Snakes of Medical Importance in India Posted by webmaster
on September 15 2007
Snakes of Medical Importance in India: Is the Concept of the [Big 4] Still Relevant and Useful?
Ian D. Simpson BSc DM; Robert L. Norris, MD From the WHO Snakebite Treatment Group and the Tamil Nadu Government Snakebite Taskforce (Dr Simpson); and Stanford University Medical Center (Dr Norris)
For many decades, the concept of the [Big 4] Snakes of Medical Importance has reflected the view that 4 species are responsible for Indian snakebite mortality-
the Indian cobra (Naja naja), the common krait (Bungarus caeruleus) the Russells viper (Daboia russelii) and the sawscaled viper (Echis carinatus)
However, a recent discovery that another species, the hump-nosed pit viper (Hypnale hypnale), is capable of causing lethal envenomation, and that this problem was being concealed by systematic misidentification of this species as the saw-scaled viper, has necessitated a review of the concept of the [Big 4]
The concept of the [Big 4] snakes is reviewed to demonstrate its failure to include all currently known snakes of medical significance in India, and its negative effects related to clinical management of snakebite.
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