Page 163 - JSOM Summer 2020

(photo left) The West African Green Mamba (Dendroaspis viridis) is one of the most feared
snakes in the region and is responsible for a large number of fatalities each year in countries like
Guinea and Sierra Leone where they are commonly found. Green mambas are an arboreal species
and prefer to live several meters above the ground in large trees with dense green foliage. Green
mambas cause a severe and rapidly progressive neurotoxic syndrome that kills most victims
within the first 2–6 hours from complete respiratory muscle paralysis. Many victims are bitten
while climbing mango or palm trees to harvest fruit or collect jugs of palm wine.
Photo compliments of Jordan Benjamin, Asclepius Snakebite Foundation.

(photo left) The leg of a young man
who arrived at the ASF Guinea clinic
18 hours after suffering a Rhinoceros
Viper (Bitis nasicornis) bite to his left
foot. Signs of the cytotoxic syndrome
(swelling, blistering, extensive tissue
destruction) and hemotoxic syndrome
(persistent bleeding and bruising along
the bitten limb) are clearly visible. This
patient was critically ill upon arrival but
ultimately made a full recovery after
receiving antivenom and aggressive
supportive care.
Photo compliments of Dr Nick Brandehoff,
Asclepius Snakebite Foundation.

(photo above) Dried venom samples collected from hundreds of
snakes over the years by Dr. Mamadou Cellou Baldé, founder and
director of the ASF Guinea clinic.
Photo compliments of Dr Nick Brandehoff, Asclepius Snakebite Foundation.
(photos above) The patient above was bitten by a Rhinoceros Viper
(Bitis nasicornis). These snakes rarely exceed 1 meter in length
but have wide heads with large venom glands that enable them to
inject massive doses of a potent cytotoxic and hemotoxic venom.
Rhinoceros Viper venom can induce a profound hypotension and
many patients die of cardiovascular collapse in the first hours after
a bite.
Photos compliments of Jordan Benjamin, Asclepius Snakebite Foundation.

(photo top left) Another photo of the West African Green Mamba (Dendroaspis viridis), showing the typical coffin-shaped head that is
characteristic of all mambas.
(photo top right) Mount Kenya Bush Viper (Atheris desaixi). African bush vipers are small, seldom encountered arboreal vipers with a wide
distribution throughout the tropical forests of equatorial Africa. Bush viper bites cause a cytotoxic syndrome +/– hemotoxicity. While there is
no specific antivenom for bush vipers, they are closely related to the African carpet vipers (Echis spp.) and patients typically respond well to
antivenoms that provide coverage against those species.
Photos compliments of Jordan Benjamin, Asclepius Snakebite Foundation.

(photo left) Dr Nick (photo left)
Brandehoff hands a ASF founder
syringe containing 2 Jordan Benjamin
vials of reconstituted administers a dose
antivenom to Jordan of reconstituted
Benjamin at the ASF polyvalent
snakebite clinic in antivenom by slow
Kindia, Guinea. intravenous push to
Photo compliments of a woman.
Aziz Baldé, Asclepius Photo compliments of
Snakebite Foundation. Aziz Baldé, Asclepius
Snakebite Foundation.