Survey of Snakebite by Protobothrops mucrosquamatus and Viridovipera stejnegeri, Taiwan, 2008

DOI: 10.6525/TEB.20170509.33(9).002

Chien-Hsin Liu, Wen-Chin Hsieh

2017 Vol.33 NO.9

Correspondence Author: Chien-Hsin Liu

  • Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan


Both Protobothrops mucrosquamatus and Viridovipera stejnegeri are the major hemorrhagic, venomous snake species in Taiwan. The number of bitten cases by them were also higher than those bitten by the other 4 venomous snakes in Taiwan. This study attempts to assess the epidemiology of snakebite cases caused by P. mucrosquamatus and V. stejnegeri in Taiwan, annual antivenom dosage consumption, the side effects after administration of antivenom, and prognosis. The questionnaires for snakebite cases seeking medical care in 2008 were collected from medical centers and district hospitals. Among 78 cases, 36 were bitten by P. mucrosquamatus, and 42 bitten by V. stejnegeri. Twenty-two (28%) cases aged 51–60 years were mostly affected. The most often bitten site was extremities, especially the upper-limbs (including palms) with 43 (55%) cases, followed by the lower-limbs (including soles) with 32 (41%) cases. Among all patients, 74% of them can be delivered to hospital within one hour for medical treatment, and 43 (55%) bitten cases were hospitalized. The average duration of hospitalization was 3.98 days. The total antivenom consumption were 282 doses, 28 (36%) cases received one dose. One case bitten by P. mucrosquamatus received 17 doses. The rate of side effects was 8%, and no serious adverse event was observed. This study showed that the antivenom manufactured by Taiwan Centers for Disease Control provides safe and effective treatment for patients bitten by P. mucrosquamatus and V. stejnegeri.