Land Snakes of Medical Significance in Malaysia

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LAND SNAKES OF MEDICAL SIGNIFICANCE IN MALAYSIA

Ahmad Khaldun Ismail, Teo Eng Wah, Indraneil Das, Taksa Vasaruchapong & Scott A. Weinstein 1 LAND SNAKES OF MEDICAL SIGNIFICANCE IN MALAYSIA

Ahmad Khaldun Ismail, Teo Eng Wah, Indraneil Das, Taksa Vasaruchapong & Scott A. Weinstein

with the support of

Malaysian Society on Toxinology

Second edition, July 2017

All images are copyrighted to the contributors

ISBN: 978-967-0250-26-7

1 Table of Contents Acknowledgements

Acknowledgements 2 “This publication was funded by the Ministry of Natural Resources and Environment (NRE) to promote Malaysia Overview 3 Biodiversity Information System (MyBIS) as a one-stop reference centre for biodiversity of Malaysia” Identifying Snakes in Malaysia 4 Faculty & Advisory Members of ASEAN Marine Animals Symbols for Snake Profile 5 & Snake Envenomation Management (AMSEM)TM Instructions for Identification 6 Symposium Remote Envenomation Consultation Services (RECS)TM Pit Vipers – Head Shape & Scalation 6 Ministry of Natural Resources and Environment (NRE) Elapidae/Colubridae – Head Shape & Scalation 7 Forest Research Institute Malaysia (FRIM) Elapidae 8 Malaysia Biodiversity Information System (MyBIS) Natricidae 27 Pythonidae 38 Viperidae 44 Snake Bite: Do's & Don'ts 76 Antivenoms Appropriate for Malaysia 77

Authors 79 Coordinator: Image Contributors 79 Ajla Rafidah Baharom Nur Hazwanie binti Abd Halim References 80 Yasser Mohamed Ariffin 2 Overview

The range of snakes of medical significance in Malaysia currently • Viperidae (vipers and pit vipers are also front-fanged snakes), encompasses four families of snakes (Natricidae, Elapidae, which could cause significant local and systemic envenoming Pythonidae and Viperidae). There are limited data on the distribution syndrome. of snakes in the country. The following account is based on available • Natricidae (non-front-fanged) snakes, of which two or three published information on snakes recorded from Peninsular Malaysia, species in Malaysia are potentially dangerous, in being able to Labuan, Sabah and Sarawak. This book should be viewed as a cause significant systemic and local envenoming syndromes, guide, especially for healthcare providers, to identify and manage while some of the others could probably cause limited local potential envenoming from snakebites in Malaysia. Information on reactions. the snake species listed here is based on the local data and those • Pythonidae (the giant constricting snakes), including pythons, all from neighbouring countries. Due to their geographical proximity, species in this family are potentially dangerous to humans and can cause significant local injuries. Large-growing members of snakes occurring in Peninsular Malaysia are genetically closer this species can even constrict and consume adult humans. to those from Thailand and Singapore, while those on Sabah and Sarawak are naturally closer to populations from Brunei Darussalam, The purpose of this book is to highlight the potentially dangerous Kalimantan and islands of the southern Philippines. species to humans, with a list of the main potentially medically significant snakes. It is important to note that if a species is not listed While a majority of snakes occurring in Malaysia are non-venomous, below, it does not necessarily mean that it does not exist in Malaysia and constitute no threat to humans, a number of species can cause nor that its bite cannot cause harmful effects in humans. In particular, mild to severe envenoming that may lead to permanent disability or the list of colubrid (non-front-fanged) snakes has been selective, to even death in humans. include only a number known to be of potential medical significance. The main groups of medically significant snakes It is also important to note that a poor surveillance of the pet trade and in Malaysia are: irresponsible importation of exotic snakes may introduce a medically significant species, which is not indigenous to Malaysia. This may • Elapidae (front-fanged snakes) are venomous snakes, which are add to the complexity of managing envenomings in this country. potentially dangerous and capable of causing significant systemic and local envenoming syndrome. This group includes all sea snakes, of which many are considered highly dangerous and may cause significant systemic envenoming syndrome. Other members include cobras, the king cobra, kraits and coral snakes.

