Due to the limited resources in our practice, we were unable to isolate the causative organisms. Delayed presentation could be an added factor. Amputation was required for four patients; three had open fractures.
This high rate of post-traumatic ischemia may reflect the extent of soft tissue damage caused by these animals. Lin et al. Their patient received 34 units of packed red blood cells and 16 units of fresh frozen plasma during this limb-saving procedure.
Drake et al. Our hospital set-up is neither equipped with vascular imaging machines nor staffed with specialized surgeons to do sophisticated vascular repairs, so amputation was the safest option for our patients. We reported three cases of limb fractures in our series, all of which were open.
Pickles reported the management of four cases; two of which presented with open fractures [ 10 ]. Our data confirm that limb fractures resulting from Hippopotamus attacks will most likely be open.
The human mortality rate from hippopotamus attacks is unknown but it is estimated to range from to per year [ 1 ]. This estimate comes from a few non-medical published papers; we did not find data in the medical literature regarding fatality rates. Treves et al. Hippopotami are one of the main tourist attractions in Africa, and attacks on tourists tend to get a lot of media attention.
For instance, the Australian Broadcasting Corporation reported the death of 13 people while on a boat trip due to a single hippopotamus attack [ 13 ]. This compares to a death rate following a grizzly bear attack of 4. In our study, we received 11 patients over 2 years who had survived hippopotamus attacks and were medically stable enough to reach our hospital from distant villages using public and private transportation.
We were unable to know how many deaths occurred on the spot or before reaching our facility, but it may be extrapolated from the published ratios; we calculated that between 5 and 74 people may have died before reaching the hospital. Our results highlight several important operational lessons. First, the high incidence of hippopotamus bite wound infection should raise a red flag to all treating surgeons to be more aggressive in the wound debridement considering them as crushing injuries rather than penetrating wounds.
This has a significant impact on patient outcomes where patients are at risk of chronic osteomyelitis and permanent disability. Second, hippopotamus injury to the limbs carries a high risk of amputation so a meticulous assessment of peripheral circulation on arrival and close observation for several hours afterwards should be part of the treatment strategy.
Third, hippopotamus bites are serious injuries as many patients required blood transfusions and complex orthopedic interventions, which may not be available in low-resource settings. Fourth, almost half of our patients had a permanent disability at discharge, which has not been reported in the literature to date.
A future study should be designed to identify the causative organisms involved in these wound infections to better inform appropriate antibiotic choices.
In particular, hippopotamus mouth flora has not been studied and would provide useful information. In view of the high morality and case-fatality rates ensuing from hippopotamus bites and other dangerous mammals in sub-Saharan Africa, we call for increased surveillance of this public health risk and greater sensitization of local populations and tourists to danger zones and situations. Our data show that the severity of injury as indicated by the START score, requirement for blood transfusion, length of hospitalization, incidence of chest and abdominal trauma, high incidence of wound infection, osteomyelitis, laparotomy, amputation and permanent disabilities would put this injury in a special group of life-threatening animal attacks.
Surgeons in rural hospitals should take them very seriously. We would like to thank Marta Balinska and Tony Reid for their editorial help. Informed consents were not required. Rafferty JP , Mammals D. Treves A , Naughton-Treves L. Risk and opportunity for humans coexisting with large carnivores. J Hum Evol ; 36 : — Google Scholar. Human-wildlife conflict in Mozambique: a national perspective, with emphasis on wildlife attacks on humans.
Case report: open femur fracture secondary to hippopotamus bite. J Orthop Trauma ; 7 : — 7. Risk to tourists posed by wild mammals in South Africa. J Travel Med ; 6 : — 9. Bob Strauss. The 10 Strongest Bites in the Animal Kingdom. Giannou C , Baldan M. Google Preview. Patrick Herard.
Pickles G. Injuries by wild animals in the African bush. J R Army Med Corps. Myers JP. Bite Wound Infections. Samaranayake L , Matsubara VH. Normal oral Flora and the oral ecosystem. Dent Clin North Am. Australian Broadcasting Corporation. Shark attack-related injuries: epidemiology and implications for plastic surgeons.
The carp multiplied, and fishing became a livelihood. When Lake Naivasha suddenly expanded in , it seemed at first like a boon to the fishing industry. Fish bred in the rich, untouched soil of newly inundated riparian land.
