Colubrid envenomations in the United States

The literature concerned with colubrid envenomations in the United States is reviewed, including cases involving Americans who were envenomated by exotic snakes, Because exotic snakes have become readily available through the pet trade, it is essential for medical personnel to realize that snake-bite victims presenting themselves at North American hospitals may have been bitten by South American, Asian, African or European animals. Major themes emerging from this review are: 1) some colubrid envenomations have been serious, even life threatening, 2) many so-called envenomations might actually be allergic reactions, 3) extreme variability seems to characterize Duvernoy's secretions, intraspecifically as well as interspecifically, 4) even within the same individual, Duvernoy's secretion can vary in composition and action from time to time, and 5) we know little about the determinants of this variability, although a variety of hypotheses are available. Opportunities for research in this area are extensive, Likewise, we know little about the historical or current biological role(s) of Duvernoy's secretions, and once again there exists a plethora of hypotheses, only a few of which have been tested. We appear to be standing at the threshold of a new era of exciting empirical and theoretical discoveries, some of which may redefine the way we think about colubrid oral secretions.