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Bitis inornata
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Family: Viperidae
Subfamily: Viperinae
Genus: Bitis
Species: inornata
Common Names
Plain Mountain Adder , Cape Puff Adder , Hornless Adder
Region
Sub-Saharan Africa
Countries
South Africa
 
Taxonomy and Biology
Adult Length: 0.25 m
General Shape
Very small, slightly depressed, moderate to extremely stout bodied snake with a very short tail. Can grow to a maximum of about 0.45 metres. Head is broad, flat, triangular and very distinct from narrow neck. Snout is short and canthus is distinct. Eyes are medium in size with vertically elliptical pupils. The low ridge above each eye lacks horns. Dorsal scales are keeled with apical pits. Posterior subcaudals faintly keeled. Dorsal scale count ( 21 to 27 ) - ( 27 to 30 ) - ( 22 - 26 ).
Habitat
Between about 1600 and 1800 metres in grassveld on rocky montane plateaus.
Habits
Terrestrial and crepuscular, usually active during early morning and late afternoons. Hibernates during the winter snows. Tends to shelter in grass tussocks and beneath large rocks on mountain plateau regions. Easily angered if disturbed, giving an explosive puff and strikes readily.
Prey
Feeds mainly on small lizards, skinks and small rodents.
Species Map
Small (Approx 20k) version
 
Venom
General: Venom Neurotoxins
Unknown
General: Venom Myotoxins
Unknown
General: Venom Procoagulants
Unknown
General: Venom Anticoagulants
Unknown
General: Venom Haemorrhagins
Unknown
General: Venom Nephrotoxins
Unknown
General: Venom Cardiotoxins
Unknown
General: Venom Necrotoxins
Unknown
General: Venom Other
Unknown
 
Clinical Effects
General: Dangerousness
Moderate envenoming possible but unlikely to prove lethal
General: Rate of Envenoming: Unknown
General: Untreated Lethality Rate: Unlikely to prove lethal
General: Local Effects
Local pain, swelling & bruising
General: Local Necrosis
Common but usually not severe
General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, dizziness, collapse or convulsions
General: Neurotoxic Paralysis
Not reported, unlikely to be significant
General: Myotoxicity
Not reported, unlikely to be significant
General: Coagulopathy & Haemorrhages
No reports of coagulopathy, though related species can cause bleeding problems
General: Renal Damage
Unlikely to occur
General: Cardiotoxicity
Unlikely to occur
General: Other
Unknown
 
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
It is possible Bitis inornata bites may cause severe local effects, including shock. All cases should be urgently assessed and require admission & IV fluid support. There is no specific antivenom, but a polyvalent antivenom is claimed to cover this species. Control of shock, secondary infection & good wound care are essential in treatment.
Key Diagnostic Features
Unknown. Consider possibility of local swelling, necrosis, ± coagulopathy
General Approach to Management
It is possible that most cases will be minor, but some cases may be more severe, requiring admission and treatment, so assess carefully before discharge.
Antivenom Therapy
No antivenom available
Antivenoms
1. Antivenom Code: SAfSAI03
Antivenom Name: SAIMR Polyvalent Antivenom
Manufacturer: South African Vaccine Producers (Pty) Ltd
Phone: +27 11 386-6000; +27 11 386-6078
Address: Postal address
PO Box 28999
Sandringham 2131
Gauteng Province

Physical address
1 Modderfontein Road
Sandringham, Johannesburg
Country: South Africa
2. Antivenom Code: SAfSAIBK
Antivenom Name: SAIMR Snakebite Kit
Manufacturer: South African Vaccine Producers (Pty) Ltd
Phone: +27 11 386-6000; +27 11 386-6078
Address: Postal address
PO Box 28999
Sandringham 2131
Gauteng Province

Physical address
1 Modderfontein Road
Sandringham, Johannesburg
Country: South Africa
3. 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
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