Zusammenfassung
Giftschlangen kommen in vielen Regionen der Welt vor und haben zahlreiche Lebensräume erobert. Sie sind weltweit für etwa 2,5 Millionen Bisse und 100 000 Todesfälle verantwortlich. Die epidemiologische Erfassung der Unfälle mit Giftschlangen erfolgt in den meisten Ländern nur lückenhaft.
Im Falle einer Vergiftung ist die Vielfalt an Symptomen komplex und keineswegs vorhersehbar. Die zur Verfügung stehenden Therapiemöglichkeiten sind begrenzt.
Der vorliegende Übersichtsartikel befasst sich mit Giftschlangenbissen und der Wirkung von Schlangengift beim Menschen.
Summary
Venomous snakes exist in many regions of the world and have conquered various habitats. About 2.5 Million humans suffer from snake bite accidents worldwide and approximately 100.000 of those bitten die. In most countries, the epidemiological registration of snake bite accidents is generally incomplete.
In case of envenomation, symptoms are complex, may vary and are by no means predictable. Therapeutical options are limited.
The current review explores the importance of venomous snake bites and action of snake venom in humans.
Literatur
Acosta O, Leiva LC, Peichoto ME, Marunak S, Teibler P, Rey L (2003) Hemorrhagic activity of the Duvernoy’s gland secretion of the xenodontine colubrid Philodryas patagoniensis from the north-east region of Argentina. Toxicon 41: 1007–1012
Alape-Giron A, Sanz L, Escolano J, Flores-Diaz M, Madrigal M, Sasa M, Calvete JJ (2008) Snake Venomics of the Lancehead Pitviper Bothrops asper: Geographic, Individual, and Ontogenetic Variations. J Proteome Res
Apel C, Ricny J, Wagner G, Wessler I (1995) alpha-Bungarotoxin, kappa-bungarotoxin, alphacobratoxin and erabutoxin-b do not affect [3H]acetylcholine release from the rat isolated left hemidiaphragm. Naunyn Schmiedebergs Arch Pharmacol 352: 646–652
Aravanis C, Ioannidis PJ, Ktenas J (1982) Acute myocardial infarction and cerebrovascular accident in a young girl after a viper bite. Br Heart J 47: 500–503
Bellefleur JP, Le Dantec P (2005) Hospital care of snakebites in Africa. Bull Soc Pathol Exot 98: 273–276
Bochner R, Struchiner CJ (2003) Snake bite epidemiology in the last 100 years in Brazil: a review. Cad Saude Publica 19: 7–16
Britt A, Burkhart K (1997) Naja naja cobra bite. Am J Emerg Med 15: 529–531
Brook GA, Torres LF, Gopalakrishnakone P, Duchen LW (1987) Effects of phospholipase of Enhydrina schistosa venom on nerve, motor end-plate and muscle of the mouse. Q J Exp Physiol 72: 571–591
Bucaretchi F, Hyslop S, Mello SM, Vieira RJ (2007) Bothrops snakebite on the head: case report and review of the literature. Ann Trop Med Parasitol 101: 733–743
Bucaretchi F, Hyslop S, Vieira RJ, Toledo AS, Madureira PR, de Capitani EM (2006) Bites by coral snakes (Micrurus spp.) in Campinas, State of Sao Paulo, Southeastern Brazil. Rev Inst Med Trop Sao Paulo 48: 141–145
Calvete JJ, Juarez P, Sanz L (2007) Snake venomics. Strategy and applications. J Mass Spectrom 42: 1405–1414
Cawrse NH, Inglefield CJ, Hayes C, Palmer JH (2002) A snake in the clinical grass: late compartment syndrome in a child bitten by an adder. Br J Plast Surg 55: 434–435
