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BMJ Case Rep 2021 Mar 25;14(3). Epub 2021 Mar 25.

Medicine, University of the West Indies at Saint Augustine, Saint Augustine, Tunapuna-Piarco, Trinidad and Tobago.

Cardiovasc Toxicol 2021 Jun 9;21(6):462-471. Epub 2021 Feb 9.

Departamento de Clínica e Cirurgia Veterinárias, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Micrurus surinamensis is a coral snake from the Elapidae family of wide distribution in Amazonia Forest. Its venom contains neurotoxins that induce muscular and respiratory paralysis; however, its cardiovascular action is not yet characterized. The aim of this study was to investigate the cardiotoxic effects caused by M. Read More

Biochimie 2021 Mar 21;182:206-216. Epub 2021 Jan 21.

Instituto de Biotecnología, Universidad Nacional Autónoma de México, Av. Universidad # 2001, Colonia Chamilpa, CP: 62210, Cuernavaca, Morelos, Mexico. Electronic address:

The elapid genus, Micruroides, is considered the sister clade of all New World coral snakes (Genus Micrurus), is monotypic, and is represented by Sonoran Coral Snakes, Micruroides euryxanthus. Coral snakes of the genus Micrurus have been reported to have venoms that are predominantly composed of phospholipases A (PLA) or three finger toxins (3FTx), but the venoms of the genus Micruroides are almost completely unstudied. Here, we present the first description of the venom of M. Read More

Vaccine 2021 Feb 8;39(6):1000-1006. Epub 2021 Jan 8.

Departamento de Medicina Molecular y Bioprocesos, Instituto de Biotecnología - UNAM, Av. Universidad 2001, Cuernavaca, Morelos 62210, Mexico. Electronic address:

Background: Micrurus venoms contain two main groups of toxic protein components: short-chain α-neurotoxins (SNtx) and phospholipases type A (PLA). In North America, generally, the Micrurus venoms have low abundance of SNtx compared to that of PLAs; however, both are highly toxic to mammals, and consequently both can play a major role in the envenomation processes. Concerning the commercial horse-derived antivenoms against Micrurus from the North America region, they contain a relatively large amount of antibodies against PLAs, and a low content of antibodies against short chain α-neurotoxins. Read More

Toxicon 2021 Feb 13;191:38-43. Epub 2020 Dec 13.

University of Florida Small Animal Hospital, 2089 Southwest 16th Avenue, Gainesville, FL, 32608, United States. Electronic address:

Thirty cats were identified to be have been suspected to have a potential coral snake envenomation after searching medical records from 2012 to 2019 at a university teaching hospital. The records were reviewed and evaluated for signalment, date and time of the snake encounter, elapsed time between encounter and hospital examination, presenting complaint, initial physical examination findings, initial laboratory findings, antivenom dose and duration of administration, adverse reactions to antivenom, additional treatments administered, progression of clinical signs, length of hospitalization, and outcome. Thirteen cats presented with clinical signs consistent with envenomation while 17 cats were treated for possible asymptomatic envenomation, as defined by the owner discovering a live or dead coral snake in their home or on their property. Read More

Wilderness Environ Med 2021 Mar 9;32(1):63-69. Epub 2020 Dec 9.

Ocala Regional Emergency Department, Ocala Regional Medical Center, Ocala, FL.

We present the case of a patient who developed myalgia as the primary symptom of envenomation by the eastern coral snake, Micrurus fulvius. The patient was evaluated and treated in the emergency department. Physical examination did not demonstrate any neuromuscular abnormalities. Read More

Toxicol Lett 2021 Feb 14;337:91-97. Epub 2020 Nov 14.

Toxin Evolution Lab, School of Biological Sciences, University of Queensland, St Lucia, QLD 4072 Australia. Electronic address:

Snakebite is a neglected tropical disease with a massive global burden of injury and death. The best current treatments, antivenoms, are plagued by a number of logistical issues that limit supply and access in remote or poor regions. We explore the anticoagulant properties of venoms from the genus Micrurus (coral snakes), which have been largely unstudied, as well as the effectiveness of antivenom and a small-molecule phospholipase inhibitor-varespladib-at counteracting these effects. Read More

Toxicon 2021 Jan 2;189:7-9. Epub 2020 Nov 2.

Faculty of Science, University of Peradeniya, Peradneiya, Sri Lanka.

