The emerging syndrome of envenoming by the New Guinea small-eyed snake Micropechis ikaheka.

The New Guinea small-eyed or ikaheka snake, Micropechis ikaheka, which occurs throughout New Guinea and some adjacent islands, is feared by the indigenes. The first proven human fatality was in the 1950s and this species has since been implicated in many other cases of severe and fatal envenoming. R...

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Main Authors: Warrell, D, Hudson, B, Lalloo, D, Trevett, A, Whitehead, P, Bamler, P, Ranaivoson, M, Wiyono, A, Richie, T, Fryauff, D, O'Shea, M, Richards, A, Theakston, R
Format: Journal article
Language:English
Published: 1996
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author Warrell, D
Hudson, B
Lalloo, D
Trevett, A
Whitehead, P
Bamler, P
Ranaivoson, M
Wiyono, A
Richie, T
Fryauff, D
O'Shea, M
Richards, A
Theakston, R
author_facet Warrell, D
Hudson, B
Lalloo, D
Trevett, A
Whitehead, P
Bamler, P
Ranaivoson, M
Wiyono, A
Richie, T
Fryauff, D
O'Shea, M
Richards, A
Theakston, R
author_sort Warrell, D
collection OXFORD
description The New Guinea small-eyed or ikaheka snake, Micropechis ikaheka, which occurs throughout New Guinea and some adjacent islands, is feared by the indigenes. The first proven human fatality was in the 1950s and this species has since been implicated in many other cases of severe and fatal envenoming. Reliable attribution of envenoming to this species in victims unable to capture or kill the snake recently became possible by the use of enzyme immunoassay. Eleven cases of proven envenoming by M. ikaheka, with two fatalities, were identified in Papua New Guinea and Irian Jaya. Five patients showed no clinical signs of envenoming. The other six patients showed symptoms typical of envenoming by other Australasian elapids: mild local swelling, local lymphadenopathy, neurotoxicity, generalized myalgia, spontaneous systemic bleeding, incoagulable blood and passage of dark urine (haemoglobinuria or myoglobinuria). Two patients developed hypotension and two died of respiratory paralysis 19 and 38 h after being bitten. In vitro studies indicate that the venom is rich in phospholipase A2, is indirectly haemolytic, anticoagulant and inhibits platelets, but is not procoagulant or fibrinolytic. It shows predominantly post-synaptic neurotoxic and myotoxic activity. Anecdotally, Commonwealth Serum Laboratories' (CSL) death adder antivenom has proved ineffective whereas CSL polyvalent antivenom may be beneficial. Anticholinesterase drugs might prove effective in improving neuromuscular transmission and should be tested in patients with neurotoxic envenoming.
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spelling oxford-uuid:a29d71a4-5dd1-4afe-8f31-5ad2ba9a5b8c2022-03-27T02:21:17ZThe emerging syndrome of envenoming by the New Guinea small-eyed snake Micropechis ikaheka.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a29d71a4-5dd1-4afe-8f31-5ad2ba9a5b8cEnglishSymplectic Elements at Oxford1996Warrell, DHudson, BLalloo, DTrevett, AWhitehead, PBamler, PRanaivoson, MWiyono, ARichie, TFryauff, DO'Shea, MRichards, ATheakston, RThe New Guinea small-eyed or ikaheka snake, Micropechis ikaheka, which occurs throughout New Guinea and some adjacent islands, is feared by the indigenes. The first proven human fatality was in the 1950s and this species has since been implicated in many other cases of severe and fatal envenoming. Reliable attribution of envenoming to this species in victims unable to capture or kill the snake recently became possible by the use of enzyme immunoassay. Eleven cases of proven envenoming by M. ikaheka, with two fatalities, were identified in Papua New Guinea and Irian Jaya. Five patients showed no clinical signs of envenoming. The other six patients showed symptoms typical of envenoming by other Australasian elapids: mild local swelling, local lymphadenopathy, neurotoxicity, generalized myalgia, spontaneous systemic bleeding, incoagulable blood and passage of dark urine (haemoglobinuria or myoglobinuria). Two patients developed hypotension and two died of respiratory paralysis 19 and 38 h after being bitten. In vitro studies indicate that the venom is rich in phospholipase A2, is indirectly haemolytic, anticoagulant and inhibits platelets, but is not procoagulant or fibrinolytic. It shows predominantly post-synaptic neurotoxic and myotoxic activity. Anecdotally, Commonwealth Serum Laboratories' (CSL) death adder antivenom has proved ineffective whereas CSL polyvalent antivenom may be beneficial. Anticholinesterase drugs might prove effective in improving neuromuscular transmission and should be tested in patients with neurotoxic envenoming.
spellingShingle Warrell, D
Hudson, B
Lalloo, D
Trevett, A
Whitehead, P
Bamler, P
Ranaivoson, M
Wiyono, A
Richie, T
Fryauff, D
O'Shea, M
Richards, A
Theakston, R
The emerging syndrome of envenoming by the New Guinea small-eyed snake Micropechis ikaheka.
title The emerging syndrome of envenoming by the New Guinea small-eyed snake Micropechis ikaheka.
title_full The emerging syndrome of envenoming by the New Guinea small-eyed snake Micropechis ikaheka.
title_fullStr The emerging syndrome of envenoming by the New Guinea small-eyed snake Micropechis ikaheka.
title_full_unstemmed The emerging syndrome of envenoming by the New Guinea small-eyed snake Micropechis ikaheka.
title_short The emerging syndrome of envenoming by the New Guinea small-eyed snake Micropechis ikaheka.
title_sort emerging syndrome of envenoming by the new guinea small eyed snake micropechis ikaheka
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