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Gloydius blomhoffii
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Gloydius blomhoffii  ( Japanese Mamushi ) subsp.  blomhoffii   [ Original photo copyright © Dr Julian White ]
Family: Viperidae
Subfamily: Crotalinae
Genus: Gloydius
Species: blomhoffii
Subspecies: blomhoffii
Common Names
( subsp. blomhoffii ) Japanese Mamushi , Mamushi
Local Names
Nihon Mamushi
Region
North Asia + Russia
Countries
Japan, Russia
 
Taxonomy and Biology
Adult Length: 0.45 m
General Shape
Small in length, medium to moderately thick bodied snake with short tapering tail. Can grow to a maximum of about 0.85 metres. Head is broad, flattened, triangular and distinct from neck. Eyes are medium sized with vertically elliptical pupils. Dorsal scales are keeled. Dorsal scale count 23 ( 21 - 25 ) - 21 ( 23 ) - 19 (17 to 20 ).
Habitat
Moist grasslands, shrublands, forests and mountain forest.
Habits
Mainly nocturnal and terrestrial with arboreal tendencies.
Prey
Feeds mainly on lizards, frogs, fish and small mammals.
Species Map
Small (Approx 20k) version
 
Venom
Average Venom Qty
15 mg ( dry weight ), Sawai (1975) ( Ref : R000768 ).
General: Venom Neurotoxins
Present but not defined
General: Venom Myotoxins
Possibly present
General: Venom Procoagulants
Fibrinogenases
General: Venom Anticoagulants
Possibly present
General: Venom Haemorrhagins
Zinc metalloproteinase
General: Venom Nephrotoxins
Possibly present
General: Venom Cardiotoxins
Probably not present
General: Venom Necrotoxins
Probably not present
General: Venom Other
Unknown
 
Clinical Effects
General: Dangerousness
Severe envenoming possible, potentially lethal
General: Rate of Envenoming: Unknown but likely to be moderate
General: Untreated Lethality Rate: Unknown but has caused deaths
General: Local Effects
Local pain, swelling, bruising & blistering
General: Local Necrosis
Rarely occurs, minor only
General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, dizziness, collapse or convulsions
General: Neurotoxic Paralysis
Only minor neurotoxicity reported
General: Myotoxicity
Uncommon to rare, but may possibly be moderate
General: Coagulopathy & Haemorrhages
Uncommon to common, may be moderate coagulopathy
General: Renal Damage
Recognised complication, usually secondary to coagulopathy
General: Cardiotoxicity
Does not occur, based on current clinical evidence
General: Other
Does not occur, based on current clinical evidence
 
First Aid
Description: First aid for bites by Viperid snakes likely to cause significant local injury at the bite site (see listing in Comments section).
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.
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. The bitten limb should be immobilised as effectively as possible using an extemporised splint or sling; if available, crepe bandaging of the splinted limb is an effective form of immobilisation.
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
Japanese Mamushi bites cause local ± systemic effects. Urgently assess, admit, IV fluids, IV antivenom for all but mild local effects.
Key Diagnostic Features
Local pain, swelling, blistering, necrosis + coagulopathy, bleeding, renal failure
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
Antivenom is the key treatment for systemic envenoming. Multiple doses may be required.
Antivenoms
1. Antivenom Code: SAsTCI01
Antivenom Name: Freeze-dried Mamushi Antivenom, Equine "Takeda"
Manufacturer: Takeda Chemical Industries Ltd.
Phone: +81-6-6204-2111
Address: 1-1, Doshomachi 4-Chome
Chuo-ku
Osaka
540-8645
Country: Japan
2. Antivenom Code: SAsKKJ01
Antivenom Name: Freeze-dried Mamushi Antivenom "Kaketsuken"
Manufacturer: The Chemo-Sero-Therapeutic Research Institute (Kaketsuken)
Phone: ++81-96-344-1211 or 345-6500
Address: 1-6-1 Okubo,
Kumamoto-shi
Kumamoto 860-8568
Country: Japan
Gloydius blomhoffii ( Japanese Mamushi ) subsp. blomhoffii [ Original photo copyright © Dr Julian White ]
Larger version
 
Gloydius blomhoffii ( Japanese Mamushi ) subsp. blomhoffii [ Original photo copyright © Dr Jurg Meier ]
Larger version
 
Gloydius blomhoffii ( Japanese Mamushi ) subsp. blomhoffii [ Original photo copyright © Dr Jurg Meier ]
Larger version
 
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