Cheng AC, Currie BJ (2004) Venomous snakebites worldwide with a focus on the Australia-Pacific region: current management and controversies. J Intensive Care Med 19: 259–269
Cher CD, Armugam A, Zhu YZ, Jeyaseelan K (2005) Molecular basis of cardiotoxicity upon cobra envenomation. Cell Mol Life Sci 62: 105–118
Ching AT, Rocha MM, Paes Leme AF, Pimenta DC, de Fatima DFM, Serrano SM, Ho PL, Junqueira-de-Azevedo IL (2006) Some aspects of the venom proteome of the Colubridae snake Philodryas olfersii revealed from a Duvernoy’s (venom) gland transcriptome. FEBS Lett 580: 4417–4422
Chippaux JP (1998) Snake-bites: appraisal of the global situation. Bull World Health Organ 76: 515–524
Chippaux JP, Goyffon M (1997) Snakes and scorpions: what are the risks for the traveler?. Med Trop (Mars) 57: 519–521
Chippaux JP, Kambewasso A (2002) Snake bites and antivenom availability in the urban community of Niamey, Niger. Bull Soc Pathol Exot 95: 181–183
Chotenimitkhun R, Rojnuckarin P (2008) Systemic antivenom and skin necrosis after green pit viper bites. Clin Toxicol (Phila) 46: 122–125
Cupo P, Azevedo-Marques MM, Hering SE (1990) Acute myocardial infarction-like enzyme profile in human victims of Crotalus durissus terrificus envenoming. Trans R Soc Trop Med Hyg 84: 447–451
Currie BJ (2006) Treatment of snakebite in Australia: the current evidence base and questions requiring collaborative multicentre prospective studies. Toxicon 48: 941–956
Daltry JC, Wuster W, Thorpe RS (1996) Diet and snake venom evolution. Nature 379: 537–540
Dart RC, McNally J (2001) Efficacy, safety, and use of snake antivenoms in the United States. Ann Emerg Med 37: 181–188
Dash S, Dash RJ (1980) Spectrum of haemolytic anaemias in Punjab, North India. Trop Geogr Med 32: 312–316
de Rezende NA, Torres FM, Dias MB, Campolina D, Chavez-Olortegui C, Amaral CF (1998) South American rattlesnake bite (Crotalus durissus SP) without envenoming: insights on diagnosis and treatment. Toxicon 36: 2029–2032
Deufel A, Cundall D (2003) Feeding in Atractaspis (Serpentes: Atractaspididae): a study in conflicting functional constraints. Zoology (Jena) 106: 43–61
Dumavibhat B (1997) A study of epidemiology, risk factors and preventive measures against snake bites. J Med Assoc Thai 80: 547–556
Fadel V, Bettendorff P, Herrmann T, de Azevedo WF, Jr., Oliveira EB, Yamane T, Wuthrich K (2005) Automated NMR structure determination and disulfide bond identification of the myotoxin crotamine from Crotalus durissus terrificus. Toxicon 46: 759–767
Faure G, Gowda VT, Maroun RC (2007) Characterization of a human coagulation factor Xa-binding site on Viperidae snake venom phospholipases A2 by affinity binding studies and molecular bioinformatics. BMC Struct Biol 7: 82
Fazelat J, Teperman SH, Touger M (2008) Recurrent hemorrhage after western diamondback rattlesnake envenomation treated with crotalidae polyvalent immune fab (ovine). Clin Toxicol (Phila): 1–4
Forks TP (1994) Evaluation and treatment of poisonous snakebites. Am Fam Physician 50: 123–130, 135
Fox JW, Serrano SM (2008) Exploring snake venom proteomes: multifaceted analyses for complex toxin mixtures. Proteomics 8: 909–920
Frangides CY, Koulouras V, Kouni SN, Tzortzatos GV, Nikolaou A, Pneumaticos J, Pierrakeas C, Niarchos C, Kounis NG, Koutsojannis CM (2006) Snake venom poisoning in Greece. Experiences with 147 cases. Eur J Intern Med 17: 24–27
