The black mamba is the most feared snake in Africa because of its size, aggression, venom toxicity and speed of onset of symptoms following envenomation, and is classified as a snake of medical importance by the
World Health Organization. A survey in South Africa from 1957 to 1979 recorded 2,553 venomous snakebites, 75 of which were confirmed as being from black mambas. Of these 75 cases, 63 had symptoms of systemic envenomation and 21 died. Bites were often fatal before antivenom was widely available. A census in rural Zimbabwe in 1991 and 1992 revealed 274 cases of snakebite, of which 5 died. Black mambas were confirmed in 15 cases, of which 2 died. The peak period for deaths is the species' breeding season from September to February, during which black mambas are most irritable. Unlike many venomous snake species, black mamba venom does not contain
protease enzymes. Its bites do not generally cause local swelling or
necrosis, and the only initial symptom may be a tingling sensation in the area of the bite. The snake tends to bite repeatedly and let go, so there can be multiple puncture wounds. and 0.33 mg/kg. Other neurological symptoms include
miosis (constricted pupils), blurred or diminished vision,
paresthesia (a tingling sensation on the skin),
dysarthria (slurred speech),
dysphagia (difficulty swallowing),
dyspnea (shortness of breath), difficulty handling saliva, an absent
gag reflex,
fasciculations (muscle twitches),
ataxia (impaired voluntary movement),
vertigo, drowsiness and loss of consciousness, and respiratory paralysis. Without appropriate antivenom treatment, symptoms typically progress to
respiratory failure, which leads to
cardiovascular collapse and death. In 2015, the
proteome (complete protein profile) of black mamba venom was assessed and published, revealing 41 distinct proteins and one
nucleoside. The venom is composed of two main families of toxic agents,
dendrotoxins (I and K) and (at a slightly lower proportion)
three-finger toxins. The composition of black mamba venom differs markedly from those of other mambas, all of which contain predominantly three-finger toxin agents. It is thought this may reflect the preferred prey items – small mammals for the mainly land-dwelling black mamba versus birds for the other predominantly arboreal mambas. Unlike many snake species, black mamba venom has little
phospholipase A2 content.
Treatment Standard
first aid treatment for any suspected bite from a venomous snake is the application of a
pressure bandage to the bite site, minimisation of movement of the victim and conveyance to a hospital or clinic as quickly as possible. The neurotoxic nature of black mamba venom means an arterial
tourniquet may be of benefit. A polyvalent antivenom produced by the
South African Institute for Medical Research is used to treat black mamba bites, and a new antivenom was being developed by the
Universidad de Costa Rica's
Instituto Clodomiro Picado.
Notable bite cases • Danie Pienaar, who was at various times from at least 2009 head of
South African National Parks Scientific Services and acting managing executive, survived the bite of a black mamba without antivenom in 1998. Despite the hospital physicians having declared it a "moderate" envenomation, Pienaar lapsed into a coma at one point and his prognosis was declared "poor". Upon arrival at the hospital, Pienaar was immediately
intubated and placed on
life support for 3 days. He was released from the hospital on the fifth day. Remaining calm after being bitten increased his chances of survival, as did the application of a tourniquet. • In March 2008, 28-year-old
British trainee
safari guide Nathan Layton was bitten by a black mamba that had been found near his classroom at the Southern African Wildlife College in
Hoedspruit,
Limpopo, South Africa. Layton was bitten by the snake on his
index finger while it was being put into a jar and first aid-trained staff who examined him determined he could carry on with lectures. and collapsed and died shortly afterwards. • American professional photographer Mark Laita was bitten on the leg by a black mamba during a photo-shoot of a black mamba at a facility in
Central America. Bleeding profusely, he did not seek medical attention, and except for intense pain and local swelling overnight, he was not affected. This led him to believe that either the snake gave him a "
dry bite" (a bite without injecting venom) or the heavy bleeding pushed the venom out. Some commenters on the story suggested that it was a
venomoid snake (in which the venom glands are surgically removed), but Laita responded that it was not. Only later did Laita find that he had captured the snake biting his leg in a photograph. • In 2016, Kenyan woman Cheposait Adomo was attacked by three black mambas, one of which bit her repeatedly on the leg, in
West Pokot County, Kenya. People coming to her aid drove off the other snakes, hacking two with a
machete. After an attempt at using traditional medicine, they placed her on a motorcycle and conveyed her 45 minutes to the nearest hospital, which had antivenom. She survived. • In 2017, a 31-year-old man named Arslan Valeev died in Saint Petersburg, Russia, after enticing a pet black mamba to bite him live on webcam in an apparent suicide. • Prominent South African anti-Apartheid activist and
Labour Court judge Anton Steenkamp died after being bitten by a black mamba while on leave in
Zambia in May 2019. He was several hours away from medical help and died before antivenom could be administered. • In June 2020,
Bulgarian
veterinarian Georgi Elenski from
Haskovo was bitten by a black mamba that was part of his personal collection of
exotic animals. His initial condition was very serious, but he recovered after extensive treatment involving the administering of antivenom and respiratory support. • In January 2022, a former newspaper office worker and farmer from Zimbabwe, Peter Dube, died after getting bitten by a black mamba, due to the hospital he was taken to not having any antivenom to treat him. • In January 2023, a 17-year-old student from Zimbabwe died after being bitten by a black mamba. The snake had gone into a high school classroom while the students were outside. ==Notes==