Early settlers feared the red-bellied black snake, though it turned out to be much less dangerous than many other species. The
murine median lethal dose (LD50) is 2.52 mg/kg when administered
subcutaneously. A red-bellied black snake yields an average of 37 mg of venom when milked, with the maximum recorded being 94 mg. It accounted for 16% of identified snakebite victims in Australia between 2005 and 2015, with no deaths recorded. Its venom contains
neurotoxins,
myotoxins, and
coagulants and also has
haemolytic properties. Bites from red-bellied black snakes can be very painful—needing
analgesia—and result in local swelling, prolonged bleeding, and even local
necrosis, particularly if the bite is on a finger. Severe local reactions may require surgical
debridement or even amputation. Symptoms of systemic envenomation—including nausea, vomiting, headache, abdominal pain,
diarrhoea, or excessive sweating—were thought to be rare, but a 2010 review found they occurred in most bite victims. Most people also go on to develop an anticoagulant
coagulopathy in a few hours. This is characterised by a raised activated
partial thromboplastin time (aPTT), and subsides over 24 hours. It resolves quickly with antivenom. A few people go on to develop a myotoxicity and associated generalised muscle pain and occasionally weakness, which may last up to 7 days. Patients may suffer a loss of sense of smell (
anosmia); this is unrelated to the severity of the envenoming and can be temporary or permanent. Although the venom contains the
three-finger toxin α-elapitoxin-Ppr1, which acts as a neurotoxin in laboratory experiments, neurotoxic symptoms are generally absent in clinical cases. A biologically active agent—pseudexin—was isolated from red-bellied black snake venom in 1981. Making up 25% of the venom, it is a single poly
peptide chain with a molecular weight around 16.5
kilodaltons. In 1989, it was found to be composed of three
phospholipase A2 isoenzymes. If antivenom is indicated, red-bellied black snake bites are generally treated with
tiger snake antivenom. While black snake antivenom can be used, tiger snake antivenom can be used at a lower volume and is a cheaper treatment. In 2006, a 12-year-old golden retriever suffered
rhabdomyolysis and
acute kidney injury secondary to a red-bellied black snake bite. Laboratory testing has found that cats are relatively resistant to the venom, with a lethal dose as high as 7 mg/kg. ==Conservation and threats==