German BT, Hack JB, Brewer K, Meggs WJ (2005) Pressure-immobilization bandages delay toxicity in a porcine model of eastern coral snake (Micrurus fulvius fulvius) envenomation. Ann Emerg Med 45: 603–608
Gibly RL, Walter FG, Nowlin SW, Berg RA (1998) Intravascular hemolysis associated with North American crotalid envenomation. J Toxicol Clin Toxicol 36: 337–343
Girish KS, Jagadeesha DK, Rajeev KB, Kemparaju K (2002) Snake venom hyaluronidase: an evidence for isoforms and extracellular matrix degradation. Mol Cell Biochem 240: 105–110
Gold BS, Dart RC, Barish RA (2002) Bites of venomous snakes. N Engl J Med 347: 347–356
Gold BS, Pyle P (1998) Successful treatment of neurotoxic king cobra envenomation in Myrtle Beach, South Carolina. Ann Emerg Med 32: 736–738
Gundappa RK, Sud K, Kohli HS, Jha V, Gupta KL, Joshi K, Sakhuja V, (2002) Snakebite induced acute interstitial nephritis: report of a rare entity. Ren Fail 24: 369–372
Gutierrez JM, Arroyo O, Chaves F, Lomonte B, Cerdas L (1986) Pathogenesis of myonecrosis induced by coral snake (Micrurus nigrocinctus) venom in mice. Br J Exp Pathol 67: 1–12
Haddad V Jr., Neto DG, de Paula Neto JB, de Luna Marques FP, Barbaro KC (2004) Freshwater stingrays: study of epidemiologic, clinic and therapeutic aspects based on 84 envenomings in humans and some enzymatic activities of the venom. Toxicon 43: 287–294
Harris JB, Goonetilleke A (2004) Animal poisons and the nervous system: what the neurologist needs to know. J Neurol Neurosurg Psychiatry 75 Suppl 3: iii 40–46
Hasle G (2002) Dangerous animals. Tidsskr Nor Laegeforen 122: 1695–1701
Hawgood BJ (1999) Doctor Albert Calmette 1863–1933: founder of antivenomous serotherapy and of antituberculous BCG vaccination. Toxicon 37: 1241–1258
Hawgood BJ (2007) Albert Calmette (1863–1933) and Camille Guerin (1872–1961): the C and G of BCG vaccine. J Med Biogr 15: 139–146
Hayes WK, Lavin-Murcio P, Kardong KV (1993) Delivery of Duvernoy’s secretion into prey by the brown tree snake, Boiga irregularis (Serpentes:Colubridae). Toxicon 31: 881–887
He YY, Lee WH, Zhang Y (2004) Cloning and purification of alpha-neurotoxins from king cobra (Ophiophagus hannah). Toxicon 44: 295–303
Hill RE, Mackessy SP (2000) Characterization of venom (Duvernoy’s secretion) from twelve species of colubrid snakes and partial sequence of four venom proteins. Toxicon 38: 1663–1687
Howes JM, Kamiguti AS, Theakston RD, Wilkinson MC, Laing GD (2005) Effects of three novel metalloproteinases from the venom of the West African saw-scaled viper, Echis ocellatus on blood coagulation and platelets. Biochim Biophys Acta 1724: 194–202
Isbister GK, Brown SG, MacDonald E, White J, Currie BJ (2008) Current use of Australian snake antivenoms and frequency of immediate-type hypersensitivity reactions and anaphylaxis. Med J Aust 188: 473–476
Ismail M, Memish ZA (2003) Venomous snakes of Saudi Arabia and the Middle East: a keynote for travellers. Int J Antimicrob Agents 21: 164–169
Jackson K (2002) How tubular venom-conducting fangs are formed. J Morphol 252: 291–297
Jackson K (2007) The evolution of venom-conducting fangs: insights from developmental biology. Toxicon 49: 975–981
