Epidemiologic, clinical, and therapeutic aspects of formally identified Echis romani bites in northern Cameroon.

<h4>Background</h4>Species of the genus Echis, particularly those of the 'ocellatus' group, are responsible for the majority of snakebite envenomations and deaths in the savannas of sub-Saharan Africa. In a clinical study conducted in Cameroon, we treated a series of patients b...

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Main Authors: Jean-Philippe Chippaux, Pierre Amta, Yoann Madec, Rodrigue Ntone, Gaëlle Noël, Pedro Clauteaux, Yap Boum Ii, Armand S Nkwescheu, Fabien Taieb
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-07-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://doi.org/10.1371/journal.pntd.0013195
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author Jean-Philippe Chippaux
Pierre Amta
Yoann Madec
Rodrigue Ntone
Gaëlle Noël
Pedro Clauteaux
Yap Boum Ii
Armand S Nkwescheu
Fabien Taieb
author_facet Jean-Philippe Chippaux
Pierre Amta
Yoann Madec
Rodrigue Ntone
Gaëlle Noël
Pedro Clauteaux
Yap Boum Ii
Armand S Nkwescheu
Fabien Taieb
author_sort Jean-Philippe Chippaux
collection DOAJ
description <h4>Background</h4>Species of the genus Echis, particularly those of the 'ocellatus' group, are responsible for the majority of snakebite envenomations and deaths in the savannas of sub-Saharan Africa. In a clinical study conducted in Cameroon, we treated a series of patients bitten by formally identified E. romani. The clinical outcomes are described and discussed.<h4>Methodology/principal findings</h4>Specimens brought in by the victim were identified by a herpetologist. Clinical description and therapeutic management followed a standardized protocol applied by trained physicians. We included 92 patients, 95% of whom (n = 87) were envenomated. More than one third of the bites occurred during agricultural work, and one quarter in the victim's home. The bite site was the foot in 48 victims (52%) and the hand in 40 others (43%), mostly children and teenagers. Cytotoxic syndrome was observed in 84 of the 87 envenomated patients (97%). Hemostasis disorders were observed in 78 patients (90%), 38 of whom (44%) experienced bleeding during hospitalization. In 5 of the latter (13%), the bleeding recurred, whereas it had stopped after antivenom administration. A further 7 patients, who were not bleeding on arrival, experienced late bleeding despite antivenom administration. Four patients (4.3%), including one pregnant woman, died. All were bleeding on arrival. Finally, 2 patients (2.2%) had permanent sequelae of moderate severity.<h4>Conclusion/significance</h4>This study confirms the frequency and severity of hemorrhagic complications in E. romani envenomation. Lethality remains high despite antivenom treatment. Cytotoxic syndromes, present in 95% of victims, rarely progress to extensive necrosis.
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spelling doaj-art-0bf412782ddc438982b1b14f2a3e14852025-08-20T02:49:53ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352025-07-01197e001319510.1371/journal.pntd.0013195Epidemiologic, clinical, and therapeutic aspects of formally identified Echis romani bites in northern Cameroon.Jean-Philippe ChippauxPierre AmtaYoann MadecRodrigue NtoneGaëlle NoëlPedro ClauteauxYap Boum IiArmand S NkwescheuFabien Taieb<h4>Background</h4>Species of the genus Echis, particularly those of the 'ocellatus' group, are responsible for the majority of snakebite envenomations and deaths in the savannas of sub-Saharan Africa. In a clinical study conducted in Cameroon, we treated a series of patients bitten by formally identified E. romani. The clinical outcomes are described and discussed.<h4>Methodology/principal findings</h4>Specimens brought in by the victim were identified by a herpetologist. Clinical description and therapeutic management followed a standardized protocol applied by trained physicians. We included 92 patients, 95% of whom (n = 87) were envenomated. More than one third of the bites occurred during agricultural work, and one quarter in the victim's home. The bite site was the foot in 48 victims (52%) and the hand in 40 others (43%), mostly children and teenagers. Cytotoxic syndrome was observed in 84 of the 87 envenomated patients (97%). Hemostasis disorders were observed in 78 patients (90%), 38 of whom (44%) experienced bleeding during hospitalization. In 5 of the latter (13%), the bleeding recurred, whereas it had stopped after antivenom administration. A further 7 patients, who were not bleeding on arrival, experienced late bleeding despite antivenom administration. Four patients (4.3%), including one pregnant woman, died. All were bleeding on arrival. Finally, 2 patients (2.2%) had permanent sequelae of moderate severity.<h4>Conclusion/significance</h4>This study confirms the frequency and severity of hemorrhagic complications in E. romani envenomation. Lethality remains high despite antivenom treatment. Cytotoxic syndromes, present in 95% of victims, rarely progress to extensive necrosis.https://doi.org/10.1371/journal.pntd.0013195
spellingShingle Jean-Philippe Chippaux
Pierre Amta
Yoann Madec
Rodrigue Ntone
Gaëlle Noël
Pedro Clauteaux
Yap Boum Ii
Armand S Nkwescheu
Fabien Taieb
Epidemiologic, clinical, and therapeutic aspects of formally identified Echis romani bites in northern Cameroon.
PLoS Neglected Tropical Diseases
title Epidemiologic, clinical, and therapeutic aspects of formally identified Echis romani bites in northern Cameroon.
title_full Epidemiologic, clinical, and therapeutic aspects of formally identified Echis romani bites in northern Cameroon.
title_fullStr Epidemiologic, clinical, and therapeutic aspects of formally identified Echis romani bites in northern Cameroon.
title_full_unstemmed Epidemiologic, clinical, and therapeutic aspects of formally identified Echis romani bites in northern Cameroon.
title_short Epidemiologic, clinical, and therapeutic aspects of formally identified Echis romani bites in northern Cameroon.
title_sort epidemiologic clinical and therapeutic aspects of formally identified echis romani bites in northern cameroon
url https://doi.org/10.1371/journal.pntd.0013195
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