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TUESDAY, Nov. 4, 2014 (HealthDay News) -- DNA tests can reliably identify the type of snake that has bitten a person and could save the lives of many people in countries with deadly venomous snakes, new research reports.

Experts found that if snake DNA could be detected on swabs taken from fang marks on victims, the species of snake could be pinpointed every time. The study was scheduled to be presented Tuesday at the annual meeting of the American Society of Tropical Medicine and Hygiene in New Orleans.

"These findings represent a significant step toward improving care for patients in areas of the world where snakebites constitute a massive but neglected health risk," study director Dr. Francois Chappuis, chief of the division of tropical and humanitarian medicine at Geneva University Hospitals in Switzerland, said in a society news release.

"This DNA test may hasten more effective bedside diagnostics for snakebite victims, giving them a better chance of surviving and making a full recovery," Chappuis added.

The researchers studied snakebite victims in Nepal and found that snake DNA could be obtained from about one in four of the bite wounds. One reason why DNA could not be collected was the use of folk or home remedies at the bite site before a patient was taken to a medical clinic.

There are no reliable numbers, but a 2008 study estimated that there are at least 421,000 venomous snakebites, resulting in up to 94,000 deaths, worldwide each year. However, experts believe those figures are much lower than the actual numbers.

It's believed that several million people may be bitten by venomous snakes each year, and hundreds of thousands die or are permanently disabled due to limb amputation or deformation that occurs because victims don't get treatment or receive it too late.

"People bitten by snakes in South Asia often do not seek treatment at a medical facility, and if they do, the vast majority don't take the snake to clinics, although it is often killed, and can't identify the species that bit them. Yet knowing the species of snake is critical to determining the best course of treatment," Chappuis said.

Dr. Sanjib Sharma is a professor of medicine at the B.P. Koirala Institute of Health Sciences in Nepal and the study's principal investigator. "We need new tools in order to save more lives," he said in the news release.

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What Snake Caused That Bite? New DNA Test Might Tell

DNA tests on newly-discovered, nearly extinct plants have given researchers the most complete picture yet of how the critically-endangered kakabeak (Clianthus maximus, or ngutukk in te reo) is clinging to survival on the inaccessible cliffs, bluffs and ledges of New Zealands wild back-country. The tests, conducted by Dr Gary Houliston, a plant geneticist at Landcare Research, found distinct groups of plants in clearly defined areas. The Forest Lifeforce Restoration (FLR) Trust, a conservation trust working with the Department of Conservation (DOC) to prevent the extinction of the kakabeak, will use this information to re-stock conservation land with genetically diverse plants it is rearing from wild seed.

Imported pests such as rabbits and deer have impacted wild populations of Kakabeak severely and the species now holds New Zealands highest possible threatened plant ranking: Nationally Critical. Although grown widely in gardens, domestic kakabeak have limited genetic variation and therefore little genetic value.

Until recently only about 110 naturally-seeded kakabeak were known to exist in the wild but earlier this year a DOC-led field trip to Ruakituri, a part of inland Hawkes Bay where only six wild plants had previously been known to exist, yielded 18 more. DOC ranger Helen Jonas said: "The Department had four people searching for kakabeak during the flowering period last season. The plan is to follow this up in the new year with aerial searching, using a helicopter to continue to look for this rare and important species."

Tests on these most recent discoveries have resulted in the most complete genetic picture of the nearly extinct New Zealand native that anyone has ever had. more

"We now have DNA data from pretty much every accessible wild kakabeak known to us," Dr Houliston said. "This allows us to make sensible, science-based decisions about what mix of plants from FLRTs seed stock should be used in restoration plantings."

FLRT forest manager Pete Shaw said the trick would be to strengthen the genetic pool of each distinct group by introducing young plants with different genetic composition. "The genetic diversity of any plant population is a good indicator of that populations strength," Shaw said. "The fact that these plants were out there highlights the value of continued field searching."

FLRT and DOC have recently called for hunters, anglers, trampers and rafters to keep their eyes out for kakabeak while in the bush. Any sightings of the flamboyant plant, which is typically found clinging to cliffs and inaccessible bluff systems and which carries heavy bunches of large, curved bright red flowers in spring, should be reported to the nearest DOC office. Seeds from any new plants are particularly valuable as they widen the pool of wild-grown seed that can be used in propagation efforts.

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DNA tests complete Kakabeak jigsaw

Starting with a simple DNA swab taken from fang marks on people bitten by snakes, an international research team correctly identified the species of the biting snake 100 percent of the time in a first-of-its-kind clinical study, according to data presented today at the American Society of Tropical Medicine and Hygiene's (ASTMH) Annual Meeting.

The study, conducted at three medical facilities in Nepal, found that if snake DNA could be isolated from the bite wound, the test identified the species of snake responsible every time.

