper at the International Fund for Animal Welfare – Wildlife Trust of India (IFAW-WTI) run Centre for Wildlife Rehabilitation and Conservation (CWRC), who was inflicted with a severe bite by a black krait (Bungarus niger), has recovered significantly following appropriate treatment.

The incident highlights the importance of first aid and knowledge in dealing with venomous snake-bites to minimise casualties. Experts estimate about 50,000 human casualties annually from across India, as a result of snakebites.

“Venomous snakes are found across India and snakebites are common. However, 50,000 is a huge number considering the fact that there are solutions to prevent such deaths. It is the lack of general awareness, ensuing panic, ill-equipped hospitals, lack of technical expertise in storage, handling and administering anti-venoms, dependence on spiritual healers, etc that compound the situation,” says Jose Louies, Assistant Manager, WTI.

According to World Health Organisation (WHO) guidelines for the management of snake-bites, it is crucial to keep the victim calm. A large number of these cases involves non-venomous snakes or ‘dry-bites’ by venomous snakes, meaning that no venom has been injected into the body. Panic causes envenomation-like symptoms, and administering anti-venoms in these cases can turn out more harmful.

Patients need to be immobilised and interference with the bite must be avoided in the absence of experts. Traditional tight tourniquets are not recommended as they can be extremely painful and very dangerous if left on for too long causing gangrenous limbs.

The CWRC keeper, Lakhiram Das, 38, was bitten on his right hand, late evening on August 30, outside his house following his return from the field. He was rushed to the centre by his colleagues who accompanied him.

“We noticed Lakhi showing symptoms of envenomation like drooping eyelids and respiratory failure within half an hour of the incident” said Dr Phulmoni Gogoi, CWRC veterinarian. “We took him to the Government Hospital at Jorhat about 80-90 kms away, where he was administered with polyvalent anti-venom. He required a ventilator, so he was moved to the Air Force Hospital in Jorhat, where his breathing was aided for 3 days, after which his condition stabilised.”

Das has now been discharged from the ICU but is still suffering from the effects of the venom; he has got a pharyngeal problem, and is still weak.

“The polyvalent serum administered to Lakhiram Das effectively neutralises venom of the four most-common venomous snake species that account for more than 95% of snake-bite related deaths in India – common cobra, common krait, Russel’s viper and saw-scaled viper. However, in the absence of monovalent anti-venoms (which need special precautions for administration as monovalent anti-venoms are species-specific) that are still unavailable in India, polyvalent serums are used as alternatives for bites by other venomous snake species including black krait, monocellate cobras etc,” said Louies.

“The problem of not having adequate antivenom to deal with other Indian species as well as the fact that there can be significant differences in venoms in the same species from different parts of the country is emerging in a big way,” says the renowned herpetologist Romulus Whitaker.

“Lakhiram seems to have survived thanks to rapid action by all concerned and the realisation that assisted breathing is what he needed. As long as a hundred years ago this was recognized and there is at least one case of krait or cobra bite on record from pre-antivenom days where a gravely affected patient was kept alive simply by assisted breathing until the body’s own defenses had neurtralised the venom,” added Whitaker.