No worries.
In short then, can we conclude that Atheris bites are highly venomous? Or was this more likely a once-off bad reaction that would normally not be so severe?
You could come to that conclusion yes, but there are many factors that determine the severity of an case of envenomation such as, but not limited to those i list below
- The venom/weight ratio. The same volume of venom is going to affect a mouse a lot more than it will affect an elephant. People with small body sizes/weights are more likely to have a severe reaction to the venom than a rugby player of 130kg.
- They type of venom (and all its funny little enzymes, which differ between species, from snakes to spiders to scorpions etc) will affect different people differently. Much the same as any allergen (something that causes allergies) would affect people differently, i might get a reaction from handlng a cat, whereas you might not. Each of us responds to cases of envenomation differently as well.
- The basic type of venom (cyto-, neuro-, heamotoxic etc) will also have a different effect on different people. Someone who is healthy might recieve a relatively mild bite from a
Naja sp, and they will have only mild neurological symptoms, I might recieve exactly the same bite, but due to my chronic asthma, the likelihood of me developing a severely compromised airway is significantly higher. The same goes for someone like a Heamophiliac (basically someone who's body lacks the proper ability to clot, for various reasons) getting bitten by a Boomslang, would be in a worse off position than someone who does not have this problem. Or would they? Perhaps the chronic medication they are on, would make the heamolytic enzymes in the venom less active. We don't know.
- Where on the body the venom is injected. A "minor" bite from a puff adder on the outside edge of the foot, is hardly as serious as the exact same bite on the shoulder. Not purely due to the tissue destruction, but there are that many vital underlying nerves, muscle groups and vascualr bundles that will be affected.
Due to these reasons, when you are told about envenomations, you get given a list of symptoms that can accompany the different venoms when injected into the body. Not ALL of these symptoms have to be present, and there being only one or two symptoms as opposed to a whole list of them, does not make an envenomation any less serious. For example, if we take the
Naja bite, we know that the symptoms can include dizziness, blurred vision, cardiac dysrhythmias, parasthesias (abnormal sensations like pins and needles), abnormal pupillary reflex, paralysis of various muscle groups, anasthesia (abscence of senstation), nausea and vomiting, unconsciousness and so forth. A patient that only exhibits abnormal respiratory function is a lot more serious than a patient that complains of blurred vision, nausea, dizziness and parasthesia of the affected limb.
What it boils down to, is that there is an almost infinite variety of variables when it comes to cases of envenomation, and each one needs to be looked at individually, and judged on its own particular merits. Yes we have case studies like the above mentioned, that can be referred to and used as guides, and we have lab studies where venom was tested on mice to give us Lethal Dosage values etc, but in the lab studies, all the mice were the same, they weighed the same, they ate the same, they looked the same, they were all 100% healthy and they all got injected the same way, with the same amount of venom. That is the only way you can be sure to get comparative results and to be able to say Vemon X is worse than Venom Y. Unfortunately none of that happens with people, we are all individuals, so are the animals that envenomate us (from the size of the animal, to the amount of venom they inject) and thus there is no absolute "This is How Envenomation
MUST be Treated" book. We do know that certain venoms are worse than others, purely becasue they are so virulent that the doasge and site of bite and all the rest can be pretty much irrelevant, but there are a number of what are popularly believed "non-virulent' venoms that have also caused significant morbidity and in some cases mortality, purely because the specific individual that was envenomated suffered a catastrophic systemic reaction.
It is very short-sighted to think, as a herpetologist, that by owning only a mildly venomous snake, that you are safe in the event you do get a wet bite. YOU may be the first statistic on that species mortality list, due to something you did not even know existed in your genetic makeup. Yes, that statement does sound very dramatic, but we know it happens, very rarely, but everything in the medical field that we know, is because it happened to someone at least once.
I have been bitten three times by venomous snakes, due to my own negligence and inexperience when i was a lot younger.
The first one was a juvenile Bibrons Stilleto snake, single puncture wound from a single tooth, on my left thumb. I spent 7 days in Garden City clinic in a lot of pain and discomfort, recieved no antivenom, only analgesics, anti-inflammatories and a lot of antibiotics because i got blood poisoning (which was probably a lot worse than the initial bite).
The second time was a little over a month later, I was bitten by a juvenile Copperhead, again on the left thumb. I was admitted again to hospital (this time Flora Clinic, as the surgeon that treated me the firs time had moved, and i felt comfortable with him) for 11 days, and i had to have surgical debridement of the wound, again recieved no antivenom, but a lot of painkillers, and antibiotics. Was the second bite more involved because it was right on the tail of the first one? Was it more involved because copperheads have a more virulent venom? Who knows.
The third bite was about a year and a bit later, when i was bitten by a juvenile Puff Adder (around the same size as the copperhead that bit me), also on the left hand, on my index and middle fingers. I recieved three bites and 5 puncture wounds, all with venom injected. I decided to watch it and see what developed (although the pain was intense, my old man would have seriously *#$$%$^& me up if he knew i still had some venomous snakes knocking around). There was some swelling of the bitten fingers, to the point that i could not bend them, the half of my hand with the thumb and fingers on was also very swollen. I went camping the next day, partly so my parents wouldn't see it, and also so that if it did get bad, i could claim i was bitten whilst out in the bush (oh how teenagers have the ability to concoct such elaborate schemes!
). After 4 days the swelling started to recede, and after about 7 days it was gone altogether. I sustained no gangrene, used no medications other than paracetamol and I have not a mark to show for my troubles. Can we deduce from this that a puff adder bite is not as serious as a Bibrons stilleto snake? most definately not, because we know for a fact that there is a marked difference in the strength of the venoms, but i put that up as a comparison of three cytotoxic bites, from three different snakes on the same place on the body on the same person, all with markedly different results and treatments.