The book "Bites, Venoms, and Venomous Snakes of Colombia" represents a scientific milestone that reinforces the National Institute of Health’s (INS) commitment to generating and managing knowledge for public health. Based on Colombia's unique biodiversity, this work comprehensively addresses toxinology, venomics, and the epidemiology of snakebite accidents, as well as the development of antivenoms and medications derived from snake venom toxins.

This work is backed by 55 national and international scientists who generously and selflessly contributed their knowledge and experiences regarding the taxonomic, biochemical, pharmacological, ecoepidemiological, and clinical aspects of Colombian snakes of medical importance. It provides a modern foundation that promotes progress in research, education, and public health policies.

The contributions in this work synergistically align with the mission of the INS, which aims to: (1) Produce scientific knowledge in health by characterizing and analyzing the diversity and biochemical properties of snake venoms, promoting an understanding of ophidism and its medical implications; and (2) Contribute to public health sovereignty by highlighting the national development of antivenoms and innovative biomedical technologies derived from snake toxins. This positions Colombia as one of the tropical countries leading biomedical advancements to reduce the morbidity and mortality caused by ophidism, one of the most neglected tropical diseases worldwide.

Similarly, the contributions from the authors and reviewers of the ten chapters and 59 snake species profiles help consolidate the strategic objectives of the INS, which aim to: (1) Generate and manage knowledge by providing scientific evidence that facilitates the formulation of public policies and health strategies based on Colombia's territorial needs; (2) Strengthen the public health surveillance system through detailed ecoepidemiological analysis, providing critical information to identify patterns and risk factors associated with snakebite incidents; (3) Produce goods of interest for public health by recounting the history and analyzing advances in antivenom production, reinforcing the INS's role as a leader in the national production of these essential medicines.

Particularly, this work enhances the INS’s leadership in public health by creating the Colombian Snakebite Geovisor (https://ofidismo.ins.gov.co/), a tool that uses open data to provide free access to epidemiological and environmental information that is openly available for consultation and download. This reinforces the INS’s commitment to transparency, free access to public information, as well as to develop public health strategies based on scientific evidence. Furthermore, the book is available in three different formats: a freely downloadable PDF, a web version (https://serpientes.ins.gov.co), and a limited printed edition. In this way, the INS promotes open access to the book as an educational, technical, and scientific resource for health professionals, researchers, policymakers, and the general public.

The book and the Geovisor actively implement territorial articulation principle of the National Institute of Health by providing direct access to high-quality information from the territories and for the territories. This contribution significantly impacts community education, promoting comprehensive knowledge of venomous snakes and encouraging the prevention and proper management of bites. These efforts are essential to reducing severe cases of ophidotoxicosis and strengthening the protection of the most vulnerable communities.

"Bites, venoms, and venomous snakes of Colombia" is a fundamental contribution to Colombia's scientific and medical advancement. Its interdisciplinary approach highlights the INS's capacity to address priority public health issues. Moreover, it strengthens the country's health sovereignty through innovation in antivenom production that responds to the territorial needs and unique challenges presented by Colombia as a biologically and culturally megadiverse country.

A step forward in safeguarding biodiversity and public health in Colombia—because public health is built with and from the territories!

Dra. Diana Marcela Pava Garzon
Medical toxicologist

Director General
National Institute of Health​

Colombia’s unique biodiversity and my friends and collaborators in the country

Colombia enjoys the richest faunal biodiversity of any country, being inhabited by 10% of the world’s animal species, many of them endemic. These include more than 1,800 species of birds, 1,500 of freshwater fish, and some 460 of mammals and 340 of snakes.

Over the last 25 years, I was privileged to be introduced to some of these wonders, during visits to Bogotá, Medellín, Villa de Leyva, and to Cartagena, where, in 2000, I helped to organise an International Congress of Tropical Medicine, opened by President Andrés Pastrana Arango. But long before my first visit to Colombia, I had corresponded with Juan José Silva-Haad at Hospital Regional de Leticia. He sent me reprints of his fascinating papers, in one of which he illustrated the horrifying local tissue destruction and haemorrhage caused by Lachesis mutaenvenoming in local Amerindians. He described a distinctive syndrome of autonomic nervous system stimulation, evolving as soon as 15 minutes after the bite [1]. It comprised vasogenic shock with marked bradycardia, vomiting, diarrhoea and abdominal colic [2].

