Symptomatology, Pathology and Treatment of the Bites of Elapid Snakes

Campbell, C. H.

doi:10.1007/978-3-642-66913-2_24

Cited by 21 publications

(6 citation statements)

References 62 publications

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“…Cobra venoms are highly toxic due to the effects of rapid neuromuscular paralysis and extensive tissue necrosis [ 2 , 17 ]. These complications are mainly attributed to the two largest protein families, i.e.…”

Section: Discussionmentioning

confidence: 99%

Neutralization of the Principal Toxins from the Venoms of Thai Naja kaouthia and Malaysian Hydrophis schistosus: Insights into Toxin-Specific Neutralization by Two Different Antivenoms

Tan

Fung

et al. 2016

Toxins

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Antivenom neutralization against cobra venoms is generally low in potency, presumably due to poor toxin-specific immunoreactivity. This study aimed to investigate the effectiveness of two elapid antivenoms to neutralize the principal toxins purified from the venoms of the Thai monocled cobra (Naja kaouthia, Nk-T) and the Malaysian beaked sea snake (Hydrophis schistosus, Hs-M). In mice, N. kaouthia Monovalent Antivenom (NKMAV) neutralization against Nk-T long neurotoxin (LNTX) and cytotoxin was moderate (potency of 2.89–6.44 mg toxin/g antivenom protein) but poor against the short neurotoxin (SNTX) (1.33 mg/g). Its cross-neutralization against Hs-M LNTX of Hs-M is compatible (0.18 mg/g) but much weaker against Hs-M SNTX (0.22 mg/g). Using CSL (Seqirus Limited) Sea Snake Antivenom (SSAV), we observed consistently weak neutralization of antivenom against SNTX of both species, suggesting that this is the limiting factor on the potency of antivenom neutralization against venoms containing SNTX. Nevertheless, SSAV outperformed NKMAV in neutralizing SNTXs of both species (0.61–2.49 mg/g). The superior efficacy of SSAV against SNTX is probably partly attributable to the high abundance of SNTX in sea snake venom used as immunogen in SSAV production. The findings indicate that improving the potency of cobra antivenom may be possible with a proper immunogen formulation that seeks to overcome the limitation on SNTX immunoreactivity.

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Section: Discussionmentioning

confidence: 99%

Neutralization of the Principal Toxins from the Venoms of Thai Naja kaouthia and Malaysian Hydrophis schistosus: Insights into Toxin-Specific Neutralization by Two Different Antivenoms

Tan

Fung

et al. 2016

Toxins

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“…Coral snake envenoming generally causes only mild local effects, while the systemic manifestations can include euphoria, lethargy, nausea, vomiting, excessive salivation, ptosis, dyspnea, convulsions, abnormal reflexes, and motor weakness or paralysis leading to respiratory paralysis, which is lethal in absence of clinical intervention (162)(163)(164)(165). In case of a coral snake envenoming, serum creatine kinase activity may rise, and myoglobin may be detected in the urine (164,166), but coagulopathy is not a feature (165)(166)(167)(168). The observation time in the hospital depends on the severity of the envenoming, the age of patient, and the location of the bite wound, ranging from at least 8 hours to 12-24 hours for mild envenomings, where repeated laboratory evaluations are advised (110).…”

Section: Snakebite Diagnosis In the United States And Canadamentioning

confidence: 99%

“…Several of these protocols mention coagulation time as a commonly investigated parameter for early detection of a pit viper envenoming (111,175,176,(178)(179)(180). Often in pit viper envenomings, the 20WBCT is positive (no clot at 20 minutes), while for elapids it remains negative (normal clot at 20 mins) (165)(166)(167)(168). In Mexico, where rattlesnakes are the predominant genus, the Lee-White clotting time (LWCT) is utilized to determine the presence of coagulation disorders, which can in turn give an indication of the urgency of commencing treatment (180).…”

Section: Snakebite Diagnosis In Latin Americamentioning

confidence: 99%

Snakebite Envenoming Diagnosis and Diagnostics

et al. 2021

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Snakebite envenoming is predominantly an occupational disease of the rural tropics, causing death or permanent disability to hundreds of thousands of victims annually. The diagnosis of snakebite envenoming is commonly based on a combination of patient history and a syndromic approach. However, the availability of auxiliary diagnostic tests at the disposal of the clinicians vary from country to country, and the level of experience within snakebite diagnosis and intervention may be quite different for clinicians from different hospitals. As such, achieving timely diagnosis, and thus treatment, is a challenge faced by treating personnel around the globe. For years, much effort has gone into developing novel diagnostics to support diagnosis of snakebite victims, especially in rural areas of the tropics. Gaining access to affordable and rapid diagnostics could potentially facilitate more favorable patient outcomes due to early and appropriate treatment. This review aims to highlight regional differences in epidemiology and clinical snakebite management on a global scale, including an overview of the past and ongoing research efforts within snakebite diagnostics. Finally, the review is rounded off with a discussion on design considerations and potential benefits of novel snakebite diagnostics.

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“…Intractable hypotension can occur in patients envenomed by Asian cobras, despite adequate respiratory support. Neurotoxic effects are completely reversible, either acutely in response to antivenom or (for example in Asian cobras) to anticholinesterases [83][84][85][86], or they may slowly wear off spontaneously [87,88]. There are examples of patients, supported by mechanical ventilators, recovering sufficient diaphragmatic movement to breathe adequately in 1-4 days; ocular muscles recover in 2-4 days, and there is usually full recovery of motor function in 3-7 days in the absence of specific antivenom.…”

Section: Clinical Presentationmentioning

confidence: 99%