On the Occurrence and Health Risks of the Venomous Palestine Viper (Vipera palaestinae Werner, 1938) in the Gaza Strip – Palestine

Introduction In spite of its small area, Palestine (27,000 km2) is home to about 40 snakes, of which at least 9 are venomous [1,2]. Kochva [1] pointed out that the most venomous snakes of Palestine and Jordan are the Palestinian Viper (Vipera palaestinae), Painted Saw-scaled Viper or Painted Carpet Viper (Echis coloratus), Field’s Horned Viper (Pseudocerastes fieldi), Horned Desert Viper (Cerastes cerastes), Black Desert Cobra (Walterinnesia aegyptia), and the Palestinian Burrowing Asp or Palestine Mole Viper (Atractaspis engaddensis). Special attention was paid by the regional scientific parties on the Palestine Viper, which is endemic to Palestine and the close neighboring countries [3-8]. Hundreds of people receive venomous bites annually in Palestine and Jordan, of whom many die [3]. In the light of these facts, the Palestinian Health Authorities usually warn the public from the adverse impacts associated with biting of the most venomous Palestinian Viper (Vipera palaestinae or Daboia palaestinae). The authorities also ensured that local antivenins are available against only two of the venomous snakes including Palestine Viper, while against others regional or European preparations are commonly used [1]. It is worth mentioning that both venomous and non-venomous snakes are active in summer and they maintain ecological balance in nature by chasing rodents and pests that disturb humans.


Introduction
In spite of its small area, Palestine (27,000 km 2 ) is home to about 40 snakes, of which at least 9 are venomous [1,2]. Kochva [1] pointed out that the most venomous snakes of Palestine and . Special attention was paid by the regional scientific parties on the Palestine Viper, which is endemic to Palestine and the close neighboring countries [3][4][5][6][7][8]. Hundreds of people receive venomous bites annually in Palestine and Jordan, of whom many die [3]. In the light of these facts, the Palestinian Health Authorities usually warn the public from the adverse impacts associated with biting of the most venomous Palestinian Viper (Vipera palaestinae or Daboia palaestinae). The authorities also ensured that local antivenins are available against only two of the venomous snakes including Palestine Viper, while against others regional or European preparations are commonly used [1]. It is worth mentioning that both venomous and non-venomous snakes are active in summer and they maintain ecological balance in nature by chasing rodents and pests that disturb humans.
The current study comes to introduce data on the occurrence, ecology and risks of the Palestine Viper (Vipera palaestinae Werner, 1938) in the Gaza Strip-Palestine. Field observations and discussions with stakeholders (snake hunters, doctors and people It is a common phenomenon to find clever snake hunters displaying on their social media pages and other internet sites different categories of alive as well as dead specimens of snakes; particularly the venomous Palestine Viper (Figure 2). Local measurements on tens of Palestine Viper specimens either being alive, or dead indicated that the average length of the snake is 80-90 cm. Many specimens were found to exceed the threshold of 100 cm and may reach a maximum length of 130 cm. The tail represents about 15% of the snake's total length. The snake is yellow in color; with twisted lines extend from its tail to its triangular head (often a feature of poisonous snakes) (Figure 1). Like other snakes of the Gaza Strip, the Palestine Viper feeds on rodents, lizards, frogs, birds and other small living organisms [13]. In summer seasons, the snake exhibits its maximum activity and breeding biology.

Health Risks of the Palestine Viper
In spites of the causalities and fatalities caused by the Palestine Viper's bites, it rarely attacks humans. Most snake bites targeting humans and livestock in the Gaza Strip were reported in the summer months extending from May till October. Some police, health or civil defense centers claimed that they received many calls from local people having troubles with snakes at their homes or buildings.
These official parties usually deal with the dangerous organisms in a safe way. If not killed, the specimens were said to be caught and transferred to appropriate ecological locations or habitats in the Gaza Strip. However, discussions with local people including those who have been bitten by the Palestine Viper itself pointed out the following bite causes:

a.
If a person stumbles on the snake deliberately or wrongly.

b.
If a person tries to attack, kill or catch the snake itself, or if the person tries to touch the eggs of snakes in their dens.

c.
Many snake hunters were said to be bitten because they caught the snake post to capture in a wrong way.

d.
Farmers are exposed to venomous snake bites when they stumble on them during agricultural operations, irrigation and crop harvesting.

e.
Many farmers were bitten when they clean irrigation canals.

f.
Many local people including children were bitten when they put their hands in dark earth burrows where snakes are hiding.
Generally speaking, envenomation by the Palestine Viper in the Palestinian Territories is not restricted to humans. It was also reported in domestic animals including dogs, cats, horses, sheep, goats, chickens, rabbits, pigeons and cows [16]. The leg was found to be the most common site for biting by venomous snakes as al. [19].
Deaths are sometimes associated with the Palestine Viper bites; though deaths resulted from other venomous snakes like Painted Saw-scaled Viper (Echis coloratus) were documented in Jordan [3].
World Health Organization reported that venomous snakes caused 5.4 million bites every year around the world, of them 2.5 million suffered with envenoming and around 125,000 died [20]. According to local doctors, the fatalities usually occur due to the absence of specific vaccines, lack of first aid or treatment after biting, and delayed presentation to the hospital. Medical reports in Palestine indicated that more than 90% of snake bites have been attributed the Palestine Viper and are therefore it was considered as the most dangerous and poisonous snake in the Palestine environment [21].

Concluding Remarks
In spite of the harmful envenomation and related causalities and even mortalities caused by the Palestine Viper in the Gaza Strip, it is necessary for the Palestinian ecological parties to raise the awareness of Palestine towards the venomous and nonvenomous snakes of the Palestine and their capital ecological role.
The possible ways to avoid snake bites and their adverse effects are of utmost priority and should be highlighted as well.