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Family: Viperidae
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Subfamily: Crotalinae
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Genus: Protobothrops
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Species: flavoviridis
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Common Names
Habu , Okinawa Habu , Yellow-green Pit Viper
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Local Names
Habu
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Region
North Asia
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Countries
Japan
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Taxonomy and Biology
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Adult Length: 1.30 m
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General Shape
Medium to large in length, moderately slender and laterally compressed bodied snake with a medium length gradually tapering tail. Most elongate of the Asian lance-headed snakes and can grow to a maximum of about 2.30 metres. Head is large, broad, triangular shaped and distinct from narrow neck. Eyes are medium in size with vertically elliptical pupils. Dorsal scales are keeled. Usually 35 ( 31 to 39 ) midbody scale rows.
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Habitat
Island habitat. Mainly mountain forest, coastal woodlands, residential areas and particularly abundant in cultivated regions and cycad woods.
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Habits
Nocturnal and terrestrial snake with strong arboreal tendencies.
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Prey
Feeds mainly on rodents and birds but will take snakes, lizards, frogs and other small vertebrates.
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Venom
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Average Venom Qty
100 to 300 mg ( dry weight ), Minton (1974) ( Ref : R000504 ).
150 to 300 mg ( dry weight ), Sawai (1975) ( Ref : R000768 ).
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General: Venom Neurotoxins
Probably not present
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General: Venom Myotoxins
Present but possibly not clinically significant
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General: Venom Procoagulants
Not present
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General: Venom Anticoagulants
Not present
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General: Venom Haemorrhagins
Not present
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General: Venom Nephrotoxins
Not present
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General: Venom Cardiotoxins
Not present
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General: Venom Necrotoxins
Not 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 high
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General: Untreated Lethality Rate: 10-20%
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General: Local Effects
Marked local effects; pain, severe swelling, bruising, blistering, necrosis
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General: Local Necrosis
Uncommon but can be moderate to severe
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General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, hypotension, dizziness, collapse
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General: Neurotoxic Paralysis
Does not occur, based on current clinical evidence
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General: Myotoxicity
Does not occur, based on current clinical evidence
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General: Coagulopathy & Haemorrhages
Does not occur, based on current clinical evidence
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General: Renal Damage
Does not occur, based on current clinical evidence
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General: Cardiotoxicity
Does not occur, based on current clinical evidence
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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
Bites by this species cause moderate, to major local & systemic effects, including coagulopathy/bleeding and hypovolaemic shock. Urgently assess & admit all cases. Antivenom therapy is probably the key treatment, especially for coagulopathy, plus fluid resuscitation for shock.
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Key Diagnostic Features
Local pain, swelling, blistering, necrosis + coagulopathy, bleeding
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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
Antivenom is the key treatment for systemic envenoming. Multiple doses may be required.
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| 1. Antivenom Code: SAsKKJ02
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Antivenom Name: Freeze-dried Habu Antivenom "Kaketsuken"
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Manufacturer: The Chemo-Sero-Therapeutic Research Institute (Kaketsuken)
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Phone: ++81-96-344-1211 or 345-6500
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Address: 1-6-1 Okubo,
Kumamoto-shi
Kumamoto 860-8568
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Country: Japan
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