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In the UK, advice from the NPIS is sought commonly regarding household products, but such exposures only rarely result in clinically serious features. As 65.5% of exposures were in children less than 5 years of age, parents clearly have an important role to play in ensuring that household products are stored safely at all times.

CONTEXT. Data on the ophthalmic and central nervous system (CNS) adverse effects of liquid detergent capsules (liquid laundry pods) are limited. OBJECTIVE. To ascertain the reported toxicity of liquid detergent capsules, particularly their ophthalmic and CNS adverse effects, in a large case series. METHODS. Between 1 May 2009 and 30 July 2012 the UK National Poisons Information Service collected prospectively 1509 telephone enquiries (involving 1486 exposures) relating to liquid detergent capsules. RESULTS. The majority of patients (95.6%) were children aged less than 5. Exposure to these products occurred mainly as a result of ingestion alone (n = 1215; 81.8%), with eye contact alone (n = 110; 7.4%), and skin contact alone (n = 20; 1.3%) being less common; multiple routes of exposure were involved in 141 (9.5%) cases. Following ocular exposure (n = 212), features suggesting conjunctivitis (n = 145; 68.4%) and corneal ulceration (n = 6; 2.8%) developed. The most common features reported following ingestion alone were nausea and vomiting (n = 721; 59.3%), followed by coughing (n = 53; 4.4%), drowsiness/CNS depression (n = 49; 42 of these were children were aged 2 years or less) and foaming at the mouth (n = 47; 3.9%). A rash occurred in 22 patients where ingestion was considered to be the route of exposure. Twenty patients were exposed via the dermal route alone and developed erythema (n = 9), rash (n = 6) and burn (n = 3). CONCLUSIONS. Ocular exposure to liquid detergent capsules may lead to conjunctivitis and corneal ulceration; detergent ingestion may result in central nervous system (CNS)depression. Greater consumer awareness is required to reduce injury from liquid detergent capsules, particularly that involving the eye.

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Introduction: Snakebite is recognised as a neglected tropical disease and a cause of substantial morbidity and mortality. Whilst the most medically important snakes are typically native of Asia, Africa, Latin America and Oceania, the possibility of encountering these snakes is no longer limited by geography due to an increasing number of exotic (non-native) snakes being held in captivity. Methods: A retrospective review of snakebite enquiries to the UK National Poisons Information Service (NPIS) between 2009 and 2020. Enquiries about the European adder (Vipera berus) or where the identity of the snake was unknown were excluded. Results: There were 321 exotic snakebites in 300 patients involving 68 different species during this period. Ten patients were bitten on more than one occasion. The majority of patients (64.5%) were male. Most bites were inflicted by snakes of the family Colubridae (184/321, 57.3%); seventeen bites resulted in moderate symptoms (predominantly swelling of the bitten limb). There were 30 (9.3%) bites by Viperidae and 14 (4.3%) bites by Elapidae. All severe cases (n ¼ 15) resulted from bites by either Viperidae (n ¼ 10) or Elapidae (n ¼ 5). Antivenom was given in 17 cases. One fatality was recorded. Conclusions: Despite their low incidence, exotic snakebites present a substantial challenge for UK healthcare professionals. Although rare, these bites typically occur in individuals (usually male) who keep snakes as part of their occupation or hobby and are therefore at risk of multiple bites. Bites can result in venom hypersensitisation and the risk of venom-induced anaphylaxis. Rapid access to expert clinical advice is available in the UK on a 24-hour basis through the National Poisons Information Service and is strongly recommended in all cases of exotic snakebite.