Cambodia - Very Venomous Snakes Found - Bungarus fasciatus

Bungarus fasciatus ( Banded Krait )

Original photo copyright © Dr Julian White

Family: Elapidae

Subfamily: Elapinae

Genus: Bungarus

Species: fasciatus

Common Names: Banded Krait , Golden Banded Snake

Local Names: Ngan-Daw-Gyar Mwe , Jin Huan She , Ular Katang Belang , Ngu Sam Lien , Ular Welang , Oraj Welang , Katam , Buku Tebu , Pomolong , Kengkang Tebu

Region: Indian Sub-continent + North Asia + Southeast Asia

Countries : Bangladesh, Brunei, Cambodia, China, Hong Kong, Indonesia, India, Laos, Malaysia, Myanmar, Nepal, Singapore, Thailand, Vietnam

Bungarus fasciatus ( Banded Krait ) Original photo copyright © Dr Julian White

Taxonomy and Biology

Adult Length: 1.20 m

General Shape: Large in length, moderately slender bodied snake with a triangular shaped cross-section ( pronounced ridge on the vertebral line ) and a short tail. Tail is blunt, thick and slightly bulbous at the tip. Can grow to a maximum of about 2.25 metres. Head is flat and slightly distinct from neck. Eyes are small in size and black with barely visible round pupils. Nostrils are large. Dorsal scales are smooth and glossy with the vertebral row enlarged and hexagonal. Ventrals are rounded. Dorsal scale count 15 ( 17 ) - 15 - 15.

Habitat: Inhabits moist and wet open plains, lowland forest ( particularly mangrove forest ) usually up to about 1300 metres ( 2300 metres has been recorded ) and in and around human habitations. Often found in rice fields and rubber plantations but has a preference for dry open forest and woodlands.

Habits: Nocturnal, terrestrial, slow moving and cannibalistic snake. Often found in large numbers. Very inoffensive ( lethargic ) disposition by day. When disturbed it coils loosely and hides its head beneath its body. Reluctant to bite except upon persistent provocation. At night it will strike readily.

Prey: Feeds on snakes and occasionally eats lizards and other vertebrates.

Bungarus fasciatus ( Banded Krait ) Original photo copyright © Dr Wolfgang Wuster - Java

Venom

General: Venom Neurotoxins	Pre- & Post-synaptic neurotoxins
General: Venom Myotoxins	Not present
General: Venom Procoagulants	Not present
General: Venom Anticoagulants	Not present
General: Venom Haemorrhagins	Not present
General: Venom Nephrotoxins	Not present
General: Venom Cardiotoxins	Not present
General: Venom Necrotoxins	Not present
General: Venom Other	Not present or not significant

Clinical Effects

General: Dangerousness	Severe envenoming possible, potentially lethal
General: Rate of Envenoming	Unknown but likely to be low
General: Untreated Lethality Rate	1-10%
General: Local Effects	None or minimal
General: Local Necrosis	Not likely to occur
General: General Systemic Effects	Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, dizziness, collapse or convulsions
General: Neurotoxic Paralysis	Very common, flaccid paralysis is major clinical effect
General: Myotoxicity	Not likely to occur
General: Coagulopathy & Haemorrhages	Unlikely to occur
General: Renal Damage	Unlikely to occur
General: Cardiotoxicity	Unlikely to occur
General: Other	Not likely to occur

First Aid

Description: First aid for bites by Elapid snakes which do not cause significant injury at the bite site, but which may have the potential to cause significant general (systemic) effects, such as paralysis, muscle damage, or bleeding.

Details

1. After ensuring the patient and onlookers have moved out of range of further strikes by the snake, the bitten person should be reassured and persuaded to lie down and remain still. Many will be terrified, fearing sudden death and, in this mood, they may behave irrationally or even hysterically. The basis for reassurance is the fact that many venomous bites do not result in envenoming, the relatively slow progression to severe envenoming (hours following elapid bites, days following viper bites) and the effectiveness of modern medical treatment.

2. The bite wound should not be tampered with in any way. Wiping it once with a damp cloth to remove surface venom is unlikely to do much harm (or good) but the wound must not be massaged. For Australian snakes only, do not wash or clean the wound in any way, as this may interfere with later venom detection once in a hospital.

