Poisonous snake bite victims usually have difficulty identifying the species, and clinical manifestations alone are not reliable because of overlapping symptoms. Thus, it is important to develop a quick and reliable mean of identifying the snake responsible. We describe the development of a sandwich-ELISA method for detection of venom in biological samples and apply it to a case of snakebite to confirm the clinical diagnosis. The sandwich-ELISA takes 6 h to complete. Cobra venom antigen gave positive absorbance at about 500 pg/ml. Good linearity with R2 values over 0.99 were observed in dilution series of 1:100 ng/mL of cobra venom in calf serum and human urine. A snakebite initially thought to be Trimeresurus mucrosquamatus was proven cobra with a serum venom level up to 288 ngmL 3 h after envenoming. Sandwich-ELISA provides a rapid and accurate method for clinical identification and evaluation of toxic antigens circulating in individuals bitten by the Taiwan cobra snake.

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