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Clinical Toxicology of Snakebite In Africa and The Middle East / Arabian Peninsula
Published in Jürg Meier, Julian White, Handbook of: Clinical Toxicology of Animal Venoms and Poisons, 2017
Mambas are very long, thin, alert, nervous and agile, arboreal or (D. polylepis) terrestrial, highly dangerous venomous snakes.Common or eastern green, or white-mouthed mamba (D. angusticeps) (Figure 3a): it is uniformly bright green. It rarely exceeds 2.5 metres in length. It is strictly arboreal and is found in thick forest or bush down the eastern coast of Africa from Kenya to South Africa. It can be confused with harmless bush snakes (genus Philothamnus) and green boomslangs (Dispholidus typus).Traill’s, Jameson’s, green forest or western green mamba (D. jamesoni) (Figure 3b): the colouring is bright green to yellowish green, with the scales edged with black. Maximum length 3.66 metres. It is mainly arboreal. In defence it spreads a hood or inflates its throat. It inhabits rain forests from Ghana east to western Kenya.Black or black-mouthed mamba (D. polylepis) (Figure 4): it is coloured greyish brown or olive brown with a black buccal lining. It is more heavily built than other mambas; maximum length 4.3 metres (fang length up to 6.5 mm). In defence, it rears up distending a small hood, opening its mouth and hissing. It occurs in dry woodland and scrub but not in rain forest or desert, throughout sub-Saharan Africa. There are few records of it in West Africa.Hallowell’s or western green mamba (D. viridis): its colouring is like D. jamesoni. Maximum length 2.4 metres. It inflates its throat and spreads a small hood in defence. This mamba is both arboreal and terrestrial and occurs in coastal rain forests of West Africa from Senegal to Nigeria and on São Tomé Island.
Epidemiologic and spatiotemporal study on access to snakebite care in Northern Nigeria
Published in Toxin Reviews, 2023
Naziru Halliru, Murtala M. Badamasi, Ibrahim Y. Tudunwada, Titus B. Dajel, Saidu B. Abubakar, Auwalu S. Hamza, Sandra B. Oluwashola, Nasiru K. Nalado, Muhammad Dahiru, Ibrahim Na’abdu, Umar N. Saleh, Abdulhakim M. Daiyab, Suleman A. Mohammed, Garba Iliyasu, Hamza Muhammad, Abdulrazaq G. Habib
Snakebite is a major public health problem throughout the rural areas of Africa. In the continent, Nigeria has the highest burden of mortality, morbidity and disability (Halilu et al.2019). Carpet viper is the main cause of envenoming especially in the valleys of rivers Benue and Niger although cobra and puff adder are important causes of bite. Envenoming mainly presents clinically with rapid swelling, local and systemic bleeding, incoagulable blood, shock, anemia and tissue damage. Nervous paralysis or neurotoxicity occasionally presents following certain cobra and green mamba bites. Both the bleeding abnormality (Warrell et al.1977) and neurotoxicity may evolve within minutes of bite and patients with the latter may die rapidly without intervention. Antivenom remains the main therapy for snakebite envenoming (SBE) effectively reducing mortality by over 75% from an untreated mortality of about 20% (Habib and Warrell 2013). However, antivenom should be administered immediately, without delay, following envenoming as 1-h delay has been shown to increase the odds of dying by 1% (Habib and Abubakar 2011). While it is a life-saving agent, it is also associated with early adverse reactions which potentially may lead to life-threatening anaphylaxis and deaths. Furthermore, neurotoxicity requires mechanical ventilation and antivenom administration within minutes for realistic chance of survival. Given these considerations, patients are best cared for in secondary facilities able to manage adverse effects and complications or in tertiary facilities equipped to manage neurotoxicity.
The clinical course and treatment of black mamba (Dendroaspis polylepis) envenomations: a narrative review
Published in Clinical Toxicology, 2021
Mark Aalten, Carsten F. J. Bakhuis, Ilias Asaggau, Maaike Wulfse, Maurits F. van Binsbergen, Eran R. A. N. Arntz, Max F. Troenokarso, Jashvin L. R. Oediet Doebe, Ubah Mahamuud, Leila Belbachir, Myrthe Meurs, Nastya A. Kovalenko, Marcel A. G. van der Heyden
The World Health Organization (WHO) has designated snakebites to be a Neglected Tropical Disease (NTD) [1]. This makes it the only NTD that is not an infectious disease [2]. Most of this burden falls on Africa. In Africa, the Black Mamba (Dendroaspis polylepis) is one of the most hazardous snakes, due to its length, speed, and the toxicity of its venom [3]. Therefore, the WHO categorized D. polylepis as a species of “highest medical importance” [4]. Bites occur mainly in endemic areas of Sub-Saharan Africa (especially from Kenya to South Africa), but also occasionally in non-endemic areas (especially Europe and North America) due to trafficking by private collectors [3,5,6]. Thus, due to its dangerousness and its prevalence in endemic and non-endemic regions, knowledge of envenomations and the biological characteristics of D. polylepis is critical to reduce casualties.
Facts and ideas from anywhere
Published in Baylor University Medical Center Proceedings, 2021
Most African snake bite victims are farmers who work in remote fields barefoot or in sandals. Once a venomous snake strikes, a race against the clock begins. Transport to the nearest hospital can take hours, even days. By then it may be too late. The venom of an elapids, a family of snakes that include mambas and cobras, can kill within hours. Their neurotoxins rapidly paralyze respiratory muscles, making breathing impossible. The venom of vipers, however, can take several days to kill, interfering with clotting and leading to inflammation, bleeding, and tissue death.