Bite and envenomation by the slender coral snake (Calliophis melanurus sinhaleyus) is rare in Sri Lanka. This case report describes an authenticated slender coral snake envenomation that occurred in a 32-year-old male. The bite to the middle phalanx of the left index finger was allowed to persist for 10 minutes. Read More

JFMS Open Rep 2020 Jul-Dec;6(2):2055116920964001. Epub 2020 Oct 15.

Small Animal Neurology Services, Veterinary Medical Teaching Hospital, Texas A&M University, College Station, TX, USA.

Case Summary: A 2-year-old castrated male domestic longhair cat presented for acute, diffuse, flaccid paralysis. Thoracic and abdominal radiographs, biochemistry panel and complete blood count were unremarkable. Titers to , myasthenia gravis radioimmunoassay testing and creatinine kinase levels were within normal limits. Read More

J Am Anim Hosp Assoc 2020 Nov;56(6):320

From Texas A&M University, College Station, Texas (J.A.H., J.M.); and BluePearl Veterinary Partners, Clearwater, Florida (M.P.).

A 12 yr old dachshund, a 7 yr old English springer spaniel, and a 1.5 yr old French bulldog presented following envenomation by a coral snake. Each patient displayed evidence of varying degrees of lower motor neuron dysfunction, but all three developed transient megaesophagus. Read More

Am J Emerg Med 2020 Aug 29. Epub 2020 Aug 29.

Rocky Mountain Poison and Drug Center, 1391 Speer Blvd #600, Denver, CO 80204, United States of America; Department of Emergency Medicine, University of Colorado School of Medicine, 12401 East 17th Avenue, Aurora, CO 80045, United States of America.

Background: There are 5000-10,000 snake envenomations annually in the United States. Fortunately, few are fatal. In this study we review the epidemiology of fatal snakebites. Read More

Wilderness Environ Med 2020 Dec 5;31(4):466-469. Epub 2020 Oct 5.

Internal Medicine Unit, District General Hospital, Matale, Sri Lanka.

Blood-bellied coral snake (Calliophis haematoetron) is a recently discovered forest-dwelling species of elapid hitherto known from 3 specimens found from central Sri Lanka. Herein we describe the first authenticated case of blood-bellied coral snakebite. The victim, an 11-mo-old infant who received the bite while handling the snake at her home, had mild transient swelling at the bite site. Read More

South Med J 2020 Oct;113(10):514-519

From the College of Science, North Carolina State University, Raleigh, Marilyn Goss Haskell Innovative One Health Solutions, Raleigh, North Carolina, Albert Einstein College of Medicine, Bronx, New York, and Emory University, Atlanta, Georgia.

Objectives: Venomous and nonvenomous snakes are found throughout the United States. Two families of venomous snakes are indigenous to this country: the Viperidae, or pit vipers (rattlesnakes, cottonmouths, and copperheads), and the Elapidae (three species of coral snakes and a sea snake). Bites from captive nonindigenous venomous snakes such as cobras also may present at medical facilities, given the interest in exotic pet ownership in the United States. Read More

Toxicon 2020 Nov 23;187:232-244. Epub 2020 Sep 23.

Laboratório de Herpetologia, Centro Multidisciplinar, Campus Floresta, Universidade Federal do Acre, Cruzeiro do Sul, Acre, Brazil; Universidade Federal do Acre, Programa de Pós-Graduação Stricto Sensu em Ciências da Saúde na Amazônia Ocidental, Rio Branco, Acre, Brazil; Programa de Pós-Graduação Bionorte, Universidade Federal do Acre, Campus Universitário - BR 364, Rio Branco, Acre, Brazil. Electronic address:

People who live in rural or forested areas are more likely to be affected by snakebites, due to their presence in the natural habitat of snakes and due to activities such as extractivism and agriculture. To conduct an ethnobiological study regarding the knowledge related to venomous snakes, snakebites and the attitudes of people who frequent areas of floodplain forests in the Alto Juruá (Brazilian Amazon), and correlate this information with data on snakebites in the region and the ecology of the ophiofauna, 100 residents, who are actively involved in extractivism, fishing, or hunting in the forests of the region were interviewed. Boards with photographs of venomous snakes from the region were used to ask questions about their experiences. Read More

J Med Toxicol 2021 01 14;17(1):51-56. Epub 2020 Aug 14.

American College of Medical Toxicology, Phoenix, AZ, USA.

Introduction: Few of the 5000-8000 snakebites reported to poison control centers annually in the USA are attributed to coral snakes. This study describes Texas coral snake envenomations reported to the North American Snakebite Registry.

Methods: All Texas coral snake envenomation cases reported to the registry were identified for the period from January 1, 2015, through December 31, 2019. Read More

Int J Biol Macromol 2020 Dec 8;164:1908-1915. Epub 2020 Aug 8.

Departamento de Bioquímica e Imunologia, ICB, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, CEP: 31270-901 Belo Horizonte, Minas Gerais, Brazil. Electronic address:

Micrurus surinamensis (Cuvier, 1817), popularly known as aquatic coral snake, has a broad geographic distribution in the Rainforest of South America. The purpose of this study was to investigate the cytotoxic effect caused by M. surinamensis venom in H9c2 cardiomyoblast cells and to identify protein components involved in cardiotoxic processes. Read More

Toxicon 2020 Oct 22;185:193-202. Epub 2020 Jul 22.

Universidade Federal do Amazonas - UFAM, Instituto de Ciências Biológicas, Programa de Pós-Graduação em Zoologia, Av. General Rodrigo Octavio, 1200, Coroado I, 69067-005, Manaus, Amazonas, Brazil.

Envenomation by coral snakes represents a little known burden in Brazilian Amazonia. So far, details on clinical and epidemiological aspects remain obscure in the region. We gathered data from medical charts and from the scientific collection of snakes from Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, finding 26 cases of envenomation by five species of Micrurus in Manaus region, between 1987 and 2018. Read More

Toxicon 2020 Jul 24;181:45-52. Epub 2020 Apr 24.

Federal University of Ceará (UFC), Department of Physiology and Pharmacology, Brazil. Electronic address:

The Micrurus snake venoms mainly cause systemic complications, essentially neurotoxicity. Previous studies, however, have described that they are involved in the occurrence of acute kidney injury (AKI) in animal models. AKI pathogenesis in snakebites is multifactorial and involves immunological reactions, hemodynamic disturbances, and direct nephrotoxicity. Read More

Toxicon 2020 Feb 27;175:7-18. Epub 2019 Nov 27.

Universidade Federal do Amazonas - UFAM, Instituto de Ciências Biológicas, Programa de Pós-Graduação em Zoologia, Av. General Rodrigo Octavio, 1200, Coroado I, 69067-005, Manaus, Amazonas, Brazil.

Coral snakes constitute a relatively diverse and little known group of venomous snakes. So far, data for this kind of snakebite in the Amazon region are based only on case reports. This study takes advantage of novel data from the Brazilian Health Ministry database from 2010 to 2015 and presents a review of the cases reported in the literature regarding the Amazonian biome both from Brazil and nearby countries. Read More

J Vet Emerg Crit Care (San Antonio) 2019 Nov 18;29(6):662-667. Epub 2019 Oct 18.

College of Veterinary Medicine, Small Animal Clinical Sciences, North Carolina State University, Raleigh, North Carolina.

Objective: To describe the use of mechanical ventilation (MV) in the management of Eastern coral snake envenomation in 7 dogs and a cat.

Design: Retrospective study (2011-2016).

Setting: University teaching hospital. Read More

Mol Immunol 2019 12 7;116:45-55. Epub 2019 Oct 7.

Laboratorio de Fisiopatología, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas, Venezuela. Electronic address:

An acute inflammatory response, cellular infiltrates, anemia, hemorrhage and endogenous fibrinolysis activation were previously described in C57BL/6 mice injected with M. tener tener venom (Mtt). As the endothelium and innate immunity may participate in these disturbances and due to our poor understanding of the alterations produced by these venoms when the neurotoxic component is not predominant, we evaluated the effects in an in vitro model. Read More

Toxicon 2019 Aug 21;166:34-38. Epub 2019 May 21.

Laboratório de Herpetologia, Campus Floresta, Universidade Federal do Acre, Cruzeiro do Sul, Acre, Brazil. Electronic address:

Bites by Micrurus snakes in Brazilian Amazon represent about 0.4% of snakebite registered in that area. There is not information available about the M. Read More

Clin Toxicol (Phila) 2020 02 13;58(2):132-135. Epub 2019 May 13.

Campinas Poison Control Center, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil.

To report two patients who developed systemic neurotoxicity after consecutive bites by the same coral snake. Two previously healthy men (32-year-old and 34-year-old) found a coral snake in a woodpile while collecting wood for a barbecue. During the barbecue, both men became drunk and "played" with the snake, believing that they were handling a false coral snake, and were bitten within a few minutes of each other. Read More

Toxicon 2019 Jun 15;164:71-81. Epub 2019 Apr 15.

Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Nacional de Medicina Tropical (INMeT), Neuquén y Jujuy s/n, 3370, Puerto Iguazú, Argentina. Electronic address:

Most colubrid snake venoms have been poorly studied, despite the fact that they represent a great resource for biological, ecological, toxinological and pharmacological research. Herein, we explore the venom delivery system of the Aesculapian False Coral Snake Erythrolamprus aesculapii as well as some biochemical and toxicological properties of its venom. Its Duvernoy's venom gland is composed of serous secretory cells arranged in densely packed secretory tubules, and the most striking feature of its fang is their double-curved shape, exhibiting a beveled bladelike appearance near the tips. Read More

J Proteomics 2019 05 1;200:90-101. Epub 2019 Apr 1.

Evolutionary and Translational Venomics Laboratory, CSIC, Valencia, Spain. Electronic address:

Micrurus is a monophyletic genus of venomous coral snakes of the family Elapidae. The ~80 recognized species within this genus are endemic to the Americas, and are distributed from southeastern United States to northern Argentina. Although relatively few bites are recorded due to their reclusive nature, semi-fossorial habits, and their occurrence in sparsely populated areas, coral snakes possess powerful venoms that target the cholinergic system and, if early treatment is missed, can cause neuromuscular paralysis, respiratory failure, and death by asphyxiation within hours of envenoming. Read More

Toxicon 2019 May 21;163:70-73. Epub 2019 Mar 21.

Laboratório de Herpetologia, Instituto Butantan, Av. Dr. Vital Brasil 1500, 05503-900, São Paulo, SP, Brazil. Electronic address:

Infrared thermography is a technique that quantifies the thermal (infrared) radiation emitted by an object and produces a high-resolution, digital thermal image of it. Medically, this technique is used to visualize the body's surface temperature distribution in a non-invasive, safe, and convenient fashion. However, to the best of our knowledge, the use of infrared thermography for assessing the systemic effects of envenomation by coral snakes has not been reported. Read More

J Emerg Med 2019 May 14;56(5):519-522. Epub 2019 Mar 14.

Department of Emergency Medicine, Baylor Scott and White Medical Center - Temple, Texas A&M Health Science Center College of Medicine, Temple, Texas.

Background: Coral snake bites from Micrurus fulvius and Micrurus tener account for < 1% of all snake bites in North America. Coral snake envenomation may cause significant neurotoxicity, including respiratory insufficiency, and its onset may be delayed up to 13 h.

Case Report: We present a unique patient encounter of M. Read More

Clin Toxicol (Phila) 2019 Aug 18;57(8):727-734. Epub 2019 Feb 18.

a Departamento de Biología Molecular y Bioprocesos , Instituto de Biotecnología Universidad Nacional Autónoma de México , Cuernavaca , México.

Historically, administration and dosing of antivenom (AV) have been guided primarily by physician judgment because of incomplete understanding of the envenomation process. As demonstrated previously, lymphatic absorption plays a major role in the availability and pharmacokinetics (PK) of coral snake venom injected subcutaneously, which suggests that absorption from subcutaneous tissue is the limiting step for venom bioavailability, supporting the notion that the bite site is an ongoing venom depot. This feature may underlie the recurrence phenomena reported in viperid envenomation that appear to result from a mismatch between venom and AV PK. Read More

Toxicon 2019 Mar 17;159:38-40. Epub 2019 Jan 17.

Division of Medical Toxicology, Department of Emergency Medicine, University of Pittsburgh School of Medicine, Iroquois Building Suite 400, 3600 Forbes Ave, Pittsburgh, PA 15213, USA. Electronic address:

The South African coral snake (Aspidelaps lubricus, Elapidae) has not previously been reported to cause any neurotoxic envenomations in humans. We recently treated a 44-year-old man who was bitten twice, once in each hand, by a captive South African coral snake (Aspidelaps lubricus) while feeding the female snake who had recently laid eggs. Approximately one hour after receiving the bite, he developed vomiting, respiratory failure requiring mechanical ventilation, and paralysis of the bulbar and upper extremity muscles, with retention of voluntary motor control in the lower extremities. Read More

J Anim Sci 2019 Feb;97(2):972-980

Laboratório de Herpetologia do Instituto Butantan, CEP, São Paulo, Brazil.

Envenoming and deaths resulting from snakebites are a particularly important public health problem in rural tropical areas of Africa, Asia, Latin America, and New Guinea. In 2015, The Lancet highlighted snake-bite envenoming as a neglected tropical disease and urged the world to increase antivenom production. In Brazil, around 20,000 snakebites occur per year affecting mostly agricultural workers and children, of which 1% is caused by coral snakes (Micrurus sp. Read More