Snake Bite case monitoring and records keeping

AMO / MO s should submit required documents by the resepctive Health Facilitites

1. Vijayanagara District Surveillance Unit SBPC Programme Review Meeting Dated: 31-01-2025

2. The Snake Bite Prevention and Control (SBPC) program.

3. Taluka Taluka Wise Animal Bite - Snake Bite cases reported for the past three Years 2022 2023 2024 Cases Deaths Cases Deaths Deaths occurred at Cases Deaths Deaths occurred at Hadagalli 60 41 52 2 1) BITHYANA THANDA 2) Thippapura Hagaribommanahalli 2 6 31   Harapanahalli 6 12 1 BASAVANAHALU 44 1 1) Kammatathahalli Hosapete 6 36   KOTTURU 1 3 1 Chiribi 2 1 1) Kandagal Kudligi 2 5 1 1) Gudekota Other Dist 1 7   Total 69 71 2 177 5  

4. Vijayanagara District Snake Bite death cases line list from 01-04-2024 to 31-12-2024 SL No Patient Name Gender Age Village Or Ward Sub District District State Patient Address Provisional Diagnosis Name Dateofdeath Batch Submitteddate Facility Name 1 Chandrappa M Male 27 Years Gudekota Kudligi Vijayanagar Karnataka Behind police station Near high school Animal Bite - Snake Bite 18/10/2024 23/10/2024 Gudekota(PHC) 2 Nagaraja Male 36 Years Kammatathahalli Harapanahalli Vijayanagar Karnataka kammathahalli camp phone no 8792148891 nandhi kamba road Animal Bite - Snake Bite 17/06/2024 19/06/2024 Kammathalli(PHC) 3 Bharathi Chandru Female 32 Years Thippapura Hadagalli Vijayanagar Karnataka Thippapura Village Animal Bite - Snake Bite 26/12/2024 31/12/2024 HADAGALI GH(SDH) 4 Manu R Male 17 Years BITHYANA THANDA Hadagalli Vijayanagar Karnataka 9636898065 C/o. Chandra Naik house, s/o. Rama Naik Kalvi Thanda sub centre Animal Bite - Snake Bite 23/07/2024 29/07/2024 Hakkandi(PHC) 5 Gowramma Female 80 Years Kandagal KOTTURU Vijayanagar Karnataka Kandagal Village , Thimalapura PHC, Kottur Tq Animal Bite - Snake Bite 28/09/2024 30/09/2024 KUDILGI GH(SDH)

5. SL No Alert Id Alert Date Sub District Syndrome/ Disease Updated Date Date of snake bite Date of Death Preliminary Information: 1 2973820245200048-EA 28/12/2024 Hadagalli Animal Bite - Snake Bite 2/1/2025 26/12/2024 26/12/2024 Smt. Bharathi Hosurappanavara, wife of Chandrappa, a resident of Thippapura village, was bitten by a snake on 26/12/2024 at approximately 12:45 PM while picking flowers near a field in front of her house. The bite occurred on her lower limb. Unaware that it was a snake bite, the victim assumed it was an insect sting and paused her work. She informed her family over the phone about the incident. When the family arrived, they observed suspicious symptoms, including swelling in the leg and bleeding at the bite site. They immediately transported her in their private vehicle to the nearest public hospital in Huvinahadagali, located 3 km away. The hospital referred her to GIMS Gadag for further treatment. However, according to the patient’s attendant, the victim likely passed away en route between 2:00 PM and 3:15 PM. Despite reaching GIMS Gadag, she was declared deceased upon arrival. 2 2973820244200033-EA 19/10/2024 Kudligi Animal Bite - Snake Bite 23/10/2024 17/10/2024 18/10/2024 Chandrappa M, a 27-year-old male from Gudekote, Kudligi Taluk, Vijayanagara District, experienced an alleged snake bite on 17/10/2024 around 6:30 PM while working on his farm. He immediately visited PHC Gudekote, where he was found asymptomatic. His vital signs were stable, with BP 120/70, PR 82 bpm, SpO2 99%, and RR 16 cpm, and his systemic examination was normal. Despite being advised to get admitted and referred to a tertiary center for observation, he and his attendants declined to get treatment, opting to return home. Chandrappa continued to be asymptomatic and went to bed as usual. However, on the morning of 18/10/2024, at around 6:30 AM, when his family tried to wake him, he was unresponsive and was declared dead. An autopsy was conducted to determine the cause of death. 3 2973820244000030-EA 30/09/2024 KOTTURU Animal Bite - Snake Bite 1/10/2024 28/09/2024 28/09/2024 Smt. Gouramma, wife of Late Revanasiddappa and a resident of Kandagallu village under the jurisdiction of PHC Thimmalapur, Kudligi Taluka, was bitten by a snake on 28-09-2024 at around 12:30 PM in front of her house. She sought treatment from a local village healer , but the medicine provided was ineffective. She was later admitted to Kudligi General Hospital at 3:30 PM, where her body did not respond to treatment, due to her care takers negligency she passed away at 4:00 PM the same day. Following this tragic incident, the local health staff conducted Information, Education, and Communication (IEC) activities in the community, educating people on the proper DOs and DON’Ts after a snakebite. These activities stressed the importance of seeking immediate medical care and avoiding unproven traditional remedies. 4 2973820242500013-EA 19/06/2024 Harapanahalli Animal Bite - Snake Bite 20/06/2024 17/06/2024 17/06/2024 One Snake bite death case reported at Kammathalli Village & Hobli , PHC : Kanchikere Harapanahalli Taluka on 17-06-2024 at 07:00 PM Deceased Name : Nagaraju , Male , 35 Years, Snake Bite Time: Around 06:30 PM, Site of snake bite: Left Lower limb, Geographical location where the victim was bitten : near house while collecting fodder for cattle’s, Cause of Death as per Form 04 A submitted by MO : Sudden cardio respirator arrest & Asphyxia due to snake bite 5 --- --- Hadagali Animal Bite - Snake Bite --- 23/07/2024 23/07/2024 Manu R 17 years BITHYANA THANDA, Hakkandi PHC Hadagali Tq

