Clinical Profile and Outcomes of Malabar Pit Viper (Trimeresurus malabaricus) Envenomation: A Retrospective Observational Study from Kerala, Southern India
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction: Kerala reports a high incidence of snakebites, with about 37 venomous species. Besides the “Big 4” (Cobra, Krait, Russell’s Viper, and Saw-scaled Viper), the Malabar Pit Viper (MPV) is also notable, especially in the Western Ghats. MPV is endemic to high-altitude, forested regions and presents with local symptoms like pain and swelling, along with haematotoxicity. Aim: To evaluate the clinical characteristics, management, and outcomes of patients with confirmed MPV envenomation at a tertiary centre in Wayanad, Kerala, India. Materials and Methods: The present retrospective observational study was conducted using data from patients admitted over a two-year period, from January 2021 to December 2022. Hospital records were reviewed to identify confirmed cases of MPV envenomation. Cases were included based on either the physical presentation or photograph of the snake brought by the patient, or a clinical diagnosis confirmed by the treating physician. Data collected included patient demographics, anatomical site of the bite, local and systemic manifestations, results of the 20-minute Whole Blood Clotting Test (WBCT), administration of antivenom, and any complications encountered. All data were anonymised and entered into Epicollect5 for collection and management. Statistical analysis was performed using R software. Results: Of the 61 patients admitted with snakebites, 20 (32.8%) were confirmed cases of MPV envenomation. The majority of bites occurred on the upper limbs (n=14, 70%). Local pain and swelling were reported in 13 patients (65%). A prolonged 20- minute WBCT was observed in eight patients (40%). Despite limited evidence of efficacy against MPV venom, 15 patients (75%) received Anti-Snake Venom (ASV). Complications were noted in two patients (10%): one developed cellulitis and the other had an adverse reaction to ASV. All patients recovered fully without any long-term sequelae. Conclusion: MPV (Trimeresurus malabaricus) bites are a notable cause of envenomation in Wayanad, Kerala, typically causing local symptoms with generally good patient outcomes. The routine use of Indian polyvalent ASV is of limited benefit and carries risk of adverse reactions. Developing region and species-specific antivenoms could improve treatment efficacy, reduce risks, and optimise clinical management.
Language: English
Subfield: Genetics
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $275
OpenAlex ID: W7154781640
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