Jayne BC, Voris HK, Ng PK (2002) Snake circumvents constraints on prey size. Nature 418: 143
John J, Gane BD, Plakkal N, Aghoram R, Sampath S (2008) Snake bite mimicking brain death. Cases J 1: 16
Jorge MT, Ribeiro LA (1992) The epidemiology and clinical picture of an accidental bite by the South American rattlesnake (Crotalus durissus). Rev Inst Med Trop Sao Paulo 34: 347–354
Jorge MT, Sano-Martins IS, Tomy SC, Castro SC, Ferrari RA, Ribeiro LA, Warrell DA (1997) Snakebite by the bushmaster (Lachesis muta) in Brazil: case report and review of the literature. Toxicon 35: 545–554
Junghanss T, Bodio M (2006) Medically important venomous animals: biology, prevention, first aid, and clinical management. Clin Infect Dis 43: 1309–1317
Kanjanabuch T, Sitprija V (2008) Snakebite nephrotoxicity in Asia. Semin Nephrol 28: 363–372
Karlson-Stiber C, Salmonson H, Persson H (2006) A nationwide study of Vipera berus bites during one year-epidemiology and morbidity of 231 cases. Clin Toxicol (Phila) 44: 25–30
Karthik S, Phadke KD (2004) Snakebite-induced acute renal failure. A case report and review of the literature. Pediatr Nephrol 19: 1053–1054
Kerrigan KR (1991) Venomous snakebite in eastern Ecuador. Am J Trop Med Hyg 44: 93–99
Kim KK (1996) Exogenous causes of myoglobinuria — review of 26 cases. J Korean Med Sci 11: 342–346
Kularatne SA (2003) Epidemiology and clinical picture of the Russell’s viper (Daboia russelii russelii) bite in Anuradhapura, Sri Lanka: a prospective study of 336 patients. Southeast Asian J Trop Med Public Health 34: 855–862
Kurecki BA, 3rd, Brownlee HJ, Jr. (1987) Venomous snakebites in the United States. J Fam Pract 25: 386–392
Kuruppu S, Robinson S, Hodgson WC, Fry BG (2007) The in vitro neurotoxic and myotoxic effects of the venom from the Suta genus (curl snakes) of elapid snakes. Basic Clin Pharmacol Toxicol 101: 407–410
Lalloo DG, Trevett AJ, Saweri A, Naraqi S, Theakston RD, Warrell DA (1995) The epidemiology of snake bite in Central Province and National Capital District, Papua New Guinea. Trans R Soc Trop Med Hyg 89: 178–182
Larreche S, Mion G, Clapson P, Debien B, Wybrecht D, Goyffon M (2008) Neurotoxins from snake venom. Ann Fr Anesth Reanim 27: 310–316
Lee MS, Scanlon JD (2002) Snake phylogeny based on osteology, soft anatomy and ecology. Biol Rev Camb Philos Soc 77: 333–401
Leikin JB, Aks SE, Andrews S, Auerbach PS, Cooper MA, Jacobsen TD, Krenzelok EP, Shicker L, Weiner SL (1997) Environmental injuries. Dis Mon 43: 809–916
Lonati D, Butera R, Cima M, Cozzio S, Locatelli C, Manzo L (2004) Exotic snakes in Europe. A case of Mexican Moccasin (Agkistrodon bilineatus) snakebite. Presse Med 33: 1582–1584
Marsh N, Gattullo D, Pagliaro P, Losano G (1997) The Gaboon viper, Bitis gabonica: hemorrhagic, metabolic, cardiovascular and clinical effects of the venom. Life Sci 61: 763–769
Mebs D (2000) Gifttiere. Ein Handbuch für Biologen, Toxikologen, Ärzte und Apotheker. 2 ed. Stuttgart: Wissenschaftliche Verlagsgesellschaft mbH 350
Miao YN, Chen MC, Huang Z (2003) Clinical observation on treatment of snake bite induced disseminated intravascular coagulation by qinwen baidu decoction. Zhongguo Zhong Xi Yi Jie He Za Zhi 23: 590–592
