Abstract:
A significant burden of illness is caused globally by snakebites particularly by the puff adder, Bitis
arietans. Presently there is no reliable and rapid method to confirm envenomation on blood chemistry;
although coagulation parameters like prothrombin time, partial thromboplastin time, international
normalized ratio and also serum electrolytes are tested. Here, we found that direct in vitro exposure
of physiological relevant whole venom levels to human healthy blood (N = 32), caused significant
physiological changes to platelet activity using a hematology analyzer, and measuring occlusion time,
as well as lyses time, with the global thrombosis test (GTT). Disintegrated platelets were confirmed
by scanning electron microscopy (SEM). We also confirmed the pathologic effects on erythrocytes
(RBCs) (visible as eryptotic RBCs), by looking at both light microscopy and SEM. Thromboelastography
showed that no clot formation in whole blood could be induced after addition of whole venom. We
propose further clinical studies to investigate the use of light microscopy smears and hematology
analyzer results immediately after envenomation, as a possible first-stage of clinical confirmation of
envenomation.
