Snake bites

Snakebite envenoming is a neglected public health challenge of compelling importance in many regions of the world, particularly sub-Saharan Africa, Asia, Latin America and Papua New Guinea. Addressing the problem of snakebite effectively demands an integrated multifocal approach, targeting complex problems and involving many participants. It must comprise:
(a) Acquisition of reliable information on the incidence and mortality attributable to snakebite envenoming, and the number of people left with permanent sequelae.
(b) Improvements in production of effective and safe antivenoms, through strategies aimed at strengthening the technological capacity of antivenom manufacturing laboratories.
(c) Increasing the capacity of low-income countries to produce specific immunogens (snake venoms) locally, and to perform their own quality control of antivenoms.
(d) Commitments from regional producers to manufacture antivenoms for countries where antivenom production is not currently feasible.
(e) Implementation of financial initiatives guaranteeing the acquisition of adequate volumes of antivenom at affordable prices in low-income countries.
(f) Performance of collaborative studies on the safety and effectiveness of antivenoms assessed preclinically and by properly designed clinical trials.
(g) Development of antivenom distribution programmes tailored to the real needs and epidemiological situations of rural areas in each country.
(h) Permanent training programmes for health staff, particularly in rural areas where snakebites are frequent.
(i) Implementation of programmes to support those people whose snakebites resulted in chronic disabilities.
(j) Preventive and educational programmes at the community level, with the active involvement of local organizations and employing modern methods of health promotion.
Such an integrated approach, currently being fostered by the Global Snake Bite Initiative of the International Society on Toxinology and by theWorld Health Organization, will help to
alleviate the enormous burden of human suffering inflicted by snakebite envenoming.

Animal and human bite wounds represent a significant global health issue. In the United States, animal and human bites are a very common health issue, causing significant morbidity and even, in rare scenarios, mortality. Most animal bite wounds in the United States are caused by dogs, with cat bites being a distant second. Human bite wounds constitute a dominant subset of all bite wounds. Several studies of bite wounds have reported improved outcomes with early diagnosis and immediate treatment. However, the available literature on the initial treatment provides a plethora of conflicting opinions and results. In this review, our aim was to identify and assess the current evidence on the management of animal (dog, cat, insects, scorpions, and snakes) and human bite wounds. Review article, level III.