Since about 2000, my guide, philosopher, and friend in Colombia has been Juan Manuel Renjifo. His photographs and publications celebrate the animals, plants, and scenery of Colombia, especially: “Ranas y Sapos de Colombia” (1997); “Anfibios y reptiles de Urrá” (1999); and the amazing “La Amazonia de Colombia” (2008). Dave Theakston and I first met him at the Instituto Nacional de Salud (INS) in Bogotá, to seek his help with the Liverpool School of Tropical Medicine’s international initiative to develop a new Pan African Polyspecific Antivenom for the neglected and deserted snakebite victims in that vast continent [3]. Juan Manuel and his colleagues at INS, including Francisco Ruiz Gómez, and Santiago Nicholls, raised our programme’s most potent candidate antivenom, successfully immunising Colombian horses against selected African snake venoms, including that of the notorious black mamba (Dendroaspis polylepis). Unfortunately, political problems prevented the implementation of this promising result. 

The need for “Bites, Venoms, and Venomous Snakes of Colombia” 

With this background of admiration for Colombian collaborators, Colombia’s venomous snakes, and INS antivenoms, I was excited to hear of the plan by the Serpentarium at INS to publish “Bites, Venoms, and Venomous Snakes of Colombia”. This ambitious project will include 10 chapters and 59 species sheets both in Spanish and English, authored by 55 experts, in three different formats: a freely downloadable pdf; a web version; and (mercifully for those of us who still prefer hard copy) a limited print edition. A database linked to the book is the “Geovisor Colombiano de Ofidismo” (https://ofidismo.ins.gov.co/). It makes all the shapefiles of epidemiological information, inventories of the environmental variables, and curated distribution records of the medically important Colombian snake species, available for free download. Such a generous strategy will display the content available to a very wide, international, and grateful readership. I anticipate publication as eagerly as the world’s many other snake, snakebite, and toxinology enthusiasts. 

I hope that this publication may stimulate discussion towards the drawing-up of new consensus guidelines for the prevention and clinical management of snakebite envenoming in Colombia. I have observed the continuing belief in traditional shamanic treatments among rural people, and diverse approaches to medical treatment in the different Latin American countries that I have been privileged to visit (Brazil, Ecuador, Peru, Costa Rica, Martinique, Saint Lucia, and Colombia). In the absence of unifying WHO/PAHO snakebite advice, or up-to-date national guidelines in many countries, controversial therapies are still used in some centres. For example, a patient bitten by Bothrops asperin Colombia, who sought my advice after returning to Europe, had been treated with topical ice packs (causing frostbite incurred during heavy opiate-sedation), an anticoagulant, platelet-inhibitor, non-steroidal anti-inflammatory agent, corticosteroid, antihistamine, and prophylactic antibiotic, and had been kept immobilisation in bed. Cryotherapy has been abandoned in most countries, because it was found to cause tissue damage in rattlesnake-bite-victims in North America [4]. Anticoagulants and the other drugs have also been proscribed by most authorities, while early re-mobilisation is encouraged, to restore normal function of the bitten limb.

In advance of publication, I have been granted a limited preview of some of the chapters.

Antivenom production in Colombia

Of particular interest to me was Chapter 7: “Venoms, Love, and Hate” by Amira Abultaif Kadamani which gives a detailed perspective of the history of antivenom production, from Albert Calmette’s original “sérum antivenimeux”, first used successfully in a human victim of monocled cobra (Naja kaouthia) envenoming in Saigon, Vietnam in 1896; to Vital Brazil in Brazil and Clodomiro Picado in Costa Rica (early 20th century); to Bernado Samper in Colombia (from 1937), with later help by Roger Bolaños from Costa Rica, and eventual antivenom production at INS by Juan Manuel Renjifo, coordinator of the Serum Group (in the mid-1970s).

