On the importance of correct snake identification. Comment on Chippaux et al. Snakebites in Cameroon by Species Whose Effects Are Poorly Described

One of the major obstacles to improving the management of snakebite envenoming is the lack of accurate identification of species responsible for clinical cases, which prevent the improvement of definitions of species-specific syndromes. Understanding which snakes are biting people in a given region of the world, and what the clinical consequences of these cases are, is a cornerstone to the formulation of strategies to reduce the burden of snakebite. Yet, in many parts of the world, this knowledge remains elusive. Nowhere is this problem more acute than in the forested zones of Central and Western Africa, where detailed epidemiological studies remain conspicuous by their absence, the key species involved in severe envenoming remain largely unknown, and their syndromes poorly understood and ill-defined. It is thus with considerable excitement that we read the recent paper by Chippaux et al. [1], promising a description of the syndromes of envenoming by several rarely documented snake species in Cameroon.
However, we were troubled to find that upon comparing clinical notes and photographs, there were multiple misidentifications of specimens to which cases were attributed. Coupled with clinical incongruities, these inaccuracies cast considerable doubt on the value of the paper.
The following are clear misidentifications of the snakes shown in the photographs: