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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 Proteomics 2018 Oct 2. Epub 2018 Oct 2.

Alistair Reid Venom Research Unit, Parasitology Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. Electronic address:

While envenoming by the southern African shield-nosed or coral snakes (genus Aspidelaps) has caused fatalities, bites are uncommon. Consequently, this venom is not used in the mixture of snake venoms used to immunise horses for the manufacture of regional SAIMR (South African Institute for Medical Research) polyvalent antivenom. Aspidelaps species are even excluded from the manufacturer's list of venomous snakes that can be treated by this highly effective product. Read More

Trop Med Infect Dis 2018 Aug 21;3(3). Epub 2018 Aug 21.

RN Kantonspital Basel 4031, Switzerland.

Venomous snake bites in the Solomon Islands can be very dangerous due to lack of access to health care. There are no documented case reports of envenomation by snake bites in the Solomon Islands. This case report highlights the management of a patient with potentially lethal neurotoxicity secondary to a (Solomons coral snake) in a low resource setting. Read More

Emerg Med Pract 2018 Sep 1;20(19 Suppl):1-2. Epub 2018 Sep 1.

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY

There are approximately 10,000 emergency department visits in the United States for snakebites every year, and one-third of those involve venomous species. Venomous North American indigenous snakes include species from the Crotalinae (pit vipers) and Elapidae (coral snakes) subfamilies. Treatment relies on supportive care, plus antivenom for select cases. Read More

Emerg Med Pract 2018 Sep 1;20(9):1-26. Epub 2018 Sep 1.

Emergency Medicine/Clinical Toxicology Fellow, Florida Poison Information Center at Jacksonville, University of Florida Health, Jacksonville, FL.

There are approximately 10,000 emergency department visits in the United States for snakebites every year, and one-third of those involve venomous species. Venomous North American indigenous snakes include species from the Crotalinae (pit vipers) and Elapidae (coral snakes) subfamilies. Treatment relies on supportive care, plus antivenom for select cases. Read More

J Venom Anim Toxins Incl Trop Dis 2018 10;24:10. Epub 2018 Apr 10.

2Laboratory of Pharmacology of Toxins, Institute of Biomedical Sciences, Center of Health Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, RJ Brazil.

Background: Bites provoked by the genus represent less than 1% of snakebite cases notified in Brazil, a tiny fraction compared with other genus such as and , which together represent almost 80% of accidents. In addition to their less aggressive behavior, habits and morphology of coral snakes are determinant factors for such low incidence of accidents. Although bites are rare, victims must be rescued and hospitalized in a short period of time, because this type of envenoming may evolve to a progressive muscle weakness and acute respiratory failure. Read More

Biochimie 2018 Apr 31;147:114-121. Epub 2018 Jan 31.

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

The three-finger toxins (3FTxs) represent an extremely diverse protein family in elapid venoms, where the short chain α-neurotoxins are the most relevant toxin group from the clinical point of view. Essentially, the 3FTxs variability and the low proportions of α-neurotoxins in the venoms of North American coral snakes make it difficult to obtain effective elapid antivenoms against the envenomation symptoms caused mainly by these α-neurotoxins. In this work, thirty 3FTx transcript sequences were obtained from the venom glands of four coral snake species from Mexico (M. Read More

Toxicon 2018 Jan 24;141:51-54. Epub 2017 Nov 24.

Escola Superior de Saúde, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil; Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.

Micrurus snakes, commonly known as coral snakes, are responsible for 0.4% of the snakebites envenomings in Brazil. In this report, we describe a case of envenoming by Micrurus averyi, the black-headed coral snake, recorded in the western Brazilian Amazon. Read More

PLoS Negl Trop Dis 2017 Nov 21;11(11):e0005874. Epub 2017 Nov 21.

Laboratory of Pharmacology, Butantan Institute, Sao Paulo, SP, Brazil.

Background/aims: Micrurus is one of the four snake genera of medical importance in Brazil. Coral snakes have a broad geographic distribution from the southern United States to Argentina. Micrurine envenomation is characterized by neurotoxic symptoms leading to dyspnea and death. Read More

Bull Soc Pathol Exot 2017 Oct 14;110(4):276-280. Epub 2017 Aug 14.

Département de biologie médicale, hôpital d'instruction des armées Bégin, 94300, Saint-Mandé, France.