Morgan DL, Blair HW, Ramsey RP (2006) Suicide attempt by the intravenous injection of rattlesnake venom. Southern Medical Journal 99: 282–284
Mosquera A, Idrovo LA, Tafur A, Del Brutto OH (2003) Stroke following Bothrops spp. snakebite. Neurology 60: 1577–1580
Murdock RT, White GL Jr., Pedersen DM, De-Faller JM, Snyder CC (1990) Prevention and emergency field management of venomous snakebites during military exercises. Mil Med 155: 587–590
Nishioka Sde A, Silveira PV, Bauab FA (1995) Bite marks are useful for the differential diagnosis of snakebite in Brazil. Wilderness Environ Med 6: 183–188
O’Leary MA, Schneider JJ, Krishnan BP, Lavis C, McKendry A, Ong LK, Isbister GK (2007) Cross-neutralisation of Australian brown and tiger snake venoms with commercial antivenoms: Cross-reactivity or antivenom mixtures? Toxicon 50: 206–213
O’Neil ME, Mack KA, Gilchrist J, Wozniak EJ (2007) Snakebite injuries treated in United States emergency departments, 2001–2004. Wilderness Environ Med 18: 281–287
Oliveira DA, Harasawa C, Seibert CS, Casais e Silva LL, Pimenta DC, Lebrun I, Sandoval MR (2008) Phospholipases A2 isolated from Micrurus lemniscatus coral snake venom: behavioral, electroencephalographic, and neuropathological aspects. Brain Res Bull 75: 629–639
Otero R, Gutierrez J, Beatriz Mesa M, Duque E, Rodriguez O, Luis Arango J, Gomez F, Toro A, Cano F, Maria Rodriguez L, Caro E, Martinez J, Cornejo W, Mariano Gomez L, Luis Uribe F, Cardenas S, Nunez V, Diaz A (2002) Complications of Bothrops, Porthidium, and Bothriechis snakebites in Colombia. A clinical and epidemiological study of 39 cases attended in a university hospital. Toxicon 40: 1107–1114
Pahari S, Mackessy SP, Kini RM (2007) The venom gland transcriptome of the Desert Massasauga rattlesnake (Sistrurus catenatus edwardsii): towards an understanding of venom composition among advanced snakes (Super-family Colubroidea). BMC Mol Biol 8: 115
Pearn J, Morrison J, Charles N, Muir V (1981) First-aid for snake-bite: efficacy of a constrictive bandage with limb immobilization in the management of human envenomation. Med J Aust 2: 293–295
Persson H (2001) Envenoming by European vipers antivenom treatment — influence on morbidity. Przegl Lek 58: 223–225
Peterson ME (2006) Snake bite: coral snakes. Clin Tech Small Anim Pract 21: 183–186
Peterson ME (2006) Snake bite: pit vipers. Clin Tech Small Anim Pract 21: 174–182
Petite J (2005) Viper bites: treat or ignore? Review of a series of 99 patients bitten by Vipera aspis in an alpine Swiss area. Swiss Med Wkly 135: 618–625
Petrovan RJ, Rapaport SI, Le DT (1999) A novel clotting assay for quantitation of plasma prothrombin (factor II) using Echis multisquamatus venom. Am J Clin Pathol 112: 705–711
Phillips RE, Theakston RD, Warrell DA, Galigedara Y, Abeysekera DT, Dissanayaka P, Hutton RA, Aloysius DJ (1988) Paralysis, rhabdomyolysis and haemolysis caused by bites of Russell’s viper (Vipera russelli pulchella) in Sri Lanka: failure of Indian (Haffkine) antivenom. Q J Med 68: 691–715
Pinho FM, Zanetta DM, Burdmann EA (2005) Acute renal failure after Crotalus durissus snakebite: a prospective survey on 100 patients. Kidney Int 67: 659–667
Plowman DM, Reynolds TL, Joyce SM (1995) Poisonous snakebite in Utah. West J Med 163: 547–551
