Few drug companies bother to make antivenins, so the prices are high.
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Antivenins exist, but they are expensive and used only rarely in developing countries.
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Because they contain horse or sheep proteins, antivenins also can trigger life-threatening anaphylactic shock or hemorrhaging.
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Global health Snakes kill or cripple 500,000 people a year, but antivenins are costly and rare in poor countries.
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Hospitals must keep many kinds of antivenins on hand, and victims must be able to produce or describe the snake that bit them.
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According to the U.S. Navy (1965, 1991), polyvalent antivenins produced by SAMIR and the Pasteur Institute are said to be effective, while Mallow et al. (2003) reported currently available antivenins are of limited effectiveness. Viljoen et al. (1982) isolated a protein, a neurotoxic phospholipase A2, from the venom, which they called "caudoxin".
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Queen Saovabha Memorial Institute produces BCG and rabies vaccines and snake antivenins for national distribution. The institute provides rabies prevention and immunisation services. Its snake farm is open to visitors and tourists, providing education in addition to its research activities.
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Bites result in mild symptoms that include pain, moderate swelling, local lymphadentitis and mild fever. Blistering has not been reported while necrosis is rare and usually secondary. The symptoms disappear after two to three days and normally without any complications. No existing antivenins are known to counteract this venom.
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Thiomersal (INN), or thimerosal (USAN, JAN), is an organomercury compound. This compound is a well-established antiseptic and antifungal agent. The pharmaceutical corporation Eli Lilly and Company gave thiomersal the trade name Merthiolate. It has been used as a preservative in vaccines, immunoglobulin preparations, skin test antigens, antivenins, ophthalmic and nasal products, and tattoo inks.
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The practice eventually spread to nearby regions, ultimately reaching North Africa and Southeast Asia. "Snakecharmers," a chromolithograph by Alfred Brehm The early 20th century proved something of a golden age for snake charmers. Governments promoted the practice to draw tourism, and snake charmers were often sent overseas to perform at cultural festivals and for private patrons. In addition, the charmers provided a valuable source of snake venom for creating antivenins.
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Bothriechis venom is primarily a haemotoxin which causes severe pain, swelling, bleb formation, bruising, and quite often necrosis. If untreated it can lead to loss of a limb, or even death. Each year several farmers and plantation workers are bitten by eyelash vipers, sometimes resulting in fatalities. Wyeth in the United States and Instituto Clodomiro Picado in Costa Rica both manufacture different polyvalent antivenins which can be used to treat eyelash viper envenomations.
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Clodomiro Picado Twight (April 17, 1887 - May 16, 1944), also known as "Clorito Picado", was a Nicaraguan scientist who was internationally recognized for his pioneering research on snake venom and the development of various antivenins. His work on molds was a precursor to the formal discovery of penicillin and resulted in compounds which he used to treat patients at least one year before the re-discovery of penicillin by Alexander Fleming. He wrote over 115 works, mainly books and monographs.
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In some regions, farmers keep mussuranas as pets in order to keep their living environment clear of pit vipers, which claim annually a large number of deaths of domestic animals, like cattle. In the 1930s a Brazilian plan to breed and release large numbers of mussuranas for the control of pit vipers was tried but did not work. The Butantan Institute in São Paulo, which specializes in the production of antivenins, erected a statue of Clelia clelia as its symbol and a tribute to its usefulness in combating venomous snake bites. Mussuranas' immunity to bothropic venom was studied by the Brazilian scientist Vital Brazil in the 1920s.
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The project proved unsuccessful, however, Slotta was recognized with an appointment at the Instituto Butantan, a Brazilian biomedical research center of the São Paulo State Secretary of Health, located near the campus of the University of São Paulo. In 1935 he was appointed director of the Chemical Institute, primarily engaged in the production of antivenins to treat local farmers. In time, the Institute developed basic and applied biomedical research in many areas, including molecular biology, immunology and epidemiology. The center has a graduate training program in collaboration with other institutions, in the areas of biotechnology and infectology, with research laboratories, production units and specialized library.
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In a review of the symptoms in all 18 bite cases for this species admitted to the hospital in São Paulo between 1975 and 1992, Jorge and Ribeiro (2000) found all suffered pain, 83% had swelling, 50% had bruising, 17% had necrosis, 12% developed coagulopathy and 5% had abscesses, can also cause high blood pressure and collapse. In a case in Germany, a 36-year-old snake keeper was bitten on the finger and developed hemorrhagic "necrosis" of the afflicted digit and swelling that extended onto the hand. Five hours after being bitten, his blood had a normal platelet count, but was incoagulable with a reduced fibrinogen concentration, elevated fibrin degradation products and D-dimer. Three different antivenins, Soro Antibotropico-Crotalico, Soro Antibotropico- Laquetico and Soro Botropico, can be used to treat bites from this species.
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