We report here the first known envenomation by Micrurus psyches, the so-called Carib coral snake, which occurred on April 2016 in the surroundings of Saint-Laurent-du-Maroni, Western French Guiana. Besides local neurological symptoms, it featured unexpected electrocardiogram changes, which were emergence of a first-degree atrioventricular block and biphasic T waves, both transient. NewWorld elapid venoms were not known for being cardiotoxic so far. Read More

Int J Biol Macromol 2017 Oct 18;103:525-532. Epub 2017 May 18.

Centro de Estudos de Biomoléculas Aplicadas a Saúde, CEBio, Fundação Oswaldo Cruz, FIOCRUZ, Fiocruz Rondônia and Departamento de Medicina, Universidade Federal de Rondônia, UNIR, 76812-245 Porto Velho, RO, Brazil; Centro Universitário São Lucas, UNISL, Porto Velho, RO, Brazil. Electronic address:

Phospholipases A inhibitors (PLIs) produced by venomous and non-venomous snakes play essential role in this resistance. These endogenous inhibitors may be classified by their fold in PLIα, PLIβ and PLIγ. Phospholipases A (PLAs) develop myonecrosis in snake envenomation, a consequence that is not efficiently neutralized by antivenom treatment. Read More

Emerg Med Clin North Am 2017 May;35(2):339-354

Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 West Arbor Drive # 8676, San Diego, CA 92103, USA.

Native US snakes that produce clinically significant envenomation can be divided into 2 groups, crotalids and elapids. The crotalids include rattlesnakes, cottonmouths, and copperheads. Crotalid envenomation can result in significant local tissue damage as well as thrombocytopenia and coagulopathy. Read More

Biochimie 2017 Jun 14;137:88-98. Epub 2017 Mar 14.

Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.

Snake venom phospholipases A (PLA) share high sequence identities and a conserved structural scaffold, but show important functional differences. Only a few PLAs have been purified and characterized from coral snake (Micrurus spp.) venoms, and their role in envenomation remains largely unknown. Read More

J Venom Anim Toxins Incl Trop Dis 2017 14;23. Epub 2017 Feb 14.

Department of Physiological Sciences, School of Health Sciences, Universidad del Valle, Cali, Colombia.

Background: Although the red-tailed coral snake () is widely distributed in Colombia and its venom is highly neurotoxic and life threatening, envenomation by this species is rare. Therefore, this report may shed some light on the clinical presentation of bites.

Case Presentations: Herein, we describe two cases of patients bitten by red-tailed coral snakes, illustrating the clinical presentation of the victims, the outcomes and treatment provided. Read More

J Venom Anim Toxins Incl Trop Dis 2016 9;22(1):25. Epub 2016 Sep 9.

Departamento de Medicina Molecular y Bioprocesos, Instituto de Biotecnología, Universidad Nacional Autónoma de México (UNAM), Av. Universidad 2001, Cuernavaca, 62210 Morelos Mexico.

Background: The cysteine-rich neurotoxins from elapid venoms are primarily responsible for human and animal envenomation; however, their low concentration in the venom may hamper the production of efficient elapid antivenoms. Therefore, the aim of the present study was to produce fully active elapid neurotoxic immunogens for elapid antivenom production.

Method: Cysteine-rich neurotoxins showed recombinant expression in two strains of E. Read More

Clin Toxicol (Phila) 2017 Jan 5;55(1):33-39. Epub 2016 Sep 5.

f Centro de Biotecnologia , IPEN , São Paulo , Brazil.

Context: Although rare, coral snake envenomation is a serious health threat in Brazil, because of the highly neurotoxic venom and the scarcely available antivenom. The major bottleneck for antivenom production is the low availability of venom. Furthermore, the available serum is not effective against all coral snake species found in Brazil. Read More

Toxicon 2016 Jul 1;117:59-68. Epub 2016 Apr 1.

Laboratório de Imunoquímica, Butantan Institute, São Paulo, SP, Brazil. Electronic address:

Micrurus snakebites can cause death by muscle paralysis and respiratory arrest a few hours after envenomation. The specific treatment for these snake envenomations is the intravenous application of heterologous antivenom. In Brazil, this antivenom is produced from horses that are immunized with a mixture of Micrurus corallinus and Micrurus frontalis venoms, which are snakes that inhabit the south and southeastern regions of the country. Read More

PLoS Negl Trop Dis 2016 Mar 3;10(3):e0004484. Epub 2016 Mar 3.

Centro de Biotecnologia, Instituto Butantan, São Paulo, São Paulo, Brazil.

Background: Envenoming by coral snakes (Elapidae: Micrurus), although not abundant, represent a serious health threat in the Americas, especially because antivenoms are scarce. The development of adequate amounts of antielapidic serum for the treatment of accidents caused by snakes like Micrurus corallinus is a challenging task due to characteristics such as low venom yield, fossorial habit, relatively small sizes and ophiophagous diet. These features make it difficult to capture and keep these snakes in captivity for venom collection. Read More

Clin Toxicol (Phila) 2016 Mar 25;54(3):222-34. Epub 2016 Jan 25.

a Campinas Poison Control Center, Faculty of Medical Sciences, State University of Campinas (UNICAMP) , Campinas , São Paulo , Brazil ;

Context: In the Americas, the main representatives of the family Elapidae are coral snakes of the genus Micrurus, of which 33 species are in Brazil. They are the smallest cause of venomous snakebite in Brazil. We analyzed literature reports of coral snake bites in Brazil from 1867 to 2014, and provide a brief review of case series and reports of coral snake bites in the Americas in general. Read More

J Proteomics 2016 Jan 17;132:1-12. Epub 2015 Nov 17.

Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Unlabelled: The venom proteome of the Malayan blue coral snake, Calliophis bivirgata flaviceps from west Malaysia was investigated by 1D-SDS-PAGE and shotgun-LCMS/MS. A total of 23 proteins belonging to 11 protein families were detected from the venom proteome. For the toxin proteins, the venom consists mainly of phospholipase A2 (41. Read More

J Med Toxicol 2015 Dec;11(4):430-2

Department of Emergency Medicine, Brody School of Medicine at East Carolina University, 600 Moye Boulevard, Room 3ED311, Greenville, NC, 27834, USA.

Antivenom is the definitive treatment for venomous snakebites. Alternative treatments warrant investigation because antivenom is sometimes unavailable, expensive, and can have deleterious side effects. This study assesses the efficacy of trypsin to treat coral snake envenomation in an in vivo porcine model. Read More

Toxicon 2015 Jan 29;93:51-60. Epub 2014 Oct 29.

Departamento de Bioquímica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address:

The main goal of this work was to develop a strategy to identify B-cell epitopes on four different three finger toxins (3FTX) and one phospholipase A2 (PLA2) from Micrurus corallinus snake venom. 3FTx and PLA2 are highly abundant components in Elapidic venoms and are the major responsibles for the toxicity observed in envenomation by coral snakes. Overlapping peptides from the sequence of each toxin were prepared by SPOT method and three different anti-elapidic sera were used to map the epitopes. Read More

Am J Emerg Med 2014 Sep 12;32(9):1024-6. Epub 2014 Jun 12.

Department of Emergency Medicine, Brody School of Medicine at East Carolina University, Greenville NC. Electronic address:

Background: Pressure immobilization bandages delay mortality for 8 hours after coral snake envenomation, but long-term efficacy has not been established.

Objective: The objective of this study is to determine the long-term efficacy of pressure immobilization bandages after coral snake envenomation in the absence of antivenom therapy.

Methods: A randomized, observational pilot study was conducted. Read More

Pediatr Emerg Care 2014 Apr;30(4):262-5

From the Division of Critical Care Medicine, Miami Children's Hospital, Miami, FL.

Objective: North America is home to 2 families of venomous snakes, Crotalinae (pit viper family) and Elapidae (coral snake family). Although there are several published reports describing and reviewing the management of pit viper snakebites in children, there are no recent similar publications detailing the clinical course and management of coral snake envenomation.

Methods: Our case series describes the hospital course of children with coral snake bites admitted to our regional pediatric intensive care. Read More

Trans R Soc Trop Med Hyg 2014 May 11;108(5):269-76. Epub 2014 Mar 11.

Departamento de Vacunas y Sueros, INPB-ANLIS 'Dr Carlos G. Malbrán', Ministerio de Salud, Argentina.

Background: The incidence and case fatality rate of snakebite in Argentina are poorly known.

Methods: The authors used questionnaires provided with antivenoms by the primary manufacturer of anti-venoms in Argentina.

Results: A total of 8083 completed questionnaires was collected between 1978 and 1998. Read More

J Proteomics 2014 Jun 5;105:295-306. Epub 2014 Mar 5.