3. All rings or other jewellery on the bitten limb, especially on fingers, should be removed, as they may act as tourniquets if oedema develops.

4. If the bite is on a limb, a broad bandage (even torn strips of clothing or pantyhose) should be applied over the bitten area at moderate pressure (as for a sprain; not so tight circulation is impaired), then extended to cover as much of the bitten limb as possible, including fingers or toes, going over the top of clothing rather than risking excessive limb movement by removing clothing. The bitten limb should then be immobilised as effectively as possible using an extemporised splint or sling.

5. If there is any impairment of vital functions, such as problems with respiration, airway, circulation, heart function, these must be supported as a priority. In particular, for bites causing flaccid paralysis, including respiratory paralysis, both airway and respiration may be impaired, requiring urgent and prolonged treatment, which may include the mouth to mask (mouth to mouth) technique of expired air transfer. Seek urgent medical attention.

6. Do not use Tourniquets, cut, suck or scarify the wound or apply chemicals or electric shock.

7. Avoid peroral intake, absolutely no alcohol. No sedatives outside hospital. If there will be considerable delay before reaching medical aid, measured in several hours to days, then give clear fluids by mouth to prevent dehydration.

8. If the offending snake has been killed it should be brought with the patient for identification (only relevant in areas where there are more than one naturally occurring venomous snake species), but be careful to avoid touching the head, as even a dead snake can envenom. No attempt should be made to pursue the snake into the undergrowth as this will risk further bites.

9. The snakebite victim should be transported as quickly and as passively as possible to the nearest place where they can be seen by a medically-trained person (health station, dispensary, clinic or hospital). The bitten limb must not be exercised as muscular contraction will promote systemic absorption of venom. If no motor vehicle or boat is available, the patient can be carried on a stretcher or hurdle, on the pillion or crossbar of a bicycle or on someone's back.

10. Most traditional, and many of the more recently fashionable, first aid measures are useless and potentially dangerous. These include local cauterization, incision, excision, amputation, suction by mouth, vacuum pump or syringe, combined incision and suction ("venom-ex" apparatus), injection or instillation of compounds such as potassium permanganate, phenol (carbolic soap) and trypsin, application of electric shocks or ice (cryotherapy), use of traditional herbal, folk and other remedies including the ingestion of emetic plant products and parts of the snake, multiple incisions, tattooing and so on.

Treatment

Treatment Summary: Krait bites can cause moderate to severe flaccid paralysis, respiratory failure, requiring intubation & ventilation in severe cases. Antivenom available for major species, may prevent worsening of paralysis, but may not reverse established paralysis.

Key Diagnostic Features: Minimal to mild local reaction + flaccid paralysis

General Approach to Management: All cases should be treated as urgent & potentially lethal. Rapid assessment & commencement of treatment including appropriate antivenom (if indicated & available) is mandatory. Admit all cases.

Antivenom Therapy: Only antivenoms available are for related species, but should be used for significant envenoming

Antivenoms

1. Antivenom Code: SAsCRI01

Antivenom Name: Polyvalent Anti Snake Venom Serum

Manufacturer: Central Research Institute

Phone: ++91-1-792-72114

Address: Kasauli (H.P.) 173204

Country: India

2. Antivenom Code: SAsTRC04

Antivenom Name: Banded Krait Antivenin

Manufacturer: Science Division, Thai Red Cross Society

Phone: ++66-2-252-0161 (up to 0164)

Address: Queen Saovabha Memorial Institute

1871 Rama IV Road

Pathumwan

Bangkok 10330

Country: Thailand

3. Antivenom Code: SAsPBF01

Antivenom Name: Antivenin Polyvalent (Equine)

Manufacturer: P.T. Bio Farma ( Persero )

Phone: ++62-22-203-3755

Address: Jl. Pasteur 28

Bandung 40161

Country: Indonesia

4. Antivenom Code: SAsSII01

Antivenom Name: SII Polyvalent Antisnake Venom Serum ( lyophilized )

Manufacturer: Serum Institute of India Ltd.

Phone: +91-20-26993900

Address: 212/2, Hadapsar,

Off Soli Poonawalla Road,

Pune-411042. India

Country: India

Source: Clinical Toxinology Resources