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Weinstein SA, Jahan-Mahin MH, Baradaran M, Kazemi SM. Local envenoming by the eastern Montpellier snake, Malpolon insignitus fuscus (Fleischmann, 1831), Psammophiidae, and review of the evidence-based medical risks of bites by Malpolon spp. Toxicon 2024; 248:107856. [PMID: 38992508 DOI: 10.1016/j.toxicon.2024.107856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/06/2024] [Accepted: 07/08/2024] [Indexed: 07/13/2024]
Abstract
For more than a century, concerns about the medical significance of Montpellier snakes, Malpolon spp. (Psammophiidae) have been expressed by herpetologists and toxinologists. Although some of the opinions have suggested that the most familiar species, the Western Montpellier snake, Malpolon monspessulanus, poses a significant medical risk, only a few detailed, formally documented reports have been published that describe effects in humans. Two reports support a rare risk of systemic envenoming (cranial nerve palsies) after prolonged bites by M. monspessulanus. Relevantly, there has been only one previous report describing a bite by the Eastern Montpellier snake, Malpolon insignitus. Reported here are the effects of a bite inflicted by a 1.1-m female Malpolon insignitus fuscus in Alborz Province, Iran. The 40-yr-old male victim was handling the snake while preparing to photograph it when he was bitten on the right wrist. The snake remained attached for approximately 40-s during which it repeatedly advanced its jaws. The bite caused moderate local envenoming that featured moderate but reportedly notably uncomfortable sharp pain, moderate edema, erythema and pruritis; wound site bleeding was transient and proportional. Full resolution required 5-days; there were no sequelae. The clinical evolution included signs/symptoms consistent with Type I hypersensitivity and subtype Type IV hypersensitivity. Detailed reports of medically significant bites by Malpolon spp. are briefly reviewed and the evidence for medical significance of the genus is evaluated. Management of envenoming by Malpolon spp. is supportive only; almost all victims with qualified medical review have developed only local envenoming that is often mild-moderate. Notably rare systemic effects, e.g., neurotoxicity so far limited to non-progressive cranial nerve palsies, should prompt airway protection, ICU admission, and consultation as indicated. Future study of Malpolon venoms and formal documentation of their bites should increase the evidence quality for the medical risk profile of the genus.
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Affiliation(s)
- Scott A Weinstein
- Young Adult Institute, 220 E. 42nd St., 8th Floor, NY, NY, 10017, USA; Premier HealthCare, 227 E. 41st St., 8th Floor, NY, NY, 10017, USA.
| | | | - Masoumeh Baradaran
- Toxicology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Mahdi Kazemi
- Zagros Herpetological Institute, 37156-88415, P. O. No 12, Somayyeh 14 Avenue, Qom, Iran
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Dibiasi W, Lüddecke T. First report of envenomation symptoms caused by the Eastern Montpellier snake, Malpolon insignitus (St.-Hilaire, 1827). Toxicon 2023; 233:107255. [PMID: 37591328 DOI: 10.1016/j.toxicon.2023.107255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/31/2023] [Accepted: 08/12/2023] [Indexed: 08/19/2023]
Abstract
Snakebite is a global health problem with disastrous consequences. Accordingly, venoms plus their function and clinical aspects were intensively studied for several snakes, primarily with proteroglyphous and solenoglyphous dentition. Much less is known about the venoms from most opisthoglyphous (rear-fanged) snakes and it is often questionable which symptoms they may cause. Here, we provide the first description of the envenomation symptoms caused by a bite of the Eastern Montpellier snake Malpolon insignitus from Croatia. The clinical manifestations elicited by the bite were only local, and included bleeding, pulsatility and paresthesia, followed by sweating and signs of inflammation. The observed features subsided quickly, and the patient recovered fully with no long-term illness. Therefore, we conclude that M. insignitus does not represent a substantial (i.e. life threatening or morbidity-causing) threat. However, as related species in the Malpolon genus are known to be capable to deliver neurotoxic envenoming, we recommend to nevertheless carefully interact with M. insignitus and recommend that future studies should unveil its venom composition.