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

Unlabelled: Here we show for the first time that the venom from an elapid (Micrurus fulvius) contains three finger toxin (3FTxs) peptides with low toxicity but high content of lethal phospholipases A2 (PLA2). The intravenous venom LD50 in mice was 0.3μg/g. Read More

Toxicon 2014 Jan 23;77:6-15. Epub 2013 Oct 23.

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

The objective of this study was to identify the venom components that could play a relevant role during envenomation caused by the coral snake Micrurus tener, through its biochemical characterization as well as the analysis of its effects on a murine model. Furthermore, it aimed to evaluate crude venom, in addition to its components, for possible specificity of action on a natural prey model (Conopsis lineata). The toxicity of the crude venom (delivered subcutaneously) showed a significant difference between the Median Lethal Dose (LD₅₀) in mice (4. Read More

Neth J Med 2013 Oct;71(8):437-41

Internist at the Havenziekenhuis and the Institute of Tropical Diseases and the Travel Clinic, Havenziekenhuis, Rotterdam, The Netherlands.

Objective: To describe the incidence of venomous snakebites and the hospital treatment thereof (if any) amongst private individuals who keep venomous snakes as a hobby.

Structure: Descriptive study.

Method: Private keepers of venomous snakes were invited via the social media Facebook, Hyves, Twitter, Google Plus, Linked In and two large discussion forums to fill in an online questionnaire on a purely voluntary and anonymous basis. Read More

Clin Toxicol (Phila) 2013 Sep-Oct;51(8):783-8. Epub 2013 Aug 20.

Department of Pharmacy, Nemours Children's Hospital , Orlando, FL , USA.

Context: Envenomation by the Eastern coral snake is rare but may be associated with significant morbidity. While effective, acquisition of North American Coral Snake Antivenin (NACSAV) is difficult because production was discontinued for many years.

Objective: The purpose of this study is to characterize coral snake exposures in Florida and determine the effects of varying treatment paradigms on patient outcomes. Read More

Rev Inst Med Trop Sao Paulo 2013 Jan-Feb;55(1):13-8

Laboratorio de Toxinopatología, Centro de Patología Experimental y Aplicada, Facultad de Medicina, Universidad de Buenos Aires, CABA, Argentina.

Envenomation by coral snakes (Micrurus sp.) is one of the most dangerous injuries in America and it is considered as a serious medical emergency, however bites by these snakes appear to be rare. We analyzed epidemiological data, clinical signs and antivenom use in Argentina during the period between 1979-2003. Read More

J Vet Emerg Crit Care (San Antonio) 2012 Dec 15;22(6):682-9. Epub 2012 Nov 15.

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA.

Objective: To describe the clinical signs, treatment, and outcomes of dogs and cats following envenomation by the eastern coral snake and to report our clinical experience with the use of Coralmyn.

Design: Retrospective study (1996-2011).

Setting: University teaching hospital. Read More

BMC Immunol 2012 Jan 16;13. Epub 2012 Jan 16.

Immunochemistry Laboratory, Butantan Institute, Av, Vital Brazil, 1500, São Paulo, 05503-900, Brazil.

Background: The genus Micrurus, coral snakes (Serpentes, Elapidae), comprises more than 120 species and subspecies distributed from the south United States to the south of South America. Micrurus snake bites can cause death by muscle paralysis and further respiratory arrest within a few hours after envenomation. Clinical observations show mainly neurotoxic symptoms, although other biological activities have also been experimentally observed, including cardiotoxicity, hemolysis, edema and myotoxicity. Read More

Medicina (Kaunas) 2011 18;47(8):461-7. Epub 2011 Nov 18.

Department of Intensive Care, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50028 Kaunas, Lithuania.

More than 5 million people are bitten by venomous snakes annually and more than 100,000 of them die. In Europe, one person dies due to envenomation every 3 years. There is only one venomous snake species in Lithuania--the common adder (Vipera berus)--which belongs to the Viperidae family; however, there are some exotic poisonous snakes in the zoos and private collections, such as those belonging to the Elapidae family (cobras, mambas, coral snakes, etc. Read More

Wilderness Environ Med 2011 Dec 1;22(4):304-8. Epub 2011 Oct 1.

Department of Biological Sciences, California State University, Sacramento, CA, USA.