Ponraj D, Gopalakrishnakone P (1996) Establishment of an animal model for myoglobinuria by use of a myotoxin from Pseudechis australis (king brown snake) venom in mice. Lab Anim Sci 46: 393–398
Prenzel F, Schulz M, Siekmeyer W, Rahn W, Kiess W (2008) Adder bites — clinical picture, diagnosis and management. Dtsch Med Wochenschr 133: 1075–1080
Re G, Trisolino G, Miglio F (1999) Eye muscle paralysis after Vipera aspis envenomation. J Accid Emerg Med 16: 458
Rigoni M, Schiavo G, Weston AE, Caccin P, Allegrini F, Pennuto M, Valtorta F, Montecucco C, Rossetto O (2004) Snake presynaptic neurotoxins with phospholipase A2 activity induce punctate swellings of neurites and exocytosis of synaptic vesicles. J Cell Sci 117: 3561–3570
Russell FE, Walter FG, Bey TA, Fernandez MC (1997) Snakes and snakebite in Central America. Toxicon 35: 1469–1522
Sakwiwatkul K, Chaiyabutr N, Sitprija V (2002) Renal function following sea snake venom (Lapemis hardwicki) administration in dogs treated with sodium bicarbonate solution. J Nat Toxins 11: 111–121
Sanz L, Escolano J, Ferretti M, Biscoglio MJ, Rivera E, Crescenti EJ, Angulo Y, Lomonte B, Gutierrez JM, Calvete JJ (2008) Snake venomics of the South and Central American Bushmasters. Comparison of the toxin composition of Lachesis muta gathered from proteomic versus transcriptomic analysis. J Proteomics 71: 46–60
Sasa M, Vazquez S (2003) Snakebite envenomation in Costa Rica: a revision of incidence in the decade 1990–2000. Toxicon 41: 19–22
Savitzky AH, Moon BR (2008) Tail morphology in the Western Diamond-backed rattlesnake, Crotalus atrox. J Morphol 269: 935–944
Schaper A, Desel H, Ebbecke M, de Haro L, Deters M, Hentschel H, Hermanns-Clausen M, Langer C (2008) Bites and stings by exotic pets in Europe: An 11 year analysis of 404 cases from Northeastern Germany and Southeastern France. Clin Toxicol (Phila): 1–5
Schneemann M, Cathomas R, Laidlaw ST, El Nahas AM, Theakston RD, Warrell DA (2004) Life-threatening envenoming by the Saharan horned viper (Cerastes cerastes) causing microangiopathic haemolysis, coagulopathy and acute renal failure: clinical cases and review. Qjm 97: 717–727
Seifert SA, Oakes JA, Boyer LV (2007) Toxic Exposure Surveillance System (TESS)-based characterization of U.S. non-native venomous snake exposures, 1995–2004. Clin Toxicol (Phila) 45: 571–578
Seignot P, Ducourau JP, Ducrot P, Angel G, Roussel L, Aubert M (1992) Fatal poisoning caused by African viper’s bite (Echis carinatus). Ann Fr Anesth Reanim 11: 105–110
Serrano SM, Shannon JD, Wang D, Camargo AC, Fox JW (2005) A multifaceted analysis of viperid snake venoms by two-dimensional gel electrophoresis: an approach to understanding venom proteomics. Proteomics 5: 501–510
Shiau DT, Sanders JW, Putnam SD, Buff A, Beasley W, Tribble DR, Riddle MS (2007) Selfreported incidence of snake, spider, and scorpion encounters among deployed U.S. military in Iraq and Afghanistan. Mil Med 172: 1099–1102
Simes DC (2002) Early and late removal of the pressure bandage in brown snake envenomation: a report of two cases. Crit Care Resusc 4: 116–118
Sitprija V (2006) Snakebite nephropathy. Nephrology (Carlton) 11: 442–448