Species characteristics and the quest for clinical phenotypes of envenoming

The emphasis of this book is on the recognition and identification of Colombia’s venomous species with details of their precise geographical distribution (Geovisor Colombiano de Ofidismo, https://ofidismo.ins.gov.co/); and their morphology, recognition, symptoms of envenoming, treatment and epidemiology of bites, conservation etc., (provided by the individual species sheets). This accords perfectly with my career-long emphasis on trying to define the clinical phenotypes (syndromes or composite pictures of clinical effects of envenoming) by the different species. Without such detailed data, optimal treatment of severely envenomed patients, and guidance to laboratory toxinologists in discovering improved treatments that target medically-relevant toxins/epitopes, will not be possible. The hand-drawn illustrations of each species are a very attractive feature of these species sheets, and provide an opportunity to emphasise distinctive features, such as the black inverted anchor nuchal marking of M. ancoralis. I note that the local Spanish name for this species is “gargantilla” meaning “choker” or bejewelled regal necklace in English, also referring to this snake’s neck markings. The lack of specific symptomatology and treatment advice highlights the need for prospective clinical studies of patients envenomed by expertly-identified snakes, for toxinological studies of their venomics, and, in particular, of their neutralisation by available antivenoms, and the possible role of first-aid with anticholinesterases [5]. 

For future use, it is encouraging that a polyspecific Micrurus antivenom developed in Medellín immune-recognised the venoms of M. ancoralis and 8 other Colombian Micrurus venoms [6], possibly expanding the range of the polyvalent coral snake antivenom developed earlier at INS [7].

Snake mythology? The dreaded surucucú/shuchúpe (Lachesis muta)

I look forward to reading the account of Colombia’s, and the Western Hemisphere’s, most spectacular venomous snakes, the bushmasters. Despite their reclusive and generally-inoffensive habits, it is perhaps not surprising that their formidable size (perhaps exceeding 3.6 m in total length) and the devastating effects of their venom (see above) have generated great, awe, and dread in the countries they inhabit. 

A recent expedition across the Guyanese jungle, shown on UK television [8] reminded me of one of the most widespread myths surrounding these marvellous animals, their alleged “song”. This was first mentioned by Evaristo García in his classic “Los Ofidios Venenosos del Cauca” (Cali, Paris: Ch. Bouret, 1896): “Á este ofidio se refieren las leyendas más singulares, contadas por los que han viajado en los Chocóes. Abunda en los bosques, en donde se la oye gritar sonidos semejantes al cacareo de la gallina… ronca durante el día cuando duerme envuelta en espirales”. However, in Guyana, the sound attributed to bushmasters was very different from García’s “cackling of a hen” or “snoring”. It was a continuous high-pitched crescendo whistle, giving the travellers the impression that their camp was being surrounded by these snakes. William Lamar, who has travelled extensively in search of reptiles throughout most Latin American countries, asserts that: “From Costa Rica across South America, disparate groups of indigenous peoples, colonists, hunters, and the like all share the belief, going back nearly two centuries, that the bushmaster has a distinctive sound”[9]. In the Western Amazon region, an explanation has been provided by the discovery of two Hylid frogs (Tepuihyla shushupe and T. tuberculosa) whose calls, in parts of Peru and Ecuador, are believed by the local people to emanate from bushmasters [10].

This is yet another example of the endless intrigue provided by snakes, and the need for the authoritative information that this welcome new publication has to offer. 

Congratulations to all those involved!

David A. Warrell 

University of Oxford, UK, November 2024.​

Teddy Angarita-Sierra.— To Myriam Sierra Guerrero, my mother, and Tulio Angarita Serrano†, my father, for encouraging me to pursue my wildest dreams and to believe in the will of the impossible.

Francisco J. Ruiz Gómez.— To María Carlina, my wife, and Ana María, my daughter, the deep roots of my effort and dedication. Endless thanks for lighting up my sleepless nights and gray days, and for always believing in me​

This book, in essence, is the result of the collective, intense, and passionate effort of all the authors of the chapters and entries who, selflessly, agreed to participate and unite their wills with the common purpose of providing a contemporary context on the knowledge surrounding snakebites, venoms, and venomous snakes in Colombia. It aims to enhance future research, strengthen the prevention, management, and treatment of snakebite incidents, and reduce the negative perceptions about snakes. For this reason, we, the editors, deeply thank the authors, as the excellence and rigor presented in this work would not have been possible without them.