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Affiliation(s)
| | - Tim Lüddecke
- Fraunhofer Institute for Molecular Biology and Applied Ecology, Department of Bioresources, Ohlebergsweg 12, 35392, Gießen, Germany; LOEWE-Centre for Translational Biodiversity Genomics, Senckenberganlage 25, 60325, Frankfurt Am Main, Germany.
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Figueroa A, Low MEY, Lim KKP. Singapore's herpetofauna: updated and annotated checklist, history, conservation, and distribution. Zootaxa 2023; 5287:1-378. [PMID: 37518684 DOI: 10.11646/zootaxa.5287.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Indexed: 08/01/2023]
Abstract
Given Singapore's location at the confluence of important maritime trading routes, and that it was established as a British East India Company trading post in 1819, it is unsurprising that Singapore has become one of the centres of natural history collecting and research in Southeast Asia. Despite its small size, Singapore is home to a diverse herpetofauna assemblage and boasts a rich herpetological history. The first systematic studies of Singapore's herpetofauna (within the Linnaean binomial framework) date back to Stamford Raffles and the naturalists hired by him who first came to the island in 1819. Specimens that were collected during and after this time were deposited in museums worldwide. Over time, 39 species from Singapore were described as new to science. Due to the entrepôt nature of Singapore with its associated purchasing and trading of specimens (both alive and dead), poor record-keeping, and human introductions, numerous extraneous species from outside of Singapore were reported to occur on the island. Such issues have left a complicated legacy of ambiguous records and taxonomic complications concerning the identity of Singapore's species-rich herpetofauna, many of which were only resolved in the past 30-40 years. By compiling a comprehensive collection of records and publications relating to the herpetofauna of Singapore, we construct an updated and more accurate listing of the herpetofauna of Singapore. Our investigation culminated in the evaluation of 309 species, in which we compiled a final species checklist recognising 166 species (149 native and 17 non-native established species). Among the 149 native species are two caecilians, 24 frogs, one crocodilian, 13 turtles (three visitors), 34 lizards, and 75 snakes. Of the 17 non-native species are five frogs, four turtles, six lizards, and two snakes. The remaining 143 species represent species to be excluded from Singapore's herpetofauna species checklist. For each of the 309 species examined, we provide species accounts and explanatory annotations. Furthermore, we discuss Singapore's herpetofauna from a historical and conservation perspective. Immediate deforestation and nationwide urbanisation following colonisation completely eliminated many species from throughout much of the country and restricted them to small, degraded forest patches. We hope this publication highlights the importance of publishing observations and serves as a valuable resource to future researchers, naturalists, biological consultants, and policy makers in initiating studies on species ecology, distribution, status, and promoting conservation efforts to safeguard Singapore's herpetofauna.
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Affiliation(s)
| | - Martyn E Y Low
- Lee Kong Chian Natural History Museum; 2 Conservatory Drive; Singapore 117377.
| | - Kelvin K P Lim
- Lee Kong Chian Natural History Museum; 2 Conservatory Drive; Singapore 117377.
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Dehghani R, Monzavi SM, Mehrpour O, Shirazi FM, Hassanian-Moghaddam H, Keyler DE, Wüster W, Westerström A, Warrell DA. Medically important snakes and snakebite envenoming in Iran. Toxicon 2023; 230:107149. [PMID: 37187227 DOI: 10.1016/j.toxicon.2023.107149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/17/2023]
Abstract
Snakebite is a common health condition in Iran with a diverse snake fauna, especially in tropical southern and mountainous western areas of the country with plethora of snake species. The list of medically important snakes, circumstances and effects of their bite, and necessary medical care require critical appraisal and should be updated regularly. This study aims to review and map the distributions of medically important snake species of Iran, re-evaluate their taxonomy, review their venomics, describe the clinical effects of envenoming, and discuss medical management and treatment, including the use of antivenom. Nearly 350 published articles and 26 textbooks with information on venomous and mildly venomous snake species and snakebites of Iran, were reviewed, many in Persian (Farsi) language, making them relatively inaccessible to an international readership. This has resulted in a revised updated list of Iran's medically important snake species, with taxonomic revisions of some, compilation of their morphological features, remapping of their geographical distributions, and description of species-specific clinical effects of envenoming. Moreover, the antivenom manufactured in Iran is discussed, together with treatment protocols that have been developed for the hospital management of envenomed patients.
