Snakes of Medical Importance in India
Posted by webmaster on September 16 2007 01:33:32
Snakes of Medical Importance in India: Is the
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
(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.

Click on the link below to read full article (PDF document)