To the reviewers: Dr. Eliecer de Jesús Jiménez Charris (Universidad del Valle); Dr. Leidy Johana Vargas (Universidad Cooperativa de Colombia); Dr. Alejandro Carbajal-Saucedo (Universidad Autónoma de Nuevo León); Dr. Osnamir Elías Bru Cordero, Dr. Thomas Defler, Dr. Nohora Vega (Universidad Nacional de Colombia); Dr. Gerardo Corzo (Universidad Nacional Autónoma de México); Dr. María Elisa Peichoto (National Scientific and Technical Research Council, Buenos aires, Argentina); Dr. Alexis Rodríguez Acosta (Universidad Central de Venezuela); Dr. Maria Elena Barragán (Gustavo Orcés Foundation, Ecuador); MSc. Juan Manuel Renjifo (Universidad del Magdalena); Dr. Paola Rey-Suarez; Dr. Rafael Otero-Patiño (Universidad de Antioquia); Dr. Santiago Ayerbe (Universidad del Cauca); Dr. Nancy Oguiura (Butantan Institute) for their critical reading, recommendations, and time invested in improving this work.

Special thanks go to our colleagues from the Venomous Animals Group of the Production Directorate of the National Institute of Health (INS) for their unconditional support, dedication, and innovative, resourceful, and meticulous contributions to this work, which honor public service and contribute to nation-building.

To the scientific committee composed of Dr. Franklyn Edwin Prieto Alvarado, Dr. William W. Lamar (Professor Emeritus, University of Texas at Tyler), and Dr. Thomas Defler (Professor Emeritus, Department of Biology, Universidad Nacional de Colombia, Bogotá campus), for ensuring the excellence and quality of this work.

Likewise, we extend our special thanks to the leaders of the Institute who believed in this vision and provided their institutional support, particularly to Dra. Diana Marcela Pava Garzón (General Director, INS), Dr. Franklyn Edwin Prieto Alvarado (Director of Surveillance and Risk Analysis in Public Health, INS), Dr. Juan Felipe Bedoya Meneses (Director of Production, INS), Dr. Helver Guiovanni Rubiano García and Dr. Martha Lucia Ospina Martínez (former General Directors, INS).

Special gratitude to Dr. William W. Lamar (University of Texas at Tyler) for openly and generously sharing his knowledge and experiences about Colombian venomous snakes, significantly improving the species sheets and chapters, and to Dr. David Warrell (University of Oxford) for reviewing the draft manuscript and contributing a warm foreword for the book.

To the artists, Oscar A. Ramírez Ruiz, and the graphic designers and web developers—María Catalina Durán, Johanna Montes Bustos, and Jonathan Medina—for imbuing this work with sensitivity, aesthetic appeal, and scientific beauty.

To Carlos A. Bravo-Vega for developing the cartography and spatial analyses, positioning this work at the forefront of knowledge.

The authors of Chapter 3 thank the Ecology and Evolution Laboratory at the Butantan Institute for their contribution to obtaining some of the DNA sequences used for phylogenetic reconstruction. Thanks also to the reviewers Thomas Defler, William Lamar, and Nancy Oguiura for their valuable input in reviewing the chapter. Furthermore, we are grateful to the institutions and funds that financed and/or supported the authors during the analysis and writing of the chapter, such as the University of São Paulo, CAPES, COLFUTURO, Universidad de Antioquia, Universidad Bernardo O’Higgins, and the National Agency for Research and Development (Fondecyt Regular Project 1220921).

The authors of Chapters 5 and 6 thank the Venomous Animals Group and the Innovation and Technological Development Group of the National Institute of Health, the Protein Research Group of the Universidad Nacional de Colombia, Universidad de Antioquia, and the Biomacromolecule Chemistry Laboratory of the National Autonomous University of Mexico for their support in the work plan, and the Universidad Nacional de Colombia, De La Paz campus, for its institutional support.

The authors of Chapter 9 thank the municipal and departmental health secretariats, as well as the Primary Data Generating Unit (UPGD), for managing the information for epidemiological surveillance in Colombia.

Dr. Lina María Peña Acevedo, co-author of Chapter 9, thanks the Universidad de Antioquia and the San Vicente Foundation Hospital Medellín, institutions where she develops all her teaching and healthcare activities, for allowing her to learn and love everything she knows about snakebites, a passion that continues to grow. She also thanks the National Institute of Health of Colombia for entrusting her with the analysis of the information presented in this book, which significantly contributes to the understanding of snakebite cases and epidemiology in Colombia and the world.

