Snakebite Treatment: Antivenom as a Universal Treatment or a Universal Antivenom
1Clinical Toxicology Research Group, University of Newcastle, Australia
The greatest burden of snakebite is in resource poor countries, which lack both antivenoms and health infrastructure to allow rapid diagnosis and treatment. Snake envenoming has again been recognised by the WHO as a neglected tropical disease. Unfortunately, the way forward has been slowed by varied agreement on antivenom quality, effectiveness and availability, and our understanding of the different clinical syndromes. This talk will explore the idea perhaps antivenom isn’t the universal treatment for snakebite, but a universal antivenom for all snakebites is a possibility. It is commonly thought that antivenom is the ‘magic bullet’, that cures all in snakebite. This belief ignores that fact that many pathophysiological processes in snakebite are rapidly irreversible. However, there is clear evidence that antivenom is effective for some clinical effects, and can prevent severe envenoming if given early enough. This means that early diagnosis of snake envenoming is essential to allow early administration of antivenom, when it will be most effective. Another problem is that antivenoms are biological therapies from last century – while vaccines and cancer immunotherapies have embraced human recombinant technology, antivenom manufacturer has changed since the first vaccines. This means that we continue to need a different antivenom for each snake, and reactions rates to antivenom are unacceptably high. Is it possible to develop a safer universal antivenom?