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Tiger snake (Notechis spp) envenoming: Australian Snakebite Project (ASP-13)
Geoffrey K Isbister1, Margaret A O'Leary, Matthew Elliott
1Discipline of Clinical Pharmacology, University of Newcastle, Newcastle, NSW. Geoffrey.isbister@newcastle.edu.au
The Medical Journal of Australia
|August 7, 2012
Summary
Tiger snake envenoming causes coagulopathy and systemic symptoms. One vial of tiger snake antivenom (TSAV) effectively neutralizes circulating venom, despite initial recommendations for higher doses.
Area of Science:
- Toxicology
- Clinical Medicine
- Pharmacology
Background:
- Tiger snake (Notechis spp.) envenoming presents a significant clinical challenge in Australia.
- Understanding the clinical manifestations and effective treatment is crucial for patient outcomes.
Purpose of the Study:
- To characterize the clinical syndrome of tiger snake envenoming.
- To evaluate the efficacy of tiger snake antivenom (TSAV) in neutralizing circulating venom in vivo.
Main Methods:
- Prospective cohort study of definite tiger snake envenoming cases (October 2004 - June 2011).
- Cases confirmed via venom-specific immunoassay or expert identification.
- Clinical effects, venom concentrations, and antivenom administration were recorded.
Main Results:
- 56 definite envenomings observed, with venom-induced consumption coagulopathy (VICC) in 53 patients.
- Systemic symptoms (n=45), myotoxicity (n=11), and neurotoxicity (n=17) were common.
- No deaths; one vial of TSAV neutralized all detected circulating venom, though 8 patients experienced hypersensitivity reactions.
Conclusions:
- Tiger snake envenoming is characterized by VICC, systemic, neurotoxic, and myotoxic effects.
- A single vial of tiger snake antivenom appears sufficient to bind all circulating venom.
- Further research into antivenom efficacy and reaction management is warranted.
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