The rapid and accurate recognition of dangerously venomous snakes following bites is crucial to making appropriate decisions regarding first aid, evacuation, and treatment. Past recommendations for identification of dangerous North American pit vipers have often required subjective determinations of head shape or relied on traits shared with some nondangerous species (elliptical pupils and undivided subcaudal scales). Heat-sensitive facial pits are diagnostic but require close examination of the dangerous head, and cephalic traits are useless when working with a decapitated carcass. Read More

J Am Coll Surg 2011 Apr;212(4):470-4; discussion 474-5

East Texas Medical Center, Crockett, Texas 75835, USA.

Background: Several thousand snakebites occur annually in the US, but fewer than 10 deaths occur. Most deaths are from envenomations by rattlesnakes (Crotalus species), but deaths from copperhead and water moccasin (Agkistrodon species) are rare.

Study Design: All snakebites presented to East Texas Medical Center, Crockett, a level III trauma center, from 1995 to 2010 were reviewed. Read More

Rev Inst Med Trop Sao Paulo 2010 Nov-Dec;52(6):333-7

Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Brazil.

Two cases of proven coral snake bites were reported in Belém, Pará State, Brazil. The first case was a severe one caused by Micrurus surinamensis. The patient required mechanical ventilation due to acute respiratory failure. Read More

J Emerg Med 2011 Jul 26;41(1):102-7. Epub 2010 May 26.

Department of Emergency Medicine, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA.

Background: Pressure immobilization bandages have been shown to delay onset of systemic toxicity after Eastern coral snake (Micrurus fulvius) envenomation to the distal extremity.

Objectives: To assess the efficacy of a novel compression device in delaying onset of systemic toxicity after truncal envenomations with Eastern coral snake (Micrurus fulvius) venom in a porcine model.

Methods: With University approval, nine juvenile pigs (11 kg to 22 kg) were sedated, anesthetized, and intubated but not paralyzed to ensure continuous spontaneous respirations in a university animal laboratory. Read More

J Med Toxicol 2010 Jun;6(2):207-11

Department of Emergency Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USA.

Nearly all prior studies to delay onset of systemic toxicity and death after snake bite use a model of distal extremity envenomation. In the first of a series of planned studies using snake venoms with different toxicity profiles, the application of a novel device in a new model of torso envenomation in the setting of Eastern Coral Snake (Micrurus fulvius) venom (a potent neurotoxin) envenomation showed promise by delaying systemic intoxication. In this pilot study, we investigated this novel localizing circumferential compression (LoCC) device's ability to delay onset of life threatening systemic toxicity after Eastern Diamondback Rattlesnake (Crotalus adamanteus) envenomation, a potent hemotoxic and myotoxic venom. Read More

Toxicon 2010 Aug 21;56(1):55-63. Epub 2010 Mar 21.

Universidade de Brasília - Pós-graduação em Biologia Animal, Brasília-DF, Brazil.

Neurotoxicity is a major symptom of envenomation caused by Brazilian coral snake Micrurus frontalis. Due to the small amount of material that can be collected, no neurotoxin has been fully sequenced from this venom. In this work we report six new three-finger like toxins isolated from the venom of the coral snake M. Read More

PLoS Negl Trop Dis 2010 Mar 9;4(3):e622. Epub 2010 Mar 9.

Immunochemistry Laboratory, Butantan Institute, São Paulo, SP, Brazil.

Background: Micrurus snake bites can cause death by muscle paralysis and respiratory arrest, few hours after envenomation. The specific treatment for coral snake envenomation is the intravenous application of heterologous antivenom and, in Brazil, it is produced by horse immunization with a mixture of M. corallinus and M. Read More

Clin Toxicol (Phila) 2010 Jan;48(1):72-8

Department of Emergency Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA.

Introduction: The only U.S. Food and Drug Administration-approved coral snake antivenom was officially discontinued in 2007, causing ever-diminishing supplies. Read More

Am Fam Physician 2009 Oct;80(8):793-802

Women's and Children's Hospital, North Adelaide, South Australia, Australia.

About 4,000 to 6,000 venomous snakebites occur each year in the United States. Although these envenomations (also known as envenomings) are rarely fatal, about 70 percent require antivenom therapy. Few evidence-based guidelines are available for the management of envenomation. Read More

Toxicon 2009 May;53(6):693-7

Department of Surgery, Stanford University, 701 Welch Rd, Suite C, Palo Alto, CA 94304-5777, USA.