3 Identifying Snakes in Malaysia

1. A reliable reference is invaluable for helping accurate 5. Knowledge of the biology, including habitat (e.g. terrestrial/ identification of snakes. Several are available in the market, arboreal/fossorial/aquatic) is also useful for making a and all illustrate the species of medical significance. You positive identification- knowing where particular snakes tend should be familiar with at least some of the identification to live will help you identify them. characteristics of the potentially dangerous snakes in 6. Knowledge of patterns of activity (diurnal/nocturnal/ Malaysia. crepuscular) of snakes may also help in identification. 2. The most noticeable characteristic about any snake, at first glance, will be its colour. This can help identify some snakes that are very distinctive in colouration. However, snakes also vary in colouration, and several non-venomous snakes are known to mimic venomous ones. Within the same species, the sexes and growth stages may display different colouration. 3. An excellent character for the identification of snakes is its scales. The shape, texture and number of scales are often unique to each species. A knowledge of scale morphology is useful if you have found a dead snake or a shed skin, but not always useful for the identification of a live snake, for obvious reasons! 4. Knowledge of the geographical distribution of a snake is helpful for its identification. Several snakes are found widespread in the country, while others have limited range, © Ahmad Khaldun and may be further restricted to specific altitudes and habitats. Elephant Trunk Snake Acrochordus javanicus

Note: The scientific name used in this book’s snake profiles are based on Uetz P. & Hošek, J. 2017. The Reptile Database. 15 Oct 2017. http://www.reptile-database.org. Accessed 6 November 2017. 4 Symbols for Snake Profile

Snake Food Venom Level

Rodent / Mammal Bird Frog/Toad Snake Fish Lizard Non Venomous Venomous

Snake Habitat Behaviour

ARBOREAL TERRESTRIAL FOSSORIAL SEMI AQUATIC AQUATIC Diurnal Nocturnal Living in tress Living on land Living digging & Living partly on Living in water bury themselves land and in water underground

Antivenom NKAV OHAV BCAV BFAV CRAV

Cobra Antivenin King Cobra Malayan Krait Banded Krait Malayan Pit Viper Antivenin Antivenin Antivenin Antivenin

GPAV HPAV NPAV RTAV

Green Pit Viper Hemato Polyvalent Snake Neuro Polyvalent Tiger Keelback Antivenin Antivenom Snake Antivenom Antivenom

5 Instructions for Identification Pit Vipers – Head Shape & Scalation

Nostral 1. Measure the length (and diameter) of the snake. <

Standard measurements of snakes include tail length, < head to vent length and head width (especially relative to its neck). Loreal pit 2. Notice and describe the colours on the snake’s body, as well as any patterns. Stripes are marks lengthwise along the body; bands are marks across the body. 3. Look at the shape of snake’s head and tail (size and arrangement of scales on the top of its head and under its tail are important for identification). Note: 4. Observe and count the scales (on head/midbody/ There is no simple way of differentiating a venomous snake from anal/subcaudals) on dead snakes. Observations a non-venomous one. Determining whether a snake is venomous on scales, including texture (bearing a keel or not), is correctly done by identification of the species with the help of pattern (overlapping or situated next to each other) and snake systematists. In their absence, close examination of the colouration, in combination with other morphological snake (make sure that they are truly dead! Wounded snakes may characteristics, are the principal means of classifying appear dead, and venomous species can inject venom after death snakes to level of species. if carelessly handled – always treat a ‘dead’ specimen with great 5. Take pictures from different perspectives, especially caution and confirm the specimen is truly dead before relaxing entire body in dorsal and ventral views (so that scale such cautions!) or good quality pictures, and using authoritative counts can be made later), head from dorsum, venter as references on the snakes of the particular geographical region, will well as lateral views. Specialists of snakes can typically help to identify it. Reliable identification can be used to guide the identify the snake from these images. most appropriate management of the patient. 6 Elapidae/Colubridae – Head Shape & Scalation

