Snakebite injuries in Hong Kong: A 10‐year review

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.