The author of the Bothrocophias tulitoi entry thanks the Biotechnology and Environment Group at INCCA University of Colombia for allowing me to be part of a team committed to advancing knowledge. Special thanks to Professor Teddy Angarita Sierra for his trust and support in inviting me to participate in this book, thus contributing to the knowledge and scientific dissemination of medically significant snakes in Colombia.

The authors of the entries for Micrurus clarki, M. spurrelli, and Bothrops taeniatus thank the members of the Evolution, Ecology, and Conservation (EECO) research group and the Biology Program at Universidad del Quindío for their contributions to obtaining information, text reviews, or logistical support during the development of these entries.

To the Universidad Nacional de Colombia, De La Paz campus, for its institutional support during the last two years of this project.

This book and the Colombian Snakebite GeoViewer (https://ofidismo.ins.gov.co/) are part of the products derived from the research project titled "Strengthening, Consolidation, and Generation of Knowledge of the Missionary Activities of the Serpentarium of the National Institute of Health," funded from 2021 to 2022 by Minciencias through Call 891 to strengthen vocations and training in Science, Technology, and Innovation (STI) for economic reactivation in the post-pandemic context of 2020.

More than just a publication, this book represents a testament to the unity of purpose of a growing group of Colombian researchers who, despite financial, technical, and social limitations that challenge scientific work daily in Colombia, persist and overcome these barriers with tenacity, passion, high academic quality, and camaraderie, contributing in a cutting-edge manner to the comprehensive understanding of Colombian snakes.​

Colombia stands as a global bastion of biodiversity, hosting approximately 10% of the world's animal species and ranking among the planet's 25 most critical biodiversity hotspots. Among its vast natural wealth, the country is home to a remarkable diversity of venomous snakes that play crucial ecological and biomedical roles. However, this extraordinary natural heritage brings a series of public health challenges related to ophidism—a medical term referring to snakebite envenomation.

In response, the book, Snakebites, Venoms, and Venomous Snakes of Colombia, offers a scientifically comprehensive assessment of the 59 snake species of medical importance in the country. This work seeks to address the pressing need for accessible and rigorous information about these feared yet extraordinary reptiles, while also enriching our understanding of the toxinological and public health knowledge of medically important species in Colombia. This book emerges as a fundamental resource that reinforces the mission of Colombia's National Institute of Health (INS) to protect public health and contribute to global scientific knowledge.

Structured into ten chapters, the book explores taxonomic, evolutionary, biochemical, toxinological, ecoepidemiological, and historical aspects related to the development of antivenoms that neutralize envenomation caused by medically significant Colombian snake species. Based on an analysis of the latest research, it provides new evidence and relevant findings for understanding ophidism, while emphasizing the need to continue investigating unresolved questions driving scientific advancement in these fields.

Chapter 1 provides a retrospective overview of snake species relevant to public health in Colombia, including an updated taxonomy, data on their distribution, and conservation status. This chapter highlights the need to continue researching the ecology and natural history of these species, which are essential for implementing conservation measures to mitigate the risk and incidence of ophidism.

A notable section of the book is the in-depth analysis of the venom of species within the genus Micrurus (coralsnakes) in Chapter 2. Known for their potent neurotoxins, coral snakes are biologically and medically fascinating. However, the significant variability in venom composition remains poorly understood. The authors call for extended studies on the ecological and evolutionary factors driving this variability and reevaluate the role of aposematic coloration (bright warning colors) in deterring predators.

Chapter 3 focuses on the evolutionary complexity and variability of venom in pit vipers (rattlesnakes, bushmasters, and lanceheads), which represent the most medically significant snakes in Colombia. Despite their prominent role in public health, these species and their venoms have been understudied compared to venomous snakes in other tropical regions. This chapter examines their evolutionary history, the variability in venom composition and biological activity, and their potential as models for studying evolutionary biology, providing new perspectives on their adaptation to Colombia’s diverse tropical landscapes.

Chapter 4 delves into colubrids (rear-fanged snakes), which are generally considered "non-venomous" snakes. Nevertheless, this chapter robustly compiles recent studies showing that many colubrids produce salivary secretions with toxins capable of causing mild but significant envenomations. Additionally, it underscores the importance of understanding the evolutionary history of their venoms, their biological significance, and their incredible pharmacological potential for the development of new drugs and biomedical applications.