F – frontal IN – internasal

PTO T L – loreal N L IN PRO La – supralabial La’ – infralabial N N – nasal P – parietal R PF – prefrontal PSO La’ La PRO – preocular PSO – presubocular PTO – postocular R – rostral

N SO – supraocular IN SO T – anterior & posterior temporals P R PO PO – postoccipital F PF

PRO PTO

7 ELAPIDAE

Adult © Teo Eng Wah

MyBIS: 20831 Malayan Krait (EN) Ular Katam Tebu (BM) IUCN Red List BCAV Bungarus candidus Least Concern (LC) NPAV

8 Adult Adult © Teo Eng Wah © Teo Eng Wah

9 ELAPIDAE

Juvenile © Taksa Vasaruchapong

MyBIS: 9935 Banded Krait (EN) Ular Katam Belang (BM) IUCN Red List BFAV Bungarus fasciatus Least Concern (LC) NPAV

10 Adult Adult © Teo Eng Wah © Teo Eng Wah

11 ELAPIDAE

Adult © Teo Eng Wah

MyBIS: 9936 Red-headed Krait (EN) Ular Katam Kepala Merah (BM) IUCN Red List Bungarus flaviceps Least Concern (LC) NPAV

12 Adult Adult © Stephen Hogg © Teo Eng Wah

13 ELAPIDAE

Adult © Teo Eng Wah

MyBIS: 21355 Monocled Cobra (EN) Ular Senduk (BM) IUCN Red List NKAV Naja kaouthia Least Concern (LC) NPAV

14 © Teo Eng Wah Adult

Juvenile © Teo Eng Wah

15 ELAPIDAE

Adult © Teo Eng Wah

MyBIS: 21356 Sumatran Spitting Cobra (EN) Ular Senduk Sembur (BM) IUCN Red List NKAV Naja sumatrana Least Concern (LC) NPAV

16 Adult Adult Juvenile © Teo Eng Wah © Teo Eng Wah © Indraneil Das

Golden Spitting Cobra © Taksa Vasaruchapong

17 ELAPIDAE

Adult © Ahmad Khaldun Ismail

MyBIS: 9942 King Cobra (EN) Ular Tedung Selar (BM) IUCN Red List OHAV Ophiophagus hannah Vulnerable (VU) NPAV

18 Adult © Teo Eng Wah

Adult © Teo Eng Wah 19 ELAPIDAE

Adult C. b. flaviceps © Teo Eng Wah

MyBIS: 48553 Blue Malayan Coral Snake (EN) Ular Pantai Biru (BM) IUCN Red List Calliophis bivirgatus

Least Concern (LC)

20 © Indraneil Das C. b. tetrataenia Adult

Adult C. b. flaviceps © Stephen Hogg

21 ELAPIDAE

Adult © Indraneil Das

MyBIS: 20886 Malayan Striped Coral Snake (EN) Ular Pantai Belang (BM) IUCN Red List Calliophis intestinalis Least Concern (LC)

22 Adult © Teo Eng Wah

Adult © Teo Eng Wah 23 ELAPIDAE

Adult © Guek Hock Ping @ Kurt

MyBIS: 20889 Speckled Coral Snake (EN) Ular Pantai Bintik Kecil (BM) IUCN Red List Calliophis maculiceps

Least Concern (LC)

24 Adult Adult © Guek Hock Ping @ Kurt © Tom Charlton

25 ELAPIDAE

MyBIS: 9937 Spotted Coral Snake (EN) Ular Pantai Bintik (BM) IUCN Red List Calliophis gracilis

Data Deficient (DD)

26 NATRICIDAE

Adult © Indraneil Das

Red-bellied Keelback (EN) MyBIS: 9926 Rhabdophis conspicillatus IUCN Red List

Least Concern (LC)

