Snakebite-reappraisal of the situation in Eastern Nepal.

Four thousand and seventy eight cases of snakebite, occurring between January and December 2000, were analysed for clinical and epidemiological features. Cases of about 379 had features of envenoming and 81 died. All the victims with systemic envenoming had neurotoxicity. No case with coagulopathy was recorded. Snakebite was more frequent between the ages of 10 and 40 years (76%) and in males (73%). The majority (80%) of the snakebites were observed during the monsoon. Seventy percent of the bites with clinical features of envenoming occurred between 1400 and 2200 h. Five thousand eight hundred and fifty nine vials of polyvalent antisnake venom were used. Case fatality rate varied in the ten centres surveyed. It was as low as 3% in some to as high as 58% in others. Overall death rate among all snakebite cases was 2%.