The Big Four
Definition
The four Indian snake species responsible for the bulk of medically significant envenomation: Naja naja (Indian cobra), Bungarus caeruleus (common krait), Daboia russelii (Russell's viper) and Echis carinatus (saw-scaled viper). Indian polyvalent antivenom is raised against the venom of these four species.
- Species count
- 4
- Cobra
- Naja naja (Indian cobra)
- Krait and vipers
- Bungarus caeruleus, Daboia russelii, Echis carinatus
- Antivenom
- Indian polyvalent antivenom
Common questions
Does polyvalent antivenom cover snakebites outside these four?+
No, bites from other medically significant species such as hump-nosed pit vipers are poorly or not neutralised by standard Indian polyvalent antivenom, a recognised clinical gap in coverage.
Why focus on these four species specifically?+
They account for the large majority of severe and fatal snakebite envenomations recorded across India, though the relative burden of each species varies by state and region.
Related terms
- 20WBCT
- Twenty minute whole blood clotting test. A few millilitres of fresh venous blood are placed in a clean dry glass tube, left...
- Autonomic Storm
- The biphasic cardiovascular crisis of Indian red scorpion envenomation. An initial cholinergic phase of vomiting, salivation and bradycardia is followed by an...
- Neurotoxic Envenomation
- Venom-induced paralysis from blockade of the neuromuscular junction. The Indian cobra produces post-synaptic blockade through alpha-neurotoxins binding the acetylcholine receptor. The common...
- Venom ELISA
- An enzyme-linked immunosorbent assay in which species-specific anti-venom antibodies are used to detect residual venom antigen in serum, urine, bite-site exudate or...
- VICC
- Venom-induced consumption coagulopathy, the haemotoxic syndrome of Russell's viper and saw-scaled viper bites in which the venom activates coagulation factors, consumes fibrinogen...