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Affiliation(s)
- Ruhollah Dehghani
- Department of Environmental Health, Kashan University of Medical Sciences, Kashan, Iran; Social Determinants of Health Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Seyed Mostafa Monzavi
- Medical Toxicology Center, Mashhad University of Medical Sciences, Mashhad, Iran; Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Mehrpour
- Medical Toxicology and Drug Abuse Research Center, Birjand University of Medical Sciences, Birjand, Iran; Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA.
| | - Farshad M Shirazi
- Arizona Poison and Drug Information Center, University of Arizona, Tucson, AZ, USA
| | - Hossein Hassanian-Moghaddam
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Daniel E Keyler
- Department of Experimental & Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Wolfgang Wüster
- Molecular Ecology and Evolution at Bangor, School of Natural Sciences, Bangor University, Bangor, UK
| | | | - David A Warrell
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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Rathnayaka RMMKN, Ranathunga PEAN, Silva MLID, Abeyrathna YNMP, Kularatne SAM. Cat-eyed snake (Genus: Boiga) bites in Sri Lanka: First authentic case series. Toxicon 2023; 225:107052. [PMID: 36791994 DOI: 10.1016/j.toxicon.2023.107052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/15/2023]
Abstract
Cat snakes (Genus: Boiga) are considered to be of lesser medical important in Sri Lanka, as their bites are known to cause only mild local effects such as local pain and swelling at the site of the bite. Five species of cat snakes are found in Sri Lanka, of which three are endemic. They are widely distributed all over the country. Out of seven cases of cat snake bites, including six adults and one child, five developed only mild local effects and two did not have any symptoms. Any of them did not develop systemic manifestations. The snakes responsible were the Sri Lanka cat snake (Boiga ceylonensis), Forsten's cat snake (Boiga forsteni), and also Ranawana's cat snake (Boiga ranawanei) which is the first report in Sri Lanka.
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Affiliation(s)
- R M M K Namal Rathnayaka
- Department of Pharmacology, Faculty of Medicine, Sabaragamuwa University of Sri Lanka, Hidellana, Ratnapura, Sri Lanka; Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya, Sri Lanka; Intensive Care Unit, Teaching Hospital, Ratnapura, Sri Lanka.
| | | | - M L I De Silva
- Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya, Sri Lanka
| | - Y N M P Abeyrathna
- Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya, Sri Lanka
| | - S A M Kularatne
- Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Bites by Non-Native Reptiles in France: Species, Circumstances and Outcome. Toxins (Basel) 2022; 14:toxins14080570. [PMID: 36006232 PMCID: PMC9412768 DOI: 10.3390/toxins14080570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
We aimed to make an exhaustive assessment of circumstances of bites by exotic reptiles bred in France. A retrospective observational study was conducted in all the reported cases from 2000 to 2020 in French poison control centers (PCCs). Two hundred and eighteen cases of bites were recorded. The sex ratio (M/F) of the patients was 1.79 and the mean age of the patients was 29.0 ± 15.8 years. Twenty-two cases (10.1%) occurred during the deep night. One hundred and eighty-six bites (85.7%) occurred in a private context; however, there were more cases of high severity when it occurred in a professional setting (60.0% vs. 11.2%, p < 0.01). The feeding/nursing activity accounted for 54.7% cases. Forty-three species of snake were identified; 28 were considered venomous. There were no deaths among the patients in the study. Most of the cases (85.8%) were of mild severity. All of the patients bitten by a venomous reptile were hospitalized: 10 patients received an antivenom; and 2 required surgery. Bites occurred at home and by a small number of popular non-venomous reptile species (pythons and boas, colubrids). These occurred mainly when handling the animals. The rare envenomations were mainly by Asian and American crotalids, followed by elapids. One-third of them were treated with antivenom when available.