6. Documents to Be Maintained After Snake Bite Deaths Proper documentation is crucial for legal, administrative, and medical purposes. Below is a list of documents to be maintained: 1. Medical Records: Patient’s Case History : Detailes of symptoms and Signs, time of bite, first aid provided, and medical interventions if any Before coming to the Hospital. Treatment Records: Time of arrival at the hospital. Regular Assessment of condition.( For Neurological,Hemotological (20min WBCT)) Administration of antivenom: dose, time,reactions and response. Supportive treatments provided (e.g., oxygen, ventilator support). Monitoring Notes : Regular documentation of vital signs and clinical progression as per Case Investigations Form (CIF) 2. Death Certificate: Issued by the attending medical officer stating the cause of death (e.g., "snakebite envenomation"). (Form 04- Institutional Death & Form 04A –Non Institutional Death) Includes details like date, time, and location of death.

7. 3. Postmortem Report (if conducted): 4. Police Intimation Report: Mandatory reporting to local authorities in snakebite deaths for legal purposes. Copy of the written communication sent to the police. 5. Incident Report: Documentation of where and how the bite occurred. Witness statements (if available). Details of snake identification, if known (e.g., description or photograph). 6. Consent and Counselling Records: Informed Consent Counselling documentation provided to the family about the patient’s condition and prognosis.

8. 7. Epidemiological Data: Record maintained for public health purposes (e.g., type of snake, geographical location, season). Submitted to health authorities for surveillance and planning preventive measures. 8. Medicolegal Case (MLC) Records: Any MLC number issued for the case. Details of interaction with legal authorities, if required. 9. Hospital Mortuary Register: Entry of the death in the mortuary or hospital death register with details like name, age, sex, time, and cause of death. 10. Family Communication Records: Documentation of discussions with the patient’s family regarding the treatment provided and the circumstances of death. Acknowledgment from family members for the release of the body (if applicable). Note: Maintaining these documents ensures accountability, facilitates legal processes, and supports public health reporting for improved snakebite management strategies

9. Micro Plan for Snake Bite Control 1. Situation Analysis: Identify high-risk areas (snake-prone regions, waterlogged areas, farmlands, forests). Review epidemiological data (number of snakebite cases and deaths in the past year). Assess availability of resources like antivenom, trained staff.

10. 2. Key Activities: Community Mapping : Identify villages and hamlets with high snakebite risks. Mark snake habitats, like water bodies and agricultural lands. Training : Train healthcare providers (doctors, nurses, and ASHAs) in snakebite management and antivenom administration. Train community volunteers in first-aid techniques,measures to avoid snake bite like Using Gum Boots,Torch etc Stock Management : Ensure adequate availability of antivenom and essential medicines in healthcare facilities. Establish protocols for timely restocking. Referral System : Strengthen referral networks to higher facilities for advanced care. Establish transport systems (ambulances, community vehicles).

11. 3. Timeline: Month-wise plan for IEC activities, training sessions, and resource distribution . 4. Resource Allocation: Manpower : Assign teams for community education, training, and logistics management. Partnerships : Collaborate with government programs (e.g., National Vector Borne Disease Control Program),RDPR and NGOs. Community-Based Monitoring Committees : Establish village-level committees to monitor snakebite incidents, organize awareness programs, and ensure rapid reporting. 5. Monitoring and Evaluation: Indicators : Reduction in snakebite cases and deaths. Increase in number of Timely Hospital admissions. Community knowledge levels (evaluated through surveys). Reporting : Regular reports from healthcare centers on snakebite cases and outcomes(IHIP). Sock status of ASV Periodic reviews and adjustments to the micro plan based on feedback.

12. 6. Emergency Response Units Rapid Snakebite Response Teams : Equip these teams with transport, antivenom, and emergency kits for deployment in remote areas. 7. Antivenom Distribution Hubs i ) Establish regional hubs with adequate antivenom stocks. ii) Use a just-in-time inventory system to prevent overstocking or expiry( Re adjustment among the Facilities). 8. Telemedicine and Helplines Set up a 24/7 Telemedicine Snakebite Helpline where rural healthcare workers can consult specialists. Use ( E sanieevani Consultation) video calls for remote patient evaluation and advice on stabilization.

13. The Following Documents to be submit to higher officers Incident Report (Preliminary Investigation Report) by AMO/MO Police Intimation Report Case Investigation Form (CIF-as per Format) Death certificate (Form 04 or Form 04 A) Sample Referral Form (If any sample collected)

14. If a snake bite death case has been reported at the health facility, please submit the following documents: Signed Copy: Incident Report/Case Summary: This should include details about the snake bite, such as the time, location, and circumstances. Medical Records: Attach the patient's medical history, symptoms, diagnosis, treatment provided, and any referrals. ( Case Investigation Form (CIF) as per Format) Death Certificate: A formal death certificate with the cause of death clearly stating snake venom. Autopsy Report (if applicable): If an autopsy was performed, include the report. Soft Copy: ([email protected]) Scanned versions of the signed documents listed above. Photographs (if any) related to the incident, such as images of the wound. Reports from health authorities or other relevant bodies, such as antidote administration logs, if available. Please submit these documents to the District Surveillance Unit, Vijayanagara District for case reporting.

15. By combining effective IEC activities with a structured micro plan, the incidence and impact of snake bites can be reduced significantly in the community.