Sir—J M Polo and colleagues (June 22, p 2164) report aphasia in a farmer after he was bitten on the left thumb by a viper. He developed swelling and ecchymosis of the corresponding limb. He reported to hospital within 2 h of being bitten, and his status was an absolute indication for immediate administration of polyvalent antivenom, according to WHO recommendations, to avoid the systemic effect...

OBJECTIVE To compare the efficacy and safety of three polyspecific antivenoms for bites by pit vipers. DESIGN Randomised double blind comparative trial of three antivenoms. SETTING Shell, Pastaza, southeastern Ecuador. PARTICIPANTS 210 patients with incoagulable blood were recruited from 221 consecutive patients admitted with snake bite between January 1997 and December 2001. INTERVENTI...

In Southeast Asia, envenoming resulting from cobra snakebites is an important public health issue in many regions, and antivenom therapy is the standard treatment for the snakebite. Because these cobras share a close evolutionary history, the amino acid sequences of major venom components in different snakes are very similar. Therefore, either monovalent or polyvalent antivenoms may offer paras...

OBJECTIVE To determine the spectrum of severity and early diagnostic predictors of redback spider bites (Latrodectus hasselti), and to examine the effect of intramuscular redback antivenom. DESIGN AND SETTING Prospective cohort study of calls to New South Wales, Queensland and Western Australian poisons information centres and presentations to Royal Prince Alfred Hospital and Royal Darwin Hos...

Objectives Nanobodies, the single domain antigen binding fragments of heavy chain-only antibodies occurring naturally in camelid sera, are the smallest intact antigen binding entities. Their minimal size assists in reaching otherwise largely inaccessible regions of antigens. However, their camelid origin raises a possible concern of immunogenicity when used for human therapy. Humanization is a ...

Sea snake envenomation is a serious occupational hazard in tropical waters. In Malaysia, the beaked sea snake (Hydrophis schistosus, formerly known as Enhydrina schistosa) and the spine-bellied sea snake (Hydrophis curtus, formerly known as Lapemis curtus or Lapemis hardwickii) are two commonly encountered species. Australian CSL sea snake antivenom is the definitive treatment for sea snake env...

It was not until the last decade of the 19th century that an experimental approach (led by Bancroft in Queensland and Martin in Sydney and Melbourne) brought a higher plane of scientific objectivity to usher in the modern era of Australian toxinology. This Australia era, 1895-1905, coincided with and in some respects was the result of the new knowledge emerging from Europe and the Americas of t...

OBJECTIVE Annually, more than 100,000 US and international military and civilian personnel work in Afghanistan within terrain harboring venomous snakes. Current literature insufficiently supports Afghan antivenom treatment and stocking guidelines. We report the clinical course and treatments for snakebite victims presenting to US military hospitals in Afghanistan. METHODS All snakebite victim...

INTRODUCTION Snakebite accidents are an important health problem in rural areas of tropical countries worldwide, including Costa Rica, where most bites are caused by the pit-viper Bothrops asper. The treatment of these potentially fatal accidents is based on the timely administration of specific antivenom. In many regions of the world, insufficient health care systems and lack of antivenom in r...

OBJECTIVE To review the clinical features and management of patients with injuries related to the Chinese cobra (Naja atra). DESIGN Retrospective study. SETTING Two acute hospitals in Hong Kong. MAIN OUTCOME MEASURES The nature of injuries, envenoming features, complications, response to antivenom therapy, and outcome. RESULTS Eighteen patients were recruited during the 5-year study per...