If the antivenom is unavailable, management of the patient is focused on supportive care, which includes airway management with mechanical ventilation. If the antivenom is available, if and when to start is decided on a case-by-case basis after careful risk/benefit assessment as antivenom administration is not without dangers. Because having a supply of the antivenom is uncommon in most hospitals, healthcare providers need to work with their regional Poison Control Center to locate a source of supply. The remaining available antivenom has passed the manufacturer-assigned expiration date of 2008, but FDA continues to provide information on expiration date extensions based evaluation of stability data.
However, the manufacturer stopped production in 2006. The traditional treatment for coral snake envenomation has been a horse-derived IgG antibody antivenom produced by Wyeth Pharmaceuticals (now a subsidiary of Pfizer, Inc.) called the North American Coral Snake Antivenin. Given the potentially serious outcomes after a coral snake bite, all people with a suspected envenomation should be seen in a hospital immediately and observed for at least 24 hours.
The major cause of death from coral snake envenomations is respiratory failure as a result of neuromuscular weakness. Symptoms of a coral snake envenomation can include nausea, vomiting, paresthesias (abnormal sensations), slurred speech, double vision, ptosis (drooping eye), muscle twitching, weakness, and paralysis. The effects of the venom are usually delayed (up to 13 hr) but progress rapidly once they develop. Blockade of acetylcholine after envenomation can lead to weakness and paralysis and even complete respiratory failure in severe cases. The neurotoxic venom blocks an important neurotransmitter called acetylcholine, which is important for the activation of muscles in the body. However, the venom of the Eastern coral snake contains very potent neurotoxins that can cause severe illness or death if left untreated. Compared to other venomous snakes, their bite marks can be easily missed, often showing no significant local tissue damage, obvious injury, or pain. Of the three species in the US, bites by the eastern coral snake tend to be the most severe, while those of the Arizona/Sonoran and Texas coral snakes aren't generally associated with serious side effects or death.Ĭoral snakes have small, fixed fangs, and when they bite they tend to latch onto their prey and "chew" for a few seconds in order to deliver their venom.
Compared to their pit viper counterparts (e.g., rattlesnakes), coral snake bites are uncommon and represent only about 2% of snake bites reported to US Poison Centers annually. Arizona or Sonoran coral snake ( Micruroides euryxanthus ) - Found in southeastern US, and Sonora, Mexico)īy nature, coral snakes are reclusive and seldom bite unless they're provoked or threatened.Texas coral snake ( Micrurus tener ) - Found in Texas and northwestern Mexico.Eastern coral snake ( Micrurus fulvius ) - Found in Florida and the southeastern US.For the purposes of this article, we'll focus primarily on the three species found in the US, which are: Coral snakes usually have a pattern of red, black, yellow (or white) colored rings that span their bodies. Coral snakes are members of the Elapidae family, which includes cobras. It's important to note that this general rule doesn't apply to non-native coral snake species, which might have different patterns. If you aren't familiar with this saying, it refers to distinguishing the venomous coral snake from its nonvenomous look-alikes (e.g., the king snake, shovel-nosed snake, and milk snake). " Of all the childhood rhymes we've grown up learning, this one might be high on the list of ones to remember if you live in coral snake country. "Red touch yellow, kills a fellow red touch black, venom lack.
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