Red-back spider envenomation in the red centre of Australia

To examine the incidence, symptoms and treatment of red-back spider envenomation at a rural hospital.

A retrospective review of all patients admitted to the intensive care unit of Alice Springs Hospital with red-back spider envenomation from 1 January 1991 until 31 December 1992.

Thirty-two patients were identified, of whom 12 were Australian Aboriginals (35%). Mean time from bite to presentation was 21 hours. Twenty-six patients required antivenom. All patients responded well to therapy and adverse reactions to the antivenom were observed. Two antivenom recipients had had previous bites requiring treatment. Aboriginals received antivenom later than non-Aboriginals (27.0 h v. 16.5 h) and this delay was associated with more sweating and fever in Aboriginals.

Red-back spider envenomation is common in Central Australia. Aboriginals and non-Aboriginals are equally at risk but later presentation is more common in Aboriginals who thereby suffer greater systemic symptoms. Antivenom use is safe and effective.