We report the first documented death due to a coral snake (Micrurus species) in the United States (U.S.) in over 40 years. Read More

Clin Toxicol (Phila) 2009 Apr;47(4):327-35

New Mexico Poison and Drug Information Center, University of New Mexico Health Sciences Center, Albuquerque, NM 87131-0001, USA.

Background: Differences in victim demographics, clinical effects, managements, and outcomes among native viperid (rattlesnake, copperhead, and cottonmouth) and elapid (coral snake) species have not been systematically characterized.

Methods: The database of the American Association of Poison Control Centers from 2001 through 2005 was analyzed.

Results: Between 2001 and 2005, there were 23,676 human exposures (average = 4,735/year) to native venomous snakes in the United States reported to U. Read More

Toxicon 2009 Mar 25;53(3):375-82. Epub 2008 Dec 25.

Instituto Nacional de Producción de Biológicos, ANLIS - Dr. Carlos G. Malbran, Av. Velez Sarsfield 563, (1282) Buenos Aires, Argentina.

Snake venom toxicity is the consequence of a combination of peptides and proteins whose identification and characterization are of great importance to understand envenomation and develop new clinical treatments. The Elapinae subfamily includes coral snakes whose bite causes mainly neurotoxic effects which disable muscle contraction and paralyse the heart as well as inhibit respiration. However, the structure-function relationship of venom toxins has been investigated only for a few species. Read More

BMJ Case Rep 2009 10;2009. Epub 2009 May 10.

Pittsburgh Poison Center, University of Pittsburgh Medical Center, Schools of Pharmacy and Medicine, University of Pittsburgh, Pennsylvania, USA.

Emergency departments throughout the USA may have some familiarity with the management of envenomation from indigenous snake species such as Crotalinae (rattlesnakes) and Micrurus (coral snakes). However, venomous species may include exotic reptiles whose bites pose substantial treatment challenges due to both a lack of experience and the difficulty in obtaining antivenoms. Two pet cobra envenomation incidents illustrate the challenges that face emergency departments, especially in urban settings, that are confronted with these exposures. Read More

Trans R Soc Trop Med Hyg 2008 Nov 16;102(11):1127-32. Epub 2008 May 16.

Hospital Vozandes del Oriente, Shell, Pastaza, Ecuador.

A man bitten by a large coral snake (Micrurus lemniscatus helleri) in the Amazon basin of Ecuador developed persistent excruciating pain in the bitten arm. On admission to hospital less than 30 min later, he had a polymorphonuclear leucocytosis, thrombocytopenia and mildly prolonged prothrombin time/partial thromboplastin time. Not until 14 h after the bite did he develop the first signs of neurotoxicity. Read More

Toxicon 2008 Feb 13;51(2):297-303. Epub 2007 Oct 13.

Natural Toxins Research Center, 975 W. Avenue B, MSC 158, Texas A&M University-Kingsville, Kingsville, TX 78363, USA.

Elapid snakes throughout the world are considered very lethal, containing neurotoxic venoms that affect the nervous system. When humans are envenomated it is considered a serious medical emergency, and antivenom is the main form of treatment considered, in spite of the fact that some patients may only survive under intensive therapy treatment such as respiratory support. Coral snakes are part of the family Elapidae and envenomations by these snakes are very low (<2% of total snakebites) in most countries from southeastern United States to Argentina. Read More

Emerg Med J 2007 Nov;24(11):796-7

Pittsburgh Poison Center, University of Pittsburgh Medical Center, School of Pharmacy, University of Pittsburgh, PA 15213, USA.

Emergency departments throughout the USA may have some familiarity with the management of envenomation from indigenous snake species such as Crotalinae (rattlesnakes) and Micrurus (coral snakes). However, venomous species may include exotic reptiles whose bites pose substantial treatment challenges due to both a lack of experience and the difficulty in obtaining antivenoms. Two pet cobra envenomation incidents illustrate the challenges that face emergency departments, especially in urban settings, that are confronted with these exposures. Read More

South Med J 2007 Feb;100(2):152-6

Central Texas Poison Center, the Department of Emergency Medicine, Scott and White Memorial Hospital, Texas A&M System Health Science Center, Temple, TX 76508, USA.

Background: The clinical features of bites from Texas coral snakes (Micrurus tener) have not been well studied. Our goal was to review the largest number of victims of Texas coral snakebites to determine their characteristics, effects, treatment, and outcome.

Methods: Retrospective case series of Micrurus tener exposures reported to the Texas Poison Center Network from 2000 to 2004. Read More