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Cerastes cerastes
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Cerastes cerastes  ( Horned Viper )  [ Original photo copyright © Dr Wolfgang Wuster ]
Family: Viperidae
Subfamily: Viperinae
Genus: Cerastes
Species: cerastes
Common Names
Horned Viper , Desert Viper , African Desert Horned Viper , Egyptian Sand Viper , Sahara Horned Viper , Sahara Sand Viper , Hornviper , Greater Cerastes Viper , Saharan Horned Viper , Desert Horned Viper
Local Names
Abu Groon , Lefaa , Lefaa Kebir , Lefaa Bin Kouroun , Haiya Hurra , Haiya Bikurun , Zus , Tachelt , Kemerto , Um Janaib , Kabsh , Haiya Biqurun , Haiya Al Qurun , Haiyat Al Jabal , Abu Qurain , Um Al Qurun , Rabudh Biskarun
Middle East + North Africa
Algeria, Chad, Egypt, Iran, Iraq, Israel, Jordan, Lebanon, Libya, Mali, Morocco, Niger, Oman, Saudi Arabia, Sudan, Tunisia, United Arab Emirates, Yemen, Mauritania, West Sahara
Taxonomy and Biology
Adult Length: 0.30 m
General Shape
Small, depressed, tapered, relatively thick bodied snake with a short tail. Can grow to a maximum of about 0.90 metres. Head is broad, flattened, covered in small scales, roughly triangular shaped when viewed from above and very distinct from narrow neck. Snout is very short and broad. Canthus is indistinct. Eyes are small to medium in size, prominent, set to the side of the head and well forward, with vertically elliptical pupils. Nostrils directed upward. There is often a long horn above each eye consisting of a single scale. Specimens without this horn-like scale have a prominent brow ridge. Dorsal scales have apical pits, are heavily keeled, large vertebrally and smaller laterally, oblique with serrated keels. Ventrals have lateral keels and subcaudals are keeled posteriorly.
Up to about 1500 metres in sandy ( including dunes ) and rocky hill desert.
Nocturnal, terrestrial and slow moving snake. Uses sidewinding locomotion on both soft sand and hard surfaces. Often lies buried in the sand with only the eyes and nostrils exposed. Sometimes shelters in rodent burrows. If disturbed it assumes an S-shaped coil position and rubs the sides of the body together making a rasping sound and hisses loudly. Very nervous, irritable and aggressive disposition, quick to strike at the slightest provocation and does not try to escape. Prefers to take refuge in rodent and lizard burrows or under grass tussocks or flat rocks.
Feeds mainly on small rodents, but will eat lizards and small birds and occasionally small or young snakes.
Species Map
Small (Approx 20k) version
Average Venom Qty
40 to 70 mg ( dry weight ), Minton (1974) ( Ref : R000504 ).

65 mg ( dry weight ), Kochva (1978) ( Ref : R000913 ).
General: Venom Neurotoxins
Probably not present
General: Venom Myotoxins
Probably not present
General: Venom Procoagulants
Mixture of procoagulants
General: Venom Anticoagulants
Probably not present
General: Venom Haemorrhagins
Possibly present
General: Venom Nephrotoxins
Probably not present
General: Venom Cardiotoxins
Probably not present
General: Venom Necrotoxins
Probably not present
General: Venom Other
Clinical Effects
General: Dangerousness
Unknown, but potentially lethal envenoming, though unlikely, cannot be excluded.
General: Rate of Envenoming: Unknown but likely to be high
General: Untreated Lethality Rate: <1%
General: Local Effects
Local pain, swelling & bruising, less commonly necrosis.
General: Local Necrosis
Uncommon but can be moderate to 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
Does not occur, based on current clinical evidence
General: Myotoxicity
Does not occur, based on current clinical evidence
General: Coagulopathy & Haemorrhages
Common, may be mild to moderate coagulopathy; severe coagulopathy not reported but cannot be excluded.
General: Renal Damage
Does not occur, based on current clinical evidence
General: Cardiotoxicity
Does not occur, based on current clinical evidence
General: Other
Shock secondary to fluid shifts due to local tissue injury is possible in severe cases
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).
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 Summary
Both significant local effects and systemic effects, including coagulopathy can occur, so all cases should be managed as potentially severe. Systemic envenoming with coagulopathy requires antivenom therapy.
Key Diagnostic Features
Local pain, swelling, blistering, necrosis + coagulopathy, bleeding
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.
1. Antivenom Code: SAfIPA02
Antivenom Name: Anti-viperin (Bivalent)
Manufacturer: Institut Pasteur d_Algerie
Phone: ++213-21-67-25-02
Address: Rue du Docteur Laveran,
16000 Alger
Country: Algeria
2. 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
3. Antivenom Code: SAfIPM02
Antivenom Name: Antiviperin Sera
Manufacturer: Institut Pasteur du Maroc
Phone: Tél standard +212 22 43 44 50
Tél Expertise +212 22 43 44 75
Tél Médical +212 22 43 44 68
Address: Place Louis Pasteur
20100 Casablanca Maroc
Country: Morocco
4. Antivenom Code: SAfIPT02
Antivenom Name: Antiviperin Sera
Manufacturer: Institut Pasteur du Tunis
Phone: ++21-61-283022
Address: 13 Place Pasteur,
B.P. 74
1002 Tunis-Belvedere,
Country: Tunisia
5. Antivenom Code: SAfVAC01
Antivenom Name: Polyvalent Anti-vipers Venom
Manufacturer: VACSERA
Phone: (+20 2) 3761-1111
Address: 51 Wezaret El Zeraa St., Agouza, Giza, 22311
Country: Egypt
6. 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
7. 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
Cerastes cerastes ( Horned Viper ) [ Original photo copyright © Dr Wolfgang Wuster ]
Larger version
Cerastes cerastes ( Horned Viper ) [ Original photo copyright © Dr Julian White ]
Larger version
Cerastes cerastes ( Horned Viper ) [ Original photo copyright © Dr Julian White ]
Larger version
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