Protobothrops jerdonii (Jerdon’s pit viper) and Protobothrops himalayanus (Himalayan lance-headed pit viper) bites: Clinical report on envenomings from North-East India, managed through remote consultation by a national-level Poison control center

• Published in: Toxicon (Oxford) 2024-05, Vol.242, p.107704-107704, Article 107704
• Main Authors: Ralph, Ravikar, Sharma, Deepak, Jain, Rohit, Balachandran, Amith, Chiang, Yu-Wei, S.R, Ganesh
• Format: Article
• Language: English
• Subjects: acute kidney injury; antivenoms; genus; India; Indian polyspecific antivenom; Pit-vipers; Protobothrops himalayanus; Protobothrops jerdonii; Snakebite envenoming; species
• ISSN: 0041-0101; 1879-3150
• DOI: 10.1016/j.toxicon.2024.107704

Members of the genus Protobothrops are amongst the more than twenty-eight range-restricted Indian pit viper species. Their bites and envenomings are rarely documented from India. Pit viper envenomings can be challenging to treat in the Indian setting, since available antivenoms do not satisfactorily neutralize their venoms. Herein, we present the first Indian reports on bites and envenoming by Protobothrops jerdonii and Protobothrops himalayanus resulting in local effects, coagulopathy and acute kidney injury in the case of the former and possible mild, isolated coagulopathy in the case of the latter; and discuss management-related challenges in the context of absent specific antivenoms. [Display omitted] •We describe the first Indian reports on bites and envenoming by Protobothrops jerdonii and Protobothrops himalayanus.•Envenoming by Protobothrops jerdonii causes local effects, coagulopathy and acute kidney injury.•Indian polyspecific snake anti-venom is ineffective in neutralizing venoms of these species.•Awareness of the range-distribution of these species is of importance to clinicians serving in north-eastern India.