27 NATRICIDAE

Adult © Tom Charlton

MyBIS: 9927 Speckle-bellied Keelback (EN) Ular Rabong Perut Bintik (BM) IUCN Red List Rhabdophis chrysargos

Least Concern (LC)

28 Adult © Teo Eng Wah

29 NATRICIDAE

Adult © Guek Hock Ping @ Kurt

MyBIS: 9921 Blue-necked Keelback (EN) IUCN Red List Macropisthodon rhodomelas

Least Concern (LC)

30 Adult © Guek Hock Ping @ Kurt

31 NATRICIDAE

Adult © Mary-Ruth Low

MyBIS: 21336 Orange-necked Keelback (EN) IUCN Red List Macropisthodon flaviceps Least Concern (LC)

32 © Guek Hock Ping @ Kurt Juvenile

Adult © Mary-Ruth Low

Juvenile © Guek Hock Ping @ Kurt 33 NATRICIDAE

Adult © Remco Hofland

MyBIS: 21530 Gunung Murud Keelback, Muruden Keelback (EN) IUCN Red List Rhabdophis murudensis Least Concern (LC)

34 © Remco Hofland Adult

Adult © Remco Hofland

35 NATRICIDAE

Adult © Taksa Vasaruchapong

MyBIS: 21531 Red-necked Keelback (EN) IUCN Red List Rhabdophis subminiatus

Least Concern (LC) RTAV

36 Adult Juvenile © Taksa Vasaruchapong © Max Jackson

37 PYTHONIDAE

Juvenile © Teo Eng Wah

MyBIS: 58057 Reticulated Python (EN) Ular Sawa Batik (BM) Malayopython reticulatus

38 Juvenile Adult © Teo Eng Wah © Ahmad Khaldun

39 PYTHONIDAE

Adult © Teo Eng Wah

MyBIS: 21538 Bornean Short Tailed (EN) Ular Sawa Darah (BM) IUCN Red List Python breitensteini Least Concern (LC)

40 Adult Female Adult © Teo Eng Wah © Teo Eng Wah

41 PYTHONIDAE

Adult © Teo Eng Wah

MyBIS: 21539 Brongersma's Short Python (EN) IUCN Red List Python brongersmai Least Concern (LC)

42 Adult Adult © Teo Eng Wah © Teo Eng Wah

43 VIPERIDAE

Adult © Teo Eng Wah

MyBIS: 20891 Malayan Pit Viper (EN) Ular Kapak Daun, Ular Kapak Bodoh (BM) IUCN Red List CRAV Calloselasma rhodostoma Least Concern (LC) HPAV

44 © Teo Eng Wah Adult

45 VIPERIDAE

Adult © Tom Charlton

MyBIS: 22578 Kinabalu Brown Pit Viper (EN) IUCN Red List GPAV Garthius chaseni Least Concern (LC) HPAV

46 Adult Adult © Guek Hock Ping @ Kurt © Guek Hock Ping @ Kurt 47 VIPERIDAE

Adult © Stephen Hogg

MyBIS: 57996 Malayan Brown Pit Viper (EN) IUCN Red List GPAV Ovophis convictus Least Concern (LC) HPAV

48 Adult Adult © Teo Eng Wah © Stephen Hogg

49 VIPERIDAE

Adult © Indraneil Das

MyBIS: 21659 Bornean Palm Pit Viper (EN) Ular Kapak Borneo (BM) IUCN Red List Trimeresurus borneensis Least GPAV Concern (LC) HPAV

50 Sub-Adult Sub-Adult © Tan Song Wei © Tan Song Wei

51 VIPERIDAE

Adult © Peter Lee Shiuh Hwa

MyBIS: 58166 Tioman Pit Viper (EN) Ular Kapak Tioman (BM) IUCN Red List GPAV Trimeresurus buniana Endangered (EN) HPAV

52 Adult © Peter Lee Shiuh Hwa

Adult © Peter Lee Shiuh Hwa 53 VIPERIDAE

Adult Male © Teo Eng Wah

MyBIS: 58164 Thai Peninsula Pit Viper (EN) IUCN Red List GPAV Trimeresurus fucatus Least Concern (LC) HPAV

