Characteristics and relative numbers of lethal snake bite cases in medicolegal practice in central Myanmar - a five year study

dc.contributor.authorThein, C.M.
dc.contributor.authorByard, R.W.
dc.date.issued2019
dc.description.abstractClinical and pathological case files of lethal snakebites were reviewed from the Magway Region General Hospital, Magway, Myanmar, over a five-year period (January 2013 December 2017). A total of 2069 post-mortem examinations were performed which included 84 cases of lethal snake bite (4.1%). The annual numbers ranged from 10 out of a total of 268 autopsies in 2013 (3.7%), to 31 out of a total of 501 autopsies in 2016 (6.2%). There were 54 males (64%) and 30 females (36%) (M:F = 1.9:1; age range 5-75yrs, mean 33yrs). The most common time for lethal envenomation was August (16/84-19%), the middle of the monsoon season. 45/84 (54%) had acute renal failure, 27/84 (32%) were shocked, and the remaining 12/84 (14%) had disseminated intravascular coagulation. Twenty cases (24%) died within 24 h after envenomation. Fang marks were identified on the legs (either right or left) in 73/84 cases (87%) and on the arms in five cases (6%). The predominant findings at autopsy were of acute renal injury (82/84-98%), pituitary haemorrhage/necrosis (36/84-43%), and adrenal gland haemorrhage (30/84-36%). Despite the reduction in fatalities over the years snakebite from Russell's viper in particular remains an important contributor to mortality in central Myanmar despite the availability of antivenom.
dc.description.statementofresponsibilityChan Myae Thein, Roger W. Byard
dc.identifier.citationJournal of Forensic and Legal Medicine, 2019; 63:52-55
dc.identifier.doi10.1016/j.jflm.2019.03.005
dc.identifier.issn1752-928X
dc.identifier.issn1878-7487
dc.identifier.orcidByard, R.W. [0000-0002-0524-5942]
dc.identifier.urihttp://hdl.handle.net/2440/120818
dc.language.isoen
dc.publisherElsevier
dc.rights© 2019 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
dc.source.urihttps://doi.org/10.1016/j.jflm.2019.03.005
dc.subjectSnake bite; Myanmar; forensic; death; Russell's viper
dc.titleCharacteristics and relative numbers of lethal snake bite cases in medicolegal practice in central Myanmar - a five year study
dc.typeJournal article
pubs.publication-statusPublished

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