The biochemical nature of snake venoms is examined in Chapter 5, focusing on key components such as metalloproteinases, phospholipases A2, and three-finger toxins. These venom components, essential for immobilizing and digesting prey as well as deterring predators, are also responsible for the pathophysiological processes observed in ophidic accidents. This chapter details the mechanisms of action of toxins, analyzes the composition and variability of venoms from medically significant Colombian species, and links venom biochemistry to the clinical profiles of envenomations. 

Understanding this relationship has immediate implications for the clinical management of snakebite incidents, as the severity of envenomations and treatment approaches are heavily influenced by venom composition and activities.

Antivenoms remain the cornerstone for treating envenomation caused by snakebites. Chapter 6 details their development and application in Colombia, highlighting advances in the pharmaceutical production of antivenoms and the use of molecular techniques to enhance their efficacy. Given the significant venom variability within and between snake species, continued research on their protein components is essential. Furthermore, the authors explore complementary therapeutic approaches, such as immunorecognition techniques, to improve antivenom effectiveness.

The history of antivenom production in Colombia is narrated in Chapter 7, from pioneering efforts to the consolidation of structured production protocols. This chapter provides an in-depth look at the role of the INS in advancing Colombian and regional public health through the management, production, and development of antivenoms to address one of the world’s most neglected tropical diseases. It captures the evolution of the INS’s production capacity for antivenoms in Colombia, situating current initiatives within a historical framework that contextualizes the country’s achievements and challenges in addressing snakebite envenomation.

Chapter 8 examines the unique challenges of maintaining venomous snakes in captivity for antivenom production. Drawing on decades of experience at the INS serpentarium, the authors share lessons learned about best practices to ensure the health and welfare of captive snakes. Additionally, the authors emphasize the importance of understanding the ideal comprehensive conditions for snake captivity, minimizing stress, and enabling physiological and behavioral pattern monitoring to ensure their well-being and survival. Consolidating these learnings contributes to the conservation efforts of these species and facilitates the acquisition of high-quality venom for research, development, and improvement of antivenoms.

Snakebite envenomation remains a priority public health issue in Colombia, particularly in rural areas where poverty, food insecurity, and limited access to medical care pose significant challenges. Chapter 9 provides an ecoepidemiological analysis of ophidic accidents using data from the national surveillance system, SIVIGILA (2010–2020). The authors examine spatial and temporal patterns in snakebite occurrences, identify demographic factors associated with envenomation risk, and review clinical management practices. In line with World Health Organization guidelines, they offer recommendations for improving data collection and medical training to reduce the morbidity and mortality associated with ophidism.

Finally, Chapter 10 explores the therapeutic potential of Colombian snake venoms, focusing on their applications in cardiovascular and nervous system treatments as well as their potential in cancer and antimicrobial therapies. The authors advocate the use of omics technologies to explore the pharmacological potential of Colombian snake venoms while emphasizing the value of traditional biochemical and pharmaceutical research to discover bioactive compounds with significant medical relevance.

This ambitious project, written by 55 scientists, is presented in three different formats: a free downloadable PDF, a web version (https://serpientes.ins.gov.co), and a limited print edition. The project includes a database linked to the book called the Colombian Ophidism Geovisor, providing free access to shapefile data with epidemiological information, environmental variables, and distribution records of medically significant snake species in Colombia (https://ofidismo.ins.gov.co). Additionally, it presents 59 species profiles summarizing key biological, toxinological, and epidemiological information about these medically significant snakes in the country.

This book titled Snakebites, venoms, and venomous snakes of Colombia thus becomes an indispensable resource for herpetologists, toxinologists, clinicians, public health professionals, and the general public. Offering a comprehensive investigation into the biological, ecological, and medical dimensions of Colombia’s venomous snakes, this book aligns with the INS mission, advancing scientific understanding and reinforcing Colombia's commitment to public health and international collaboration in the fields of toxinology and public health. The meticulous research and accessible format of this work will undoubtedly support the development of informed public health policies and promote the conservation of these misunderstood and ecologically significant creatures.

Teddy Angarita-Sierra and Francisco J. Ruiz-Gómez

Editors​