54 Adult Adult Male Female © Teo Eng Wah © Teo Eng Wah

Adult Female © Teo Eng Wah

55 VIPERIDAE

Adult © Teo Eng Wah

MyBIS: 21437 Hagen's Pit Viper (EN) Ular Kapak Hijau (BM) IUCN Red List GPAV Trimeresurus hageni Least Concern (LC) HPAV

57 VIPERIDAE

MyBIS: 58145 Kinabalu Pit Viper (EN) IUCN Red List GPAV Trimeresurus malcolmi Near Threatened (NT) HPAV

MyBIS: 58162 Cameron Highlands Pit Viper (EN) IUCN Red List GPAV Trimeresurus nebularis Vulnerable (VU) HPAV

61 VIPERIDAE

MyBIS: 57766 Mangrove Pit Viper (EN) Ular Kapak Bakau (BM) IUCN Red List GPAV Trimeresurus purpureomaculatus Least Concern (LC) HPAV

MyBIS: 58159 Sabah Green Pit Viper (EN) IUCN Red List GPAV Trimeresurus sabahi Least Concern (LC) HPAV

65 VIPERIDAE

MyBIS: 58157 Sumatran Pit Viper (EN) Ular Kapak Sumatra (BM) IUCN Red List GPAV Trimeresurus sumatranus Least Concern (LC) HPAV

MyBIS: 53771 Beautiful Pit Viper (EN) GPAV Trimeresurus venustus HPAV

MyBIS: 53772 Wirot's Palm Pit Viper (EN) IUCN Red List GPAV Trimeresurus wiroti Least Concern (LC) HPAV

71 VIPERIDAE

MyBIS: 57443 Bornean Keeled Pit Viper (EN) Ular Kapak (BM) IUCN Red List GPAV Tropidolaemus subannulatus Least Concern (LC) HPAV

73 VIPERIDAE

MyBIS: 21662 Wagler's Pit Viper (EN) Ular Kapak Tokong (BM) IUCN Red List GPAV Tropidolaemus wagleri Least Concern (LC) HPAV

75 Snakebite:

Do's

Calm down, Bring patient to the nearest hospital with reduce movements emergency care and immobilize

Don'ts

Go to a tantrik or Suck the wound Cut the wound Tie ligatures Massage Apply ice or Burn the wound Apply or ingest shaman electric shock herbal remedies

76 ANTIVENOMS APPROPRIATE FOR MALAYSIA Antivenom raised from Antivenom manufacturer First Dose/vials Monocled Cobra, Naja kaouthia QSMI Thai Red Cross: Cobra Antivenin to 100mls/10 vials Subsequent dose neutralize 0.6 mg/ml of venom 1-2 hr King Cobra, Ophiophagus hannah QSMI Thai Red Cross: King Cobra Antivenin to 100mls/10 vials Subsequent dose neutralize 0.8 mg/ml of venom 1-2 hr Malayan Krait, Bungarus candidus QSMI Thai Red Cross: Malayan Krait Antivenin to 50mls/5 vials Subsequent dose 1-2 hr neutralize 0.4 mg/ml of venom Banded Krait, Bungarus fasciatus QSMI Thai Red Cross: Banded Krait Antivenin to 50mls/5 vials Subsequent dose 1-2 hr neutralize 0.6 mg/ml of venom Malayan Pit Viper, Calloselasma rhodostoma QSMI Thai Red Cross: Malayan Pit Viper Antivenin 30mls/3 vials Subsequent dose 6 hr to neutralize 1.6 mg/ml of venom Green Pit Viper, Cryptelytrops albolabris QSMI Thai Red Cross: Green Pit Viper Antivenin to 30mls/3 vials Subsequent dose 6 hr neutralize 0.7 mg/ml of venom Malayan Pit Viper, Calloselasma rhodostoma, Green Pit Viper, QSMI Thai Red Cross: Hemato Polyvalent Snake 30mls/3 vials Subsequent dose 6 hr Cryptelytrops albolabris, SEA Russell’s Viper, Daboia siamensis Antivenom Monocled Cobra, Naja kaouthia, King Cobra Ophiophagus hannah, QSMI Thai Red Cross: Neuro Polyvalent Snake 50-100mls/ 5-10 vials Subsequent Banded Krait, Bungarus fasciatus, Malayan Krait, Bungarus candidus. Antivenom dose 1-2 hr

