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Naja haje
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Naja haje ( Egyptian Cobra ) subsp. haje [ Original photo copyright © Dr Julian White ]
Family: Elapidae
Subfamily: Elapinae
Genus: Naja
Species: haje
Subspecies: haje
Common Names
( subsp. haje ) Egyptian Cobra , Brown Cobra
Local Names
Egiptiese Kobra, Bou-Ftira, Bou Sekka, Golo , Thaaban, Nachir, Nchweira , Nsuweila , Arrer, Hanes Arrer , Swila
Region
North Africa + Sub-Saharan Africa
Countries
Algeria, Benin, Burkina Faso, Cameroon, Chad, Democratic Republic of Congo, Cote d'Ivoire ( Ivory Coast ), Djibouti, Egypt, Eritrea, Ethiopia, Gambia, Ghana, Kenya, Libya, Mali, Morocco, Niger, Nigeria, Senegal, Sudan, Tanzania, Togo, Tunisia, Uganda, Mauritania, West Sahara, Somalia
 
Taxonomy and Biology
Adult Length: 1.40 m
General Shape
Large in length, slightly depressed to cylindrical, tapered and moderately slender bodied snake with a medium to moderately short length tail. Body is compressed dorsoventrally and sub-cylindrical posteriorly. Has long cervical ribs capable of expansion to form a hood when threatened. Can grow to a maximum of about 2.59 metres. Head broad, flattened and slightly distinct from neck. Canthus is distinct. Snout is rounded. Eyes are medium to moderately small in size with round pupils. Dorsal scales are long, smooth and strongly oblique.
Habitat
Dry to moist savanna and semi-desert regions with at least some water and vegetation ( never in desert regions ). Frequently found near water.
Habits
Terrestrial, crepuscular and nocturnal and somewhat aggressive snake. Shows a preference for a permanent home in abandoned animal burrows, termite mounds or rock outcrops etc. Active forager sometimes entering human habitations ( especially hunting domestic fowl ). Generally attempts to escape when approached, at least for a few metres but if threatened assumes the typical upright posture with the hood expanded
Prey
Prefers toads but will eat small mammals, birds, eggs, lizards and other snakes.
Species Map
Small (Approx 20k) version
 
Venom
Average Venom Qty
175 to 300 mg ( dry weight ), Minton (1974) ( Ref : R000504 ).
General: Venom Neurotoxins
Postsynaptic neurotoxins
General: Venom Myotoxins
Possibly present but not clinically significant
General: Venom Procoagulants
Probably not present
General: Venom Anticoagulants
Probably not present
General: Venom Haemorrhagins
Probably not present
General: Venom Nephrotoxins
Probably not present
General: Venom Cardiotoxins
Possibly present
General: Venom Necrotoxins
Present but not defined
General: Venom Other
Not present or not significant
 
Clinical Effects
General: Dangerousness
Severe envenoming possible, potentially lethal
General: Rate of Envenoming: Unknown but likely to be high
General: Untreated Lethality Rate: Unknown but has caused deaths
General: Local Effects
Marked local effects; pain, severe swelling, bruising, blistering
General: Local Necrosis
Does not occur, based on current clinical evidence
General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, dizziness, collapse or convulsions
General: Neurotoxic Paralysis
May cause moderate to severe flaccid paralysis
General: Myotoxicity
Does not occur, based on current clinical evidence
General: Coagulopathy & Haemorrhages
Does not occur, based on current clinical evidence
General: Renal Damage
Rare, usually secondary effect
General: Cardiotoxicity
Rare, usually secondary
General: Other
Does not occur, based on current clinical evidence
 
First Aid
Description: First aid for bites by Elapid snakes which do not cause significant injury at the bite site (see Comments for partial listing), but which may have the potential to cause significant general (systemic) effects, such as paralysis, muscle damage, or bleeding.
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. For Australian snakes only, do not wash or clean the wound in any way, as this may interfere with later venom detection once in a hospital.
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. If the bite is on a limb, a broad bandage (even torn strips of clothing or pantyhose) should be applied over the bitten area at moderate pressure (as for a sprain; not so tight circulation is impaired), then extended to cover as much of the bitten limb as possible, including fingers or toes, going over the top of clothing rather than risking excessive limb movement by removing clothing. The bitten limb should then be immobilised as effectively as possible using an extemporised splint or sling.
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
Potentially severe bites, with both local tissue damage and paralysis. Admit all cases. Support impaired respiration. Good wound care essential. Avoid unnecessary surgery. For cases with paralytic features or major local effects, IV antivenom is appropriate.
Key Diagnostic Features
Local pain, swelling, blistering, necrosis ± flaccid paralysis
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: SAfAVC02
Antivenom Name: Polyvalent Snake Antivenom
Manufacturer: National Antivenom and Vaccine Production Centre
Phone: ++966-1-252-0088 ext 45626, 45637.
Address: P.O. Box 22490
Riyadh 11426
Country: Saudi Arabia
2. Antivenom Code: SAfAVC03
Antivenom Name: Bivalent Naja / Walterinnesia Snake Antivenom
Manufacturer: National Antivenom and Vaccine Production Centre
Phone: ++966-1-252-0088 ext 45626, 45637.
Address: P.O. Box 22490
Riyadh 11426
Country: Saudi Arabia
3. Antivenom Code: SAfIBM01
Antivenom Name: Antivipmyn Africa
Manufacturer: Instituto Bioclon
Phone: ++56-65-41-11
Address: Calzada de Tlalpan No. 4687
Toriello Guerra
C.P. 14050
Mexico, D.F.,
Country: Mexico
4. Antivenom Code: SAfVAC02
Antivenom Name: Polyvalent Snake Venom Antiserum
Manufacturer: VACSERA
Phone: (+20 2) 3761-1111
Address: 51 Wezaret El Zeraa St., Agouza, Giza, 22311
Country: Egypt
5. Antivenom Code: SAfSPF02
Antivenom Name: FAV-Afrique
Manufacturer: Sanofi-Pasteur
Phone: +33 (0)4 37 37 01 00
Address: 2, Avenue Pont Pasteur, CEDEX 07, Lyon 69367
Country: France
6. Antivenom Code: SAfSPF03
Antivenom Name: Favirept
Manufacturer: Sanofi-Pasteur
Phone: +33 (0)4 37 37 01 00
Address: 2, Avenue Pont Pasteur, CEDEX 07, Lyon 69367
Country: France
Naja haje ( Egyptian Cobra ) subsp. haje [ Original photo copyright © Dr Julian White ]
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