Antivenom vials available in Delhi hospitals, snake bite cases reported from remote areas: Experts

By Shalini Bhardwaj
New Delhi [India], October 4 : At least 12 persons died due to various ailments, mostly snake bites at a government hospital in Maharashtra's Nanded early this week. According to media reports, there was a shortage of medicines in the hospital.
However, most of the hospitals in the national capital were found to have medicines and antivenoms for the treatment of snake bites. The challenge in treating snake bites is that in most cases patients are completely unaware.
According to the experts, Delhi reports a lower number of snake bite cases.
"Snake bite cases are more reported in remote areas, we usually see one or two cases of snake bite in Delhi during the rainy season," said Dr Akshay Kumar, Associate Professor, Department of Emergency Medicine, AIIMS, Delhi.
"If a person comes to the hospital for snake bite treatment, then we give antivenom. The quantity of vials to be given to the patient could be ten, twenty, or thirty vials."
"We have enough procurement of antivenoms in RML Hospital in comparison to the cases we get every year. But investigating whether a snake has bitten is sometimes very challenging because patients are completely unaware in most of the cases," said Dr Ajay Shukla, Director and MS, RML Hospital.
Currently, Lok Nayak Jai Prakash (LNJP) has in stock approximately 90 vials of antivenom.
"Only ten vials of antivenom used during floods in Delhi and 90 more left with us. But we get a very low number of snake bite cases in Delhi," said Dr Suresh Kumar, Medical Director, LNJP Hospital.
"Many times, it's difficult to procure Anti-Snake Venom (ASV) from private medical stores in Delhi if the patient comes in odd hours. Most of the big hospitals keep 20 vials in their stores, which are replaced once finished, especially government and big private hospitals. Due to its short expiration period, private chemists avoid keeping ASV," said Dr Dhiren Gupta, Pediatrics Pulmonologist, Sir Ganga Ram Hospital.
On the treatment of snake bites, he said,"Anti Snake Venom (ASV) administration is the only definitive treatment which acts by neutralising the circulating venom in the blood and tissue fluid. Early administration of ASV is therefore essential to neutralise the maximum circulating venom before it is fixed in the tissues."
"It is suggested that the early institution of ASV is beneficial to prevent complications like kidney injury and respiratory paralysis. The delay in ASV administration (after 6 to 12 hours ) increases the incidence of kidney injury and respiratory paralysis. Hence it is important to make the availability of ASV universal in the areas where the incidence of snake bite is high and to adequately train the health care providers about the appropriate management of patients with snake bite envenomation in order to decrease morbidity and mortality," Dr Dhiren Gupta said.
"The patient needs to be taken to emergency treatment, depending on the species of snake," said Dr Roli Munshi, Paediatrician.
At least 24 persons, including 12 infants died at a government hospital in Maharashtra's Nanded allegedly due to a shortage of medicines.
Talking to ANI on October 2, Dr Shyamrao Wakode of the Government Medical College, Nanded, said, "Around 12 children died in the last 24 hours...12 adults also died due to various ailments (snake bites, arsenic and phosphorus poisoning etc.,). Due to transfers of various staff, there was some difficulty for us...We were supposed to buy medicines from the Haffkine Institute but that also didn't happen....Also, patients come from far off to this hospital and there were many patients whose sanctioned budget also got disturbed...,".