Snakebite Threat Lags in U.S., but Still Remains

Snakebites in the U.S. are seldom deadly -- but invariably excruciating.

November 6, 2008, 5:44 PM

Nov. 7, 2008— -- "I feel pretty good, considering what happened," said 21-year-old Eric Couch of Hazard, Ky., as he recovered at the University of Kentucky Medical Center on June 30. "It's a sucky experience, I can say that."

Couch, who works in salvage, was bitten on his left hand by a copperhead rattlesnake while moving some bricks. The strike was laden with venom -- a fact that soon became clear to Couch.

"After it bit me, it took it about 15 minutes for it to kick in," he said. "I felt like I was higher than a kite. I was wobbling all over, and everything was going in circles."

Couch immediately went to the hospital, where treatment for his bite began. He was later transported to the University of Kentucky Medical Center for further treatment.

Fortunately, Couch's quick thinking saved his life. But the bite came with serious potential consequences.

"They said two things could have happened: It could have caused me to get my hand amputated, or it could have killed me," he said. "So I said, 'Let's get this taken care of; I don't want to get my hand amputated, and I'm not ready to die.'"

While Couch's experience was harrowing, it is fortunately one that relatively few people in the United States will experience. Between 7,000 and 8,000 people are bitten by venomous snakes in the U.S. every year, according to the U.S. Centers for Disease Control and Prevention. Of those, only about 1 in 500 will die from the bite they receive. In fact, deaths by snakebite rarely exceed 10 in any given year in this country.

Such is not the case throughout the rest of the world. In a study released Monday in the journal PLoS Medicine, Sri Lankan researchers said a conservative estimate is that 421,000 people worldwide fall victim to poisonous snakebites each year -- and at least 20,000 die.

But the study authors noted that the figures could run as high as 1.8 million venomous bites -- and 94,000 deaths.

Many of the bites occur in countries like India, Sri Lanka and Vietnam -- countries that not only have larger populations of venomous snakes, but which also have poorer rural populations that may not have access to proper emergency medical treatment.

Dr. Ryan Stanton -- the emergency medicine physician who treated Couch at the University of Kentucky Medical Center -- said that, by contrast, care for snakebites in the U.S. is nearly always close by. He added that, even though medical centers in the U.S. see a fairly large number of snakebites every year -- "and there are a lot of bites we don't see," he notes -- only a few of these victims die if they are treated quickly.

"So, this is a very low-fatality event; it's very rare for someone to die," he said. "But it is certainly severe enough for someone to die."

Although most who are bitten do not die, venomous snakes are widely feared. Ed Smith, a biologist at the Smithsonian's National Zoo in Washington, D.C., has had his own experience with being "envenomated" -- what most would call getting bitten by a poisonous snake.

In Smith's case, the snake in question was a rattler.

"I was in my early 20s and working at a zoo," he recalled, adding that, because of his relatively young age and good health, "It was a very good time for a bite."

Good time or not, Smith said the bite was extremely painful -- "like sticking a soldering iron in your arm and keeping it there for however long," he chuckled.

Smith said he doesn't like to dwell so much on snakebites for the very reason that he feels these usually gentle creatures have been demonized for this aspect of their behavior.

"From my perspective, they are one of the pinnacles of evolution ... in that they are so elegantly fashioned to do the work that they do," he said. "These are really amazing creatures, and they're under threat from encroachment and also a bad-spirited nature among people that consider them to be vermin that require eradication."

Importance of Rapid Attention

Surprisingly, a number of people who get bitten by snakes do not seek immediate medical attention. And while Stanton said that someone who has been bitten by a snake should not panic, quick action is the best strategy.

This action, he added, should not begin with chasing down the snake that bit you.

"You should not try to get the snake and bring it to the hospital; we get a lot of secondary bites that way," he said.

Once in the hospital, a bite victim's prognosis is generally very good. Stanton said that in many cases, the snake is not poisonous -- and even in the case of poisonous snakes, victims do not always need anti-venom.

But he added that the best policy when it comes to snakebites is to avoid them altogether -- a simple proposition for most.

"In terms of avoiding them, people just need to be aware of where they're walking," he said. "If they see a snake, they should not try to pick it up or get close and poke it with a stick. Most of the interactions come when people try to get too close."

Smith agreed.

"Venomous snakes are dangerous no more or no less than any kind of inappropriate behavior on a tall bridge or in heavy traffic," he said.

"If you're in an area that really does have a high population of venomous snakes, just pay attention," he added. "Look where you put your hands and feet, and stay on the path. Any rattlesnake that's seen is not going to be advancing on you."

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