Suchithra N, Pappachan JM, Sujathan P (2008) Snakebite envenoming in Kerala, South India: clinical profile and factors involved in adverse outcomes. Emerg Med J 25: 200–204
Tans G, Rosing J (2001) Snake venom activators of factor X: an overview. Haemostasis 31: 225–233
Thachil RT, Tony JC, Jude E, Ross C, Vincent ND, Sridhar CB (1992) Antisnakevenom: an over-used medication. Trop Doct 22: 113–115
Tibballs J, Henning RD, Sutherland SK, Kerr AR (1991) Fatal cerebral haemorrhage after tiger snake (Notechis scutatus) envenomation. Med J Aust 154: 275–276
Top LJ, Tulleken JE, Ligtenberg JJ, Meertens JH, van der Werf TS, Zijlstra JG (2006) Serious envenomation after a snakebite by a Western bush viper (Atheris chlorechis) in the Netherlands: a case report. Neth J Med 64: 153–156
Toyama OD, Boschero CA, Martins AM, Fonteles CM, Monteiro SH, Toyama HM (2005) Structure-function relationship of new crotamine isoform from the Crotalus durissus cascavella. Protein J 24: 9–19
Veto T, Price R, Silsby JF, Carter JA (2007) Treatment of the first known case of king cobra envenomation in the United Kingdom, complicated by severe anaphylaxis. Anaesthesia 62: 75–78
Warrell DA (2001) „To search and Studdy out the secrett of Tropical Diseases by way of Experiment“. Lancet 358: 1983–1988
Warrell DA (2005) Treatment of bites by adders and exotic venomous snakes. Bmj 331: 1244–1247
Warrell DA, Arnett C (1976) The importance of bites by the saw-scaled or carpet viper (Echis carinatus): epidemiological studies in Nigeria and a review of the world literature. Acta Trop 33: 307–341
White J (2000) Bites and stings from venomous animals: a global overview. Ther Drug Monit 22: 65–68
Williams D, Wuster W, Fry BG (2006) The good, the bad and the ugly: Australian snake taxonomists and a history of the taxonomy of Australia’s venomous snakes. Toxicon 48: 919–930
Wozniak EJ, Wisser J, Schwartz M (2006) Venomous adversaries: a reference to snake identification, field safety, and bite-victim first aid for disaster-response personnel deploying into the hurricane-prone regions of North America. Wilderness Environ Med 17: 246–266
Yamamoto C, Tsuru D, Oda-Ueda N, Ohno M, Hattori S, Kim ST (2001) Trimeresurus flavoviridis (habu snake) venom induces human erythrocyte lysis through enzymatic lipolysis, complement activation and decreased membrane expression of CD55 and CD59. Pharmacol Toxicol 89: 188–194
Young BA, Blair M, Zahn K, Marvin J (2001) Mechanics of venom expulsion in Crotalus, with special reference to the role of the fang sheath. Anat Rec 264: 415–426
Young BA, Kardong KV (2007) Mechanisms controlling venom expulsion in the western diamondback rattlesnake, Crotalus atrox. J Exp Zool Part A Ecol Genet Physiol 307: 18–27
Young BA, Zahn K (2001) Venom flow in rattlesnakes: mechanics and metering. J Exp Biol 204: 4345–4351
Zahradnicek O, Horacek I, Tucker AS (2008) Viperous fangs: Development and evolution of the venom canal. Mech Dev
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Geier, M.V., Quarcoo, D., Spallek, M.F. et al. Giftschlangenbisse — eine globale Herausforderung. Zbl Arbeitsmed 59, 8–21 (2009). https://doi.org/10.1007/BF03344195
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DOI: https://doi.org/10.1007/BF03344195