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Reality Bites

Antivenin supplies running low as snakebite season hits

FRIDAY, May 17, 2002 (HealthDayNews) -- Hospitals from California to Florida are facing an unusual shortage of medicine to treat poisonous snake bites, so they're crossing their fingers that Americans use extra caution outdoors this summer.

New supplies of snake antivenin, also known as antivenom, should start arriving in the United States soon, but poison control officials fear it may be too little, too late.

"We expect there to be a shortage and very tough times," said Stuart Heard, executive director of the California Poison Control System.

Without antivenin, snakebite victims may face obscure treatments to reduce pressure from swelling. The worst snakebites can lead to permanent disability or death.

Protherics, a small British company, stopped producing an antivenin called CroFab in March after harmful bacteria was discovered at a production plant.

The United States is by far the top market for the CroFab. Doctors use it in an intravenous solution to treat bites from 10 types of poisonous snakes known as pit vipers, which include rattlesnakes, cottonmouths, copperheads and water moccasins. According to the U.S. Food and Drug Administration (FDA), almost 99 percent of the venomous bites in this country are from pit vipers.

The London-based company started making the antivenin again in late April, but it's difficult to boost production because the manufacturing process takes two years, said Andrew Heath, chief executive officer of Protherics. No other companies produce antivenin for U.S. rattlesnakes.

Since the 1950s, U.S. doctors had used an antivenin made by Wyeth-Lederle Laboratories. However, the company stopped producing the product, a horse-derived serum, last year.

The CroFab serum, which Heath said costs about $10,000 for a typical treatment of several injections, is derived from sheep.

Heath said the shortage may not be that severe.

"From where we are at the moment, I think the difficulties are going to be limited," he said.

However, poison control officials are preparing for the worst and are closely tracking supplies in California, Arizona and Florida.

Officials in Arizona have spread antivenin supplies around the state so hospitals will have it available nearby if needed, said Jude McNally, managing director of the Arizona Poison & Drug Information Center.

In Florida, no snakebite victim has gone without antivenin, but the stocks of the medicine are in short supply, said Dawn Sollee, a pharmacist at the Florida Poison Information Center in Jacksonville.

In California, antivenin shortages are especially serious in the central and southern parts of the state. The intensive tracking of antivenin supplies is unusual, said Ben Tsutaoka, a toxicologist with the San Francisco division of the California Poison Control System.

To be most effective, the treatment must begin within hours after a bite. "We don't know where the bites will occur, and we don't know if they'll happen near the hospitals that have the antivenom," he said.

About 8,000 people a year receive venomous bites in the United States; nine to 15 victims die, according to the FDA.

Tsutaoka said that in Northern California, an estimated half of all snakebites are serious, although the others are mild or don't transmit venom.

In the most serious cases, rattlesnake bites can cause major swelling, which can put pressure on blood vessels and nerves, said Rose Ann Soloway, associate director of the American Association of Poison Control Centers. The venom can also cause bleeding by diminishing the blood's ability to clot properly.

Antivenin reverses or slows the symptoms.

Experts said the best way to avoid a snakebite is to wear proper clothing in risky areas and avoid any contact with poisonous snakes. McNally estimated that 50 percent to 70 percent of snake bites in Arizona are easily preventable.

Although many snake bites are minor, your best bet is to seek medical attention. Doctors don't recommend that you try any home remedies like trying to suck out the venom. Just get to your car or a phone.

What To Do

To read more about snakebites, check out the American Academy of Family Physicians.

For specific information about rattlesnakes lurking in the Golden State, check out this fact sheet.

Go here for a list, complete with pictures of all snakes in North America. You can also watch a movie of a cobra snake being milked of its venom.

Should you be unlucky enough to be bitten, you can go to the American Poison Control Center for help.

SOURCES: Andrew Heath, chief executive officer, Protherics, London; Stuart Heard, Pharm.D., executive director, California Poison Control System, San Francisco; Ben Tsutaoka, Pharm.D., toxicologist, San Francisco division, California Poison Control System; Jude McNally, RPH, managing director, Arizona Poison & Drug Information Center; Dawn Sollee, Pharm.D., pharmacist, Florida Poison Information Center, Jacksonville; Rose Ann Soloway, associate director, the American Association of Poison Control Centers
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