Tiger Keelback, Rhabdophis tigrinus Japan Snake Institute: Tiger Keelback,Rhabdophis One vial (one additional vial if tigrinus antivenom clinically indicated/available) Beaked Sea Snake, Hydrophis schistosus CSL, Australia: Sea Snake Antivenom 10-30mls/1-3 vials Subsequent dose 1-2 hr

Note: Subsequent doses are according to the clinical symptoms. Monocled cobra, Naja Monocled cobra, Naja kaouthia, King cobra, Ophiophagus hannah and Malayan kaouthia antivenom has good cross neutralization with the Equatorial spitting krait, Bungarus candidus. However, its use is not recommended in Malaysia or cobra, Naja sumatrana venom. Malayan pit viper, Calloselasma rhodostoma, SEA SEA region. Russell’s Viper, Daboia siamensis and Monocled cobra, Naja kaouthia are not Tiger keelback, Rhabdophis tigrinus antivenom neutralizes Red-necked keelback, indigenous to Borneo. The ViNS Indian Polyvalent antivenom is not appropriate Rhabdophis subminiatus venom in animal models and should be considered for for treating pit viper envenomations in Malaysia. It may have limited neutralizing severe Red-necked keelback, Rhabdophis subminiatus envenomings in humans capacity against the venoms of Equatorial spitting cobra, Naja sumatrana, whenever possible.

77 Antivenoms Appropriate for Venomous Land Snakes in Malaysia

QSMI Thai Red Cross: Cobra QSMI Thai Red Cross: King Cobra QSMI Thai Red Cross: Malayan QSMI Thai Red Cross: Banded Antivenin to neutralize 0.6 mg/ml Antivenin to neutralize 0.8 mg/ml Krait Antivenin to neutralize 0.4 Krait Antivenin to neutralize 0.6 of venom of venom mg/ml of venom mg/ml of venom

QSMI Thai Red Cross: Malayan QSMI Thai Red Cross: Green Pit QSMI Thai Red Cross: Hemato QSMI Thai Red Cross: Neuro Pit Viper Antivenin to neutralize Viper Antivenin to neutralize 0.7 Polyvalent Snake Antivenom Polyvalent Snake Antivenom 1.6 mg/ml of venom mg/ml of venom

78 Authors Image Contributors AHMAD KHALDUN ISMAIL Ahmad Khaldun Ismail Universiti Kebangsaan Malaysia Medical Centre Senior Medical Lecturer & Consultant Emergency Physician Gernot Vogel Department of Emergency Medicine, Im Sand 3, 69115 Heidelberg, Germany Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Guek Hock Ping (Kurt aka orionmystery) Orion Herp Adventure Travel Cheras, Kuala Lumpur. Indraneil Das TEO ENG WAH (VINCE ADAM) Institute of Biodiversity & Environmental Conservation, Universiti Malaysia Sarawak Senior Lecturer Max Jackson 4 Cooba Close, Buderim, Queensland 4556, Australia Sports Centre, University of Malaya, Max Ong Wei Ling Kuching, Sarawak Kuala Lumpur. Mary-Ruth Low Wildlife Reserves Singapore INDRANEIL DAS Mohd Abdul Muin Md Akil Professor Universiti Sains Malaysia Institute of Biodiversity and Environmental Conservation, Nick Weigner James Cook University, Australia Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Sarawak. Peter Lee Shiuh Hwa Singapore Remco Hofland TAKSA VASARUCHAPONG Rotterdam, The Netherlands Veterinarian Stephen Hogg Snake Farm, Stephen’s Place, Malaysia Queen Saovabha Memorial Institute, Taksa Vasaruchapong Thai Red Cross Society, Snake Farm, Queen Saovabha Memorial Institute, Thailand Bangkok, Thailand. Tan Song Wei Kuching, Sarawak SCOTT A. WEINSTEIN Teo Eng Wah (aka Vince Adam) Clinical Toxinologist & Family Physician University of Malaya Department of Toxinology, Tom Charlton Women’s & Children’s Hospital, Eco Animal Encounters, United Kingdom North Adelaide, South Australia, Australia. Zee Kum Yeng Penang