They grew into thousands of pounds of fresh food—more fish than anyone can remember. Now, on the southwestern shore, Karagita boat landing is overrun each morning with fishermen unloading their catches. Teenage boys are paid pennies to repair old nets that have been tangled or cut by a propeller. And each day, tourists arrive at the landing and hire boat captains to take them on hippo tours.
Early one morning, a captain named Douglas Mokano puttered toward a pod of hippos. Watch: Is this hippo in Botswana grieving the loss of her baby? Despite their girth, they manage to squeeze together so tightly that a pod of five hippos looks like a single blob of grey and pink flesh. Kenya Wildlife Service has been unable or unwilling to put a stop to the illegal fishing. The agency did not respond to repeated requests for comment. One night when they tried to arrest a group of fishermen, the fishermen fought back.
They tied up the rangers, overturned their boat, and set it on fire, stranding the rangers until they could be rescued. Scientists estimate that between 29 and 87 percent of hippo attacks are fatal. Though hippos are herbivores, when grass is hard to come by, on rare occasion s they have been known to eat other animals— even deceased hippos.
Kilo has witnessed or investigated eight attacks in which fishermen died. Attacks have become so common that he has transformed his car into a makeshift rescue vehicle, removing the back seats so victims can be loaded easily and laying down plastic to catch the blood. But Kilo is no EMT. Wabomba treats an average of one or two hippo victims each week. Hippos can trample victims or drag them.
Related: Delayed treatment and antivenom shortages put tens of thousands in Africa at risk of dying from snakebites. Wabomba estimates that 40 percent of the hippo victims he sees ultimately die. This is what we call damage-control surgery. Driving his Land Cruiser across one of them on a recent afternoon, he stopped to watch a lone hippo resting in a shallow pool of mud.
Sometimes they stare at you, caught in the headlights. But usually they trot away, showing you only their pink behinds as their tiny tails wag frantically. Fishermen have taken to casting lines from these trunks, their legs dangling just feet above the heads of hippos.
Periodically the hippos grunt, reminding the fishermen that danger is only a slip away. When a particular hippo is believed to have attacked multiple times, fishermen sometimes ask rangers to kill it. As more and more fishermen take to the lake, some have called for the hippos to be culled, to decrease their numbers. It estimated that there were 1, hippos. Last year, according to Kilo, the Kenya Wildlife Service estimated the number was closer to Hippos are notoriously difficult to count, spending their days underwater in pods, often with only their eyes and ears above the water.
Learn more: Poaching for hippo teeth has led to declines in Uganda and Tanzania. Culling is sometimes considered when a habitat can no longer support the number of animals living on it—when the population exceeds the supply of grass needed to feed them, said Hartley. If the lake continues to swallow more grassland, he says wildlife rangers might consider culling the hippos rather than let dozens starve to death. That would be an international embarrassment for Kenya, a nation known for its wildlife, Hartley says.
Culling would be saying we no longer care about the wildlife. Standing by the lake, Meshack Ogjah limped toward the swampy shore. He pointed to a small area of open water, surrounded by water hyacinth and fallen trees. He said that one evening at dusk he was working in the dark water when a hippo brushed his left side.
He knew the dangers of fishing in a hippo-infested lake. The hippo bit him at least twice. He did not survive. Still, Ogjah kept fishing. A shark? A tiger? What about a crocodile? Although these apex predators are terrifying killers, the world's deadliest animal, year after year, is actually something much smaller - the mosquito.
According to the World Health Organization, about , people are killed every year by mosquito-borne diseases. Malaria alone affects million, of which an estimated , die. Mosquitoes also carry dengue fever, yellow fever and encephalitis. The sheer number of mosquitoes adds to the risk they pose to humans.
Unlike many other dangerous creatures, they can be found in nearly every part of the world at various times of year, and at peak breeding season they outnumber every other animal except ants and termites.
An estimated 50, people are killed every year by snakes. The most venomous snake in the world is the Inland Taipan, also known as the Western Taipan. Its venom is highly toxic and can kill a human being in under 45 minutes. But it is not the biggest killer, because it rarely bites humans. The saw-scaled viper is estimated to kill about 5, people every year - more than any other kind of snake.
The various Krait species, also among the world's most deadly, are found mostly in East Asia. Man's best friend? Perhaps, but not mankind's. Rabid dogs are responsible for the deaths of an estimated 25, people per year.
0コメント