"These findings represent a significant step toward improving care for patients in areas of the world where snakebites constitute a massive but neglected health risk," said Franois Chappuis, MD, PhD, chief of the division of tropical and humanitarian medicine at Geneva University Hospitals, Switzerland, who directed the study and presented the results. "This DNA test may hasten more effective bedside diagnostics for snakebite victims, giving them a better chance of surviving and making a full recovery."

Bites from venomous snakes are common in many parts of the world and an especially serious unresolved health problem to millions of people living in South and Southeast Asia, as well as Africa and Latin America. Although there are no reliable numbers at the global scale, a study published in 2008 estimated at least 421,000 cases of envenomation and up to 94,000 deaths occur worldwide from snakebite each year. However, experts warn that these figures may underestimate the real problem, which is believed to affect several million people bitten by venomous snakes annually and hundreds of thousands who die or survive disabled, suffering from amputation or deformed limbs as a result of unavailable or delayed treatment.

In some villages of the study area of southeast Nepal reported today, a community-based survey in 2002 revealed an estimated 1,162 snakebites and 162 snakebite deaths per 100,000 people per year, one of the highest rates ever reported. Likewise, a recent survey of more than one million deaths in India, published in the journal PLoS Neglected Tropical Diseases in 2011, found that 46,000 people die every year in India from snakebites. This figure is about 20 times the official death toll recorded in Indian hospitals, most likely because less than one in four fatal snakebite cases had received any hospital treatment, the study revealed.

"People bitten by snakes in South Asia often do not seek treatment at a medical facility, and if they do, the vast majority don't take the snake to clinics, although it is often killed, and can't identify the species that bit them," Chappuis said. "Yet knowing the species of snake is critical to determining the best course of treatment."

In Nepal, for example, cobras and kraits are among the most common venomous snakes. Their venoms attack the nervous system and can be fatal. Patients bitten by either snake have similar symptoms, such as nausea, headache, drowsiness and limb as well as respiratory paralysis. However, the toxins of these snakes and their mechanisms of action differ, and so does the response to antivenom and other drugs. For example, the locally available antivenom has limited or no efficacy against krait envenomation, which often leads to useless repeated doses resulting in increased cost and--possibly--adverse side effects, explained Chappuis. Also, bites by cobras and kraits lead to different complications that the attending physicians need to prevent or be prepared for. Therefore, positive identification of the biting species becomes important to effective treatment.

Preliminary results presented today show that among 194 bite-site DNA samples collected in Nepal during the study, 87 were from a venomous species. The spectacled cobra accounted for 42 bites and the common krait for 22. In 21 cases, the patients brought the dead snake with them, and in those cases expert examination of the snake and the DNA test, performed by different investigators, independently provided the correct identification. Snake DNA could be obtained from about one in four bite wounds. According to the researchers, one factor that excluded samples was if the patient attempted folk or home remedies tampering with the bite site prior to arriving at the medical clinic.

The research team also correlated clinical symptoms with the species biting patients. They found that krait bites happened more often at night, indoors, or while people were sleeping, while cobra or pitviper bites were more likely to cause swelling at the bite site. The technique also identified several species of non-venomous snake involved in bites.

"The proportion of non-venomous snakes that bite people is actually rather high," said Ulrich Kuch, PhD, of the department of tropical medicine and public health in the Institute of Occupational, Social and Environmental Medicine of Goethe University (Frankfurt, Germany), and developer of the snake DNA identification test. "Snakebite patients are kept in the hospital for 24-hour observation, which strains healthcare resources in many countries. By identifying species of nonvenomous snake, it is also possible to assist the local people and avoid hospital stays for those not at risk of envenomation."

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Forensic DNA test conclusively links snake bite marks on people to species

If this snake bit you, would you know that it was a great lakes bush viper? (Photo: Shutterstock)

When a snake-bite victim shows up at a hospital, it's vitally important for caregivers to know what species of snake bit them. Without that knowledge, they won't know what sort of anti-venom if any is required. Making that ID could one day be much easier, thanks to a current study in which species were reliably identified via snake DNA obtained from fang marks in victims' bite wounds.

Directed by Dr. Franois Chappuis from Switzerland's Geneva University Hospitals, the international study was conducted at small medical facilities in Nepal and Bangladesh. Usable DNA could be collected from only about one in four wounds, although this was largely due to patients applying folk remedies before seeking professional treatment. In all cases where untainted DNA was obtained and the patient brought the dead snake with them, however, the researchers were able to able to confirm that the DNA-based ID was accurate.

In its current form, the identification process takes a fair bit of time and effort, so it isn't practical for everyday use. That said, the scientists are now working on a quick and simple "dip stick"-type DNA test similar in form to a home pregnancy test which could be used to rule out common venomous snakes as the culprit.

A larger multi-center clinical study will be conducted next, in Myanmar and Nepal.

The research was presented this week in New Orleans, at the American Society of Tropical Medicine and Hygiene's Annual Meeting.

Source: Burness Communications

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DNA test identifies venomous snakes from their bites

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