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The epidemiology of snakebites in tropical regions differs considerably from that seen in more temperate climates. In general, the absolute number of venomous snakes is higher in the tropics, and snakes are often located in areas of high population density. The prevalence of bites is also higher due to differences in agricultural and hunting practices, frequent flooding, lack of adequate footwear in many locations, and housing that allows access of snakes into living areas. The annual mortality of snakebite in India may exceed 20,000. Snakebite is said to be the 5th most common cause of death in Myanmar. In some indigenous populations in South America, up to 20% of adult deaths are from snakebite. Places where snakebites are common are often in remote locations where medical care may not be immediately available. Signs and symptoms depend on the type of envenomation and the amount of toxin injected. Local pain, swelling, and blistering are seen with many snakebites. Clotting disturbances, frank hemorrhage, and shock are seen with many viper bites, while neurotoxicity can be seen with elapid and sea snake bites.
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Management and Disposition
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Patients should be reassured and kept as immobile as possible. Any involved ...