Snakebite injuries in Hong Kong: A 10‐year review

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Abstract
Background: Snakebite envenomation is a priority neglected tropical disease according to the World Health Organization. To address the issue, enhanced epidemiological evidence in endemic countries and an improved availability of snake antivenoms were proposed. Objectives: To understand the local epidemiology of snakebite cases, promote awareness of potential snakebite injuries in our locality, and provide insight on the presentation and management of these injuries. Methods: An epidemiological study reviewing cases between 2012 and 2021 in our Hong Kong Poison Information Center (HKPIC) database was conducted. Snakebite cases from 1 January 2012, to 31 December 2021, were identified from the HKPIC database, by using “snake” as the poison name or category. Results: A total of 592 cases were captured, approximately 59 cases per year. The top recognised offending snake was Green Pit Viper ( Trimeresurus albolabris ) (71.8%) followed by Chinese Cobra ( Naja atra ) (3.2%), and Many‐Banded Krait ( Bungarus multicinctus ) (2.2%). Native non‐venomous or minimally venomous snakes accounted for 4.1% and pet snakes for 2.5%. Snakebites most often occur during summer and autumn, between 7 and 9PM, in rural neighborhoods. Work‐related bites accounted for 19.3% of cases. Local cytotoxicity was seen in 88%, haemotoxicity in 45.3%, and neurotoxicity in 1.5% cases. Antivenom was administered in 58.1% cases, the acute allergic reaction rate was 3.5%. Conclusions: Life‐threatening severe cytotoxicity, haemotoxicity, and neurotoxicity were observed following native snakebites in Hong Kong. GPV was the commonest observed snakebite in our locality, accounting for 71.8% cases. The general principles of prompt medical care, snake envenomation recognition, and consideration of early antivenom treatment are all critical steps in reducing snakebite mortality and morbidity.

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