Family: Viperidae
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Subfamily: Crotalinae
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Genus: Gloydius
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Species: halys
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Subspecies: halys , affinis , boehmei , caraganus , caucasicus , cognatus , mogoi , liupanensis , stejnegeri
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Common Names
Haly's Pit Viper , Siberian Pit Viper ( G. h. halys ) , Boehme's Pit Viper ( G. h. boehmei ) , Karaganda Pit Viper ( G. h. caraganus ) , Caucasian Pit Viper ( G. h. caucasicus ) , Alashan Pit Viper ( G. h. cognatus ) , Gobi Pit Viper ( G. h. stejnegeri ) , Gobi Desert Pit Viper ( G. h. stejnegeri )
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Region
West Asia + North Asia + Russia
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Countries
Afghanistan, Azerbaijan, China, Iran, Kazakstan, Kyrgyzstan, Russia, Tajikistan, Turkmenistan, Uzbekistan, Mongolia
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Taxonomy and Biology
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Adult Length: 0.40 m
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General Shape
Small in length, medium bodied snake with short tapering tail. Can grow to a maximum of about 0.75 metres. Head is broad, flattened, triangular and distinct from neck. Snout slightly is very slightly upturned. Dorsal scales are keeled with or without apical pits. Eyes are medium in size with vertically elliptical pupils. Dorsal scale count 23 ( 25 ) - 23 ( 21 or 25 ) - 17 ( 19 ).
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Habitat
Montane slopes and plains extending into rocky high mountain plateaus. Found at elevations up to about 3500 metres.
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Habits
Mainly diurnal and terrestrial.
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Prey
Feeds on a variety of prey including lizards, frogs, rodents, small snakes and small birds.
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Venom
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General: Venom Neurotoxins
Possibly present
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General: Venom Myotoxins
Probably not present
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General: Venom Procoagulants
Prothrombin convertors
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General: Venom Anticoagulants
Possibly present
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General: Venom Haemorrhagins
Possibly present
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General: Venom Nephrotoxins
Probably not present
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General: Venom Cardiotoxins
Probably not present
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General: Venom Necrotoxins
Possibly present
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General: Venom Other
Unknown
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Clinical Effects
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General: Dangerousness
Severe envenoming possible, potentially lethal
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General: Rate of Envenoming: Unknown but likely to be moderate
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General: Untreated Lethality Rate: Unknown but lethal potential cannot be excluded
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General: Local Effects
Moderate to marked local effects; pain, severe swelling, bruising, blistering, necrosis
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General: Local Necrosis
Potentially may occur
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General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, tachypnoea, respiratory distress, hypotension, dizziness, collapse or convulsions
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General: Neurotoxic Paralysis
No clinical reports for this species, but related species cause flaccid paralysis
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General: Myotoxicity
No case reports for this species, but related species may cause systemic myolysis
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General: Coagulopathy & Haemorrhages
May cause moderate to severe coagulopathy
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General: Renal Damage
Recognised complication, usually secondary to coagulopathy
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General: Cardiotoxicity
Uncommon to rare, usually secondary effect
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General: Other
Shock secondary to fluid shifts due to local tissue injury is likely in severe cases
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First Aid
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Description: First aid for bites by Viperid snakes likely to cause significant local injury at the bite site (see listing in Comments section).
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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.
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Treatment
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Treatment Summary
Central Asian pit viper bites cause local ± systemic effects. Urgently assess, admit, IV fluids, supportive & symptomatic treatment. No specific antivenom available.
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Key Diagnostic Features
Local pain, swelling, blistering, necrosis + coagulopathy, bleeding, renal failure & mild paralysis
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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.
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Antivenom Therapy
Only antivenoms available are for related species, but should be used for significant envenoming
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1. Antivenom Code: SAsRII02
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Antivenom Name: Polyvalent Snake Antivenin
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Manufacturer: Razi Serum and Vaccine Research Institute
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Phone: +98 261 3119708
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Address: Iran Karaj P.O. Box : 31975/148 Post No. :3197619751
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Country: I.R. Iran
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2. Antivenom Code: SAsSIC01
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Antivenom Name: Purified Agkistrodon halys Antivenom
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Manufacturer: Shanghai Institute of Biological Products
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Phone: ++86-21-6280-3189
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Address: No. 1262, Yan An Rd. (W) Shanghai 200052
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Country: Peoples Republic of China
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