Trimeresurus purpureomaculatus Family: Viperidae Subfamily: Crotalinae Genus: Trimeresurus Species: purpureomaculatus Common Names Mangrove Pit Viper , Shore Pit Viper , Gray's Pit Viper , Purple-spotted Pit Viper Local Names Ular Kapak Bakau Region Indian Sub-continent + Southeast Asia Countries Bangladesh, Indonesia, India, Malaysia, Myanmar, Singapore, Thailand   Taxonomy and Biology Adult Length: 0.40 m General Shape Small in length, slender, cylindrical bodied snake with a medium length prehensile tail. Can grow to a maximum of about 0.67 metres for males and about 0.90 metres for females. Head is large, longer than broad, triangular shaped and distinct from neck. Eyes are medium in size with vertically elliptical pupils. Dorsal scales are strongly keeled. Dorsal scale count usually 25 - ( 23 to 29 ) - ( 19 or 21 ) with males usually with 23 or 25 midbody scale rows and females usually with 25 or 27 midbody scale rows. Habitat Coastal mangrove and swamp forest. Particularly common on some smaller offshore islands. Has also been found in inland bamboo jungle at elevations up to about 2000 metres. Habits Arboreal and restricted to the lower canopy. Prey Feeds mainly on ground and tree rodents, tree frogs, lizards and small birds. Species Map Small (Approx 20k) version   Venom General: Venom Neurotoxins Probably not present General: Venom Myotoxins Unknown General: Venom Procoagulants Probably present General: Venom Anticoagulants Possibly present General: Venom Haemorrhagins Present, clinical significance uncertain General: Venom Nephrotoxins Unknown General: Venom Cardiotoxins Probably not present General: Venom Necrotoxins Unknown General: Venom Other Unknown   Clinical Effects General: Dangerousness Severe envenoming possible, potentially lethal General: Rate of Envenoming: Unknown but likely to be moderate General: Untreated Lethality Rate: Unknown but has caused deaths General: Local Effects Marked local effects; pain, severe swelling, bruising, blistering, necrosis General: Local Necrosis Potentially may occur General: General Systemic Effects Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, dizziness, collapse or convulsions General: Neurotoxic Paralysis Unlikely to occur General: Myotoxicity Not likely to occur General: Coagulopathy & Haemorrhages Uncommon to rare, but may be moderate to severe coagulopathy General: Renal Damage Insufficient clinical reports to know General: Cardiotoxicity Unlikely to occur General: Other Insufficient clinical reports to know   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 Bites by this species cause moderate, possibly major local & systemic effects, including coagulopathy/bleeding. Assess & admit all major cases. Antivenom therapy is probably the key treatment, especially for coagulopathy. 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. Antivenoms 1. Antivenom Code: SAsCRI01 Antivenom Name: Polyvalent Anti Snake Venom Serum Manufacturer: Central Research Institute Phone: ++91-1-792-72114 Address: Kasauli (H.P.) 173204 Country: India 2. Antivenom Code: SAsTRC01 Antivenom Name: Green Pit Viper Antivenin Manufacturer: Science Division, Thai Red Cross Society Phone: ++66-2-252-0161 (up to 0164) Address: Queen Saovabha Memorial Institute 1871 Rama IV Road Pathumwan Bangkok 10330 Country: Thailand 3. Antivenom Code: SAsSII01 Antivenom Name: SII Polyvalent Antisnake Venom Serum ( lyophilized ) Manufacturer: Serum Institute of India Ltd. Phone: +91-20-26993900 Address: 212/2, Hadapsar, Off Soli Poonawalla Road, Pune-411042. India Country: India 4. Antivenom Code: SAsSII02 Antivenom Name: SII Bivalent Antisnake Venom Serum ( lyophilized ) Manufacturer: Serum Institute of India Ltd. Phone: +91-20-26993900 Address: 212/2, Hadapsar, Off Soli Poonawalla Road, Pune-411042. India Country: India   Images Trimeresurus purpureomaculatus ( Mangrove Pit Viper ) [ Original photo copyright © Dr Anita Malhotra ] Trimeresurus purpureomaculatus ( Mangrove Pit Viper ) [ Original photo copyright © Dr Julian White ] Trimeresurus purpureomaculatus ( Mangrove Pit Viper ) [ Original photo copyright © Dr Julian White ] Trimeresurus purpureomaculatus ( Mangrove Pit Viper ) [ Original photo copyright © Franck Principaud] Click here for larger version Click here for larger version Click here for larger version Click here for larger version