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Villca-Corani H, Nieto-Ariza B, León R, Rocabado JA, Chippaux JP, Urra FA. First reports of envenoming by South American water snakes Helicops angulatus and Hydrops triangularis from Bolivian Amazon: A one-year prospective study of non-front-fanged colubroid snakebites. Toxicon 2021; 202:53-59. [PMID: 34562494 DOI: 10.1016/j.toxicon.2021.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Abstract
Although snakebite incidence is underestimated in Bolivia, the Amazon region presents the highest incidence of these accidents. The local effects of bites by some non-front-fanged colubroid (NFFC) snakes are usually confused with that of viperids, resulting in the improper use of antivenoms and medications. Since there is scarce information on clinical treatment and management of NFFC bites from Bolivian Amazon, we conducted a prospective study of NFFC snakebites by reviewing the records of patients admitted with a snakebite diagnosis at Hospital Central Ivirgarzama, Bolivia. Snakebites were recorded for 12 months (December 2019-November 2020), including information about the sex and age of the patient, snakebite date, and treatment. Eight (5.7 %) of 152 patients were bitten by NFFC Helicops angulatus, Hydrops triangularis, and Erythrolamprus sp. Our results showed that 5/7 patients had prolonged clotting time and INR, as well as local edema and mild pain, suggesting systemic envenoming. Previously non-documented mild coagulopathy was observed for H. angulatus and H. triangularis bites. In some cases, incorrect first-aid measures, and inappropriate use of bothropic/lachesic antivenom were administrated. All the patients received supportive therapy and antihistamine drugs. Unsupported use of non-evidence-based treatments for snakebites such as corticoids, non-steroidal anti-inflammatory drugs (NSAIDs), and prophylactic antibiotic prescription were recorded. In conclusion, we describe the first formally documented snakebite cases produced by NFFC from Bolivia, highlighting the urgent need for training of the medical team in the snake identification, clinical management of snakebite, and the existence of a human-snake conflict involving NFFC species.
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Affiliation(s)
- Huber Villca-Corani
- Proyecto Pucarara, Hospital Central Ivirgarzama, Red de Salud 4, Cochabamba, Bolivia; Network for Snake Venom Research and Drug Discovery, Santiago, 7800003, Chile.
| | - Beatriz Nieto-Ariza
- Proyecto Pucarara, Hospital Central Ivirgarzama, Red de Salud 4, Cochabamba, Bolivia; Network for Snake Venom Research and Drug Discovery, Santiago, 7800003, Chile
| | - Raúl León
- Proyecto Pucarara, Hospital Central Ivirgarzama, Red de Salud 4, Cochabamba, Bolivia; Network for Snake Venom Research and Drug Discovery, Santiago, 7800003, Chile
| | - José A Rocabado
- Proyecto Pucarara, Hospital Central Ivirgarzama, Red de Salud 4, Cochabamba, Bolivia
| | - Jean-Philippe Chippaux
- Proyecto Pucarara, Hospital Central Ivirgarzama, Red de Salud 4, Cochabamba, Bolivia; CRT, Institut Pasteur, MERIT, Institut de Recherche pour le Développement et Université de Paris, Paris, France; Network for Snake Venom Research and Drug Discovery, Santiago, 7800003, Chile
| | - Félix A Urra
- Programa de Farmacología Molecular y Clínica, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Independencia 1027, Santiago, 7800003, Chile; Network for Snake Venom Research and Drug Discovery, Santiago, 7800003, Chile.