79 References Cox M.J., Hoover M.F., Lawan C. & Kumthorn T. (2012). The snakes Sibunruang S., Suteparuk S. & Sitprija V. (2013). Manual of Practical of Thailand. Chulalongkorn, University Museum of National History, Management of Snake-bites and Animal Toxin Injury. Bangkok: Queen Thailand. pp. 845. Saovabha Memorial Institute, The Thai Red Cross Society, Thailand. pp. 88. Das I. (2012). A Naturalist's Guide to the Snakes of South-East Asia: Including Malaysia, Singapore, Thailand, Myanmar, Borneo, Sitprija V. & Suteparuk S. (2012). Clinical Physiology of Animal Toxins: Sumatra, Java and Bali. John Beaufoy Publishing, Oxford, England. An Overview. Queen Saovabha Memorial Institute, The Thai Red Cross pp. 160. Society, Thailand. pp. 119.

Das, I., Ahmed, N., & Lim, B. L. (2015). Venomous terrestrial snakes Snake Farm Exhibition, 2010. Snake Farm, Queen Saovabha Memorial of Malaysia: Their identity and biology. Clinical Toxinology in Asia Institute, The Thai Red Cross Society, Thailand. pp. 97. Pacific and Africa, 53-69. The IUCN Red List of Threatened Species. Retrieved June 21, 2017, from Ismail, A. K. (2015). Snakebite and envenomation management in http://www.iucnredlist.org/ Malaysia. Clinical Toxinology in Asia Pacific and Africa, 71-102. Uetz P. & Hošek, J. 2017. The Reptile Database. 15 Oct 2017. Ismail, A. K. (2017). Quick Guide on Snakebite Management http://www.reptile-database.org. Accessed 6 November 2017. for Healthcare Providers in Malaysia. Retrieved June 21, 2017, World Health Organization. (2016). Guidelines for the Management of from https://www.dropbox.com/s/zsz2l7rizoltwjo/Snakebite%20 Snakebites, 2nd edition. World Health Organization: Regional Office for Management%20Guide%20for%20Healthcare%20Providers%20 South-East Asia: New Delhi, India. pp. 201. in%20Malaysia. pdf?dl=0

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Marlon R., Supriatna J., Liswanto D., Baskoro K., Putra S. & Patty H.R. (2014). Panduan Visual dan Identifikasi Lapangan: 107+ Ular Indonesia. Indonesia Nature & Wildlife Publishing, Indonesia. pp. 251.

Rusli N., Marlon R., Lilley R., Ekariyono W. & Laister A. (2016). Mengenal Ular Jabodetabek - Snakes of Jakarta and Its Surroundings. Ciliwung Reptile Center, Jakarta, Indonesia. pp. 168.

80 Land Snakes of Medical Significance in Malaysia

While a majority of snakes occurring in Malaysia are not equipped with venom and constitute little threat to humans, a number of species can cause envenoming that may lead to permanent disability or death. The range of snakes of medical significance in Malaysia encompasses the families Natricidae, Elapidae, Pythonidae and Viperidae. This book highlights thirty-five land snakes with short descriptions and photographs. It is intended as a guide for healthcare providers, permitting them to identify and manage potential envenoming from snakebites. The purpose of this book is also to increase public awareness on the diversity and beauty of our snakes.

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