Snakebite Documentary on ABC tonight

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****e David ... 1 vial left :shock:

Hi Mate,

We actually had more in the AVRU-PNG lab at the local Medical School, but it would have taken an extra 30 minutes to get it, so my immediate decision was to go ahead and use the vial of polyvalent antivenom that was on hand in the Emergency Dept, since the over-arching need was to neutralise the cause of my anaphylaxis - the snake venom - as soon as possible.

We actually receive quite a lot of antivenom from hospitals, zoos and venom producers in Australia as donations, and we keep this for those times when the Health Dept has none in stock and there is going to be a delay before more arrives. This not only enables AVRU to supply free emergency stock to Port Moresby General Hospital, but we also supply it to quite a few other hospitals and health centres in PNG as well.

Cheers


David
 
One is where do the Papuan Taipans rank on the world ranking list? That has been questioned in another thread - why it doesn't appear on any of the lists?

Hi Jozz,

The Papuan taipan has what we call and LD50 (the lethal dose that will kill 50% of test animals in a given time) of 0.05 mg/kg which is just behind the Inland taipan (0.01 mg/kg) and common brown snake (0.041 mg/kg), and just ahead of the coastal taipan (0.64 mg/kg) - making it technically the third on the basis of venom toxicity alone.

Of course when it come to which is the most 'dangerous' that is a whole different issue, and one that is infinitely debatable because lots of other criteria can come into it, least of all, determining the definition of 'dangerous'...

First Aid training now teaches to wrap the bandage starting at the end of the limb? Is that correct, or should you start at the bite site? Or doesn't it really matter?

Ideally the correct way would be to start at the extremity and work up the limb - that is the current Australian Resuscitation Council recommendation from memory. The logic is that it is less likely to result in high peripheral venous return pressure - the pressure of blood returning through the veins to the heart.

In my case, this bite was on the thigh in a highly vascular area about 15 cm above the knee, and my immediate concern since we were about 25 km outside town was to get direct pressure over the bite site and stop the veno from spreading as quickly as possible - the price I paid was a very painful lower leg due to high venous blood pressure - but in my situation that was something that at the time I was willing to tolerate if it saved my life.

Is that the first time you have been bitten by one?

This is my first snake bite since 1995 - which was also a taipan bite. In total I have been bitten by venomous snakes 6 times, hospitalised on 5 occasions and have received antivenom 3 times. I have however also experienced three serious anaphylactic reactions to snake venom, and in my case that is possibly a far more serious risk than the effects of the venom per se.

Do you feel it was your fault (carelesness / loss of attention), or was this an unavoidable accident? The one that was playing up in the room looked difficult to handle?

If you work with venomous snakes and get bitten, you only ever have yourself to blame. In this case the snake was 2.4 metres long, and struck me on the thigh from a distance of about 1.5 metres away. My mistake was in under-estimating the strike distance of such a large snake.

Taipans are probably the most dangerous snake in the world to work with. They are large, fast and extremely agile in addition to having extremely toxic venom and the ability to deliver lots of it. Wild snakes are in a completely different class to long-term captive specimens, and nearly all of our work involves working with wild snakes, often in very remote areas of PNG where access to medical treatment is unlikely; hence the risks in my work are considerable.

Had I let this snake escape, I could have avoided the bite, but I made a decision to catch it, and bite was a consequence of that decision.

Cheers


David
 
I was glued to the screen hoping you would be ok David! Glad you have recovered well and hope the leg is ok. Your work is amazing!!!
 
Hi David. Great work thanks for sharing that with us all and allowing us to discuss it with you. I have a question about allergic reactions to venom. If someone had some kind of allergic reaction to a particular snakes venom, is it reasonable to say that they would have a reaction to the venom of another snake of a different species. Also how did you find that your encounter changed your perspective on your research? Thank you!

G'day Ewen,

Many snakes share similar classes and types of toxins, and this means that a person with an allergy that develops from exposure to one particular type of venom, can definitely react badly on exposure to other venoms. Several years ago the late Professor Struan Sutherland conducted some studies of my allergy and found that I was sensitised to a wide range of venoms from snakes from all over the world, including a number of species that at that time I had never been exposed to, such as South American pit vipers.

Venom allergy is an occupational hazard for people working with venomous snakes or snake venoms, and it can be rapidly fatal. The only reason I am still here now is because I had a very comprehensive emergency medical kit in the car containing adrenaline and other drugs that can be used to treat anaphylaxis. I am absolutely certain that had I not been able to self-administer these drugs enroute to hospital, I would be dead now.

Every bite I have had has taught me valuable lessons. One of the things I learned was that these snakes have a far greater striking range than I had ever seen before - I was hit from about 1.5 metres away by a 2.4 metre long snake - that's effectively 60% its body length + the vertical lift - my bite was 15 cm or so above my knee on my right thigh! As a result of the bite we have modified a number of our work practices. Even after more than 35 years of catching, keeping and handling snakes I am still being taught new things!

Cheers


David
 
David, was the bite directly on skin, or did the fangs go throgh your shorts?.

I have a black costal taipan, Even though its been a captive for over a two years now ( its 5 yrs old) I still sweat, get the shakes before,during and after i handle it. i admire you catching nasty wild ones on a daily basis. And especially wearing shorts, id have at least two pairs of jeans on :).
 
David, was the bite directly on skin, or did the fangs go throgh your shorts?.

I have a black costal taipan, Even though its been a captive for over a two years now ( its 5 yrs old) I still sweat, get the shakes before,during and after i handle it. i admire you catching nasty wild ones on a daily basis. And especially wearing shorts, id have at least two pairs of jeans on :).

G'day mate,

The bite was direct to skin, just below the shorts. Even had I been wearing trousers, the bite was a very deliberate, determined strike - the snake hooked down with the left fang and stabbed 3 times very quickly with the right before disengaging - all