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Ineich I, Girard F, Weinstein SA. Local envenoming by the Schokari sand racer, Psammophis schokari Forskål, 1775 (Serpentes, Psammophiidae) and a brief review of reported bites by sand racers (Psammophis spp.). Toxicon 2020; 185:72-75. [DOI: 10.1016/j.toxicon.2020.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/12/2020] [Accepted: 06/23/2020] [Indexed: 12/14/2022]
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Toxinological characterization of venom from Leptodeira annulata (Banded cat-eyed snake; Dipsadidae, Imantodini). Biochimie 2020; 174:171-188. [DOI: 10.1016/j.biochi.2020.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 03/27/2020] [Accepted: 04/06/2020] [Indexed: 02/08/2023]
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Angarita-Sierra T, Montañez-Méndez A, Toro-Sánchez T, Rodríguez-Vargas A. A case of envenomation by the false fer-de-lance snake Leptodeira annulata (Linnaeus, 1758) in the department of La Guajira, Colombia. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2020; 40:20-26. [PMID: 32220160 PMCID: PMC7357383 DOI: 10.7705/biomedica.4773] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 08/05/2019] [Indexed: 11/30/2022]
Abstract
Envenomations by colubrid snakes in Colombia are poorly known, consequently, the clinical relevance of these species in snakebite accidents has been historically underestimated. Herein, we report the first case of envenomation by opisthoglyphous snakes in Colombia occurred under fieldwork conditions at the municipality of Distracción, in the department of La Guajira. A female biologist was bitten on the index finger knuckle of her right hand when she tried to handle a false fer-de-lance snake (Leptodeira annulata). Ten minutes after the snakebite, the patient started to have symptoms of mild local envenomation such as edema, itching, and pain in the wound. After 40 minutes, the edema reached its maximum extension covering the dorsal surface of the right hand and causing complete loss of mobility. The clinical treatment focused on pain and swelling control. No laboratory tests were performed. The patient showed good progress with the total regression of the edema 120 hours after the snake-bite accident and complete recovery of the movement of the limb in one week. Venomous bites of "non-venomous snakes" (opisthoglyphous colubrid snakes) must be considered as a significant public health problem because patients lose their work capability during hours or even days and they are forced to seek medical assistance to treat the envenomation manifestations.
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Affiliation(s)
- Teddy Angarita-Sierra
- Vicerrectoría de Investigación, Universidad Manuela Beltrán, Bogotá, D.C., Colombia; Yoluka ONG, Fundación de Investigación en Biodiversidad y Conservación, Bogotá, D.C., Colombia.
| | | | - Tatiana Toro-Sánchez
- Yoluka ONG, Fundación de Investigación en Biodiversidad y Conservación, Bogotá, D.C., Colombia.
| | - Ariadna Rodríguez-Vargas
- Grupo de Investigación en Proteínas, Departamento de Química, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
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Junqueira-de-Azevedo ILM, Campos PF, Ching ATC, Mackessy SP. Colubrid Venom Composition: An -Omics Perspective. Toxins (Basel) 2016; 8:E230. [PMID: 27455326 PMCID: PMC4999846 DOI: 10.3390/toxins8080230] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 07/04/2016] [Accepted: 07/08/2016] [Indexed: 01/12/2023] Open
Abstract
Snake venoms have been subjected to increasingly sensitive analyses for well over 100 years, but most research has been restricted to front-fanged snakes, which actually represent a relatively small proportion of extant species of advanced snakes. Because rear-fanged snakes are a diverse and distinct radiation of the advanced snakes, understanding venom composition among "colubrids" is critical to understanding the evolution of venom among snakes. Here we review the state of knowledge concerning rear-fanged snake venom composition, emphasizing those toxins for which protein or transcript sequences are available. We have also added new transcriptome-based data on venoms of three species of rear-fanged snakes. Based on this compilation, it is apparent that several components, including cysteine-rich secretory proteins (CRiSPs), C-type lectins (CTLs), CTLs-like proteins and snake venom metalloproteinases (SVMPs), are broadly distributed among "colubrid" venoms, while others, notably three-finger toxins (3FTxs), appear nearly restricted to the Colubridae (sensu stricto). Some putative new toxins, such as snake venom matrix metalloproteinases, are in fact present in several colubrid venoms, while others are only transcribed, at lower levels. This work provides insights into the evolution of these toxin classes, but because only a small number of species have been explored, generalizations are still rather limited. It is likely that new venom protein families await discovery, particularly among those species with highly specialized diets.
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Affiliation(s)
- Inácio L M Junqueira-de-Azevedo
- Laboratório Especial de Toxinologia Aplicada, Center of Toxins, Immune-Response and Cell Signaling (CeTICS), Instituto Butantan, São Paulo 05503-900, Brazil.
| | - Pollyanna F Campos
- Laboratório Especial de Toxinologia Aplicada, Center of Toxins, Immune-Response and Cell Signaling (CeTICS), Instituto Butantan, São Paulo 05503-900, Brazil.
| | - Ana T C Ching
- Laboratório de Imunoquímica, Instituto Butantan, São Paulo 05503-900, Brazil.
| | - Stephen P Mackessy
- School of Biological Sciences, University of Northern Colorado, Greeley, CO 80639-0017, USA.
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