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Micrurus nigrocinctus
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Micrurus nigrocinctus mosquitensis( Central American Coral Snake )  [ Original photo copyright © Dr Julian White ]
Family: Elapidae
Subfamily: Elapinae
Genus: Micrurus
Species: nigrocinctus
Subspecies: nigrocinctus , babaspul , coibensis , divaricatus , mosquitensis , zunilensis
Common Names
Central American Coral Snake , Black-banded Coral Snake

M. n. nigrocinctus : Common Central American Coral Snake

M. n. babaspul : Babaspul Coral Snake

M. n. coibensis : Coiban Coral Snake

M. n. divaricatus : Honduras Coral Snake

M. n. mosquitensis : Misquito Coral Snake

M. n. melanocephalus : Black-headed Coral Snake

M,. n. zunilensis : Zunil Coral Snake
Local Names
Babaspul , Coral , Coral Macho , Coralillo , Gargantilla , Coral Centroamericana , Lim Lim , Silviara

M. n. nigrocinctus : Coral Centroamericana Comun

M. n. babaspul : Babaspul

M. n. coibensis : Coral de Coiba

M. n. divaricatus : Coral Hondurena

M. n. mosquitensis : Coral Misquita

M. n. melanocephalus : Coral Negra Cabeza

M,. n. zunilensis : Coral Zunilense
Region
Central America + South America
Countries
Belize, Colombia, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama
 
Taxonomy and Biology
Adult Length: 0.50 m
General Shape
Medium in length, slender bodied coral snake with a short tail. Can grow to over 1.15 metres. Head is small, rounded and barely distinct from neck. Eyes are moderately small in size with round pupils. Dorsal scales are smooth and glossy without apical pits. Supra-anal keels are present in males. Dorsal scale count 15 - 15 - 15.
Habitat
Lower montane wet forest, lower montane dry forest, lowland dry forest, lowland rainforest and thorn forest.
Prey
Feeds on a wide range of amphibians and reptiles and their eggs.
Species Map
Small (Approx 20k) version
 
Venom
Average Venom Qty
M. n. nigrocinctus : 7 mg ( dry weight ), Roze (1996) ( Ref : R000985 ).
General: Venom Neurotoxins
Postsynaptic neurotoxins
General: Venom Myotoxins
Systemic myotoxins present
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
Probably not present
General: Venom Necrotoxins
Probably not present
General: Venom Other
Unknown
 
Clinical Effects
General: Dangerousness
Severe envenoming possible, potentially lethal
General: Rate of Envenoming: Unknown but likely to be low
General: Untreated Lethality Rate: Unknown but has caused deaths
General: Local Effects
Minimal local effects, to local pain & swelling only
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
Commonly develop flaccid paralysis
General: Myotoxicity
Common, usually mild to moderate
General: Coagulopathy & Haemorrhages
Does not occur, based on current clinical evidence
General: Renal Damage
Recognised complication, usually secondary to myolysis
General: Cardiotoxicity
Uncommon to rare, usually secondary effect
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
Bites by coral snakes can cause potentially lethal paralysis & myolysis; all cases should be admitted for 24hrs+ and given AV if paralysis develops, + support of respiration, as required.
Key Diagnostic Features
Minimal to mild local reaction + 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: SAmICP03
Antivenom Name: Anticoral monovalent
Manufacturer: Instituto Clodomiro Picado
Phone: ++506-2511-7888
Address: Contiguo a la plaza de deportes,
Dulce Nombre de Coronado.
San José
Costa Rica
Country: Costa Rica
2. Antivenom Code: SAmNIA04
Antivenom Name: Antimicrurus
Manufacturer: Instituto Nacional de Produccion de Biologics
A.N.L.I.S.
Phone: ++54-11-4303-1806 (to 11)
Address: Avdo. Velez Sarsfield 563,
CP 1281 Buenos Aires,
Country: Argentina
3. Antivenom Code: SAmFED05
Antivenom Name: Soro Anti-Elapidico
Manufacturer: Fundacao Ezequiel Dias - FUNED
Phone: ++55-31-3371-9525
Address: Rua Conde Pereira Carneiro, 80 - Gameleria
Belo Horizonte, MG - CEP 30510-010
Country: Brazil
4. Antivenom Code: SAmIBM08
Antivenom Name: Coralmyn
Manufacturer: Instituto Bioclon
Phone: ++56-65-41-11
Address: Calzada de Tlalpan No. 4687
Toriello Guerra
C.P. 14050
Mexico, D.F.,
Country: Mexico
5. Antivenom Code: SAmLBP02
Antivenom Name: Anti : Micruricos - Corales
Manufacturer: Laboratorios Biologicos PROBIOL Ltda.
Phone: +571-6773057, +571-6711023
Address: Sandafe de Bogota
Country: Colombia
Micrurus nigrocinctus mosquitensis( Central American Coral Snake ) [ Original photo copyright © Dr Julian White ]
Larger version
 
Micrurus nigrocinctus nigrocinctus ( Central American Coral Snake ) [ Original photo copyright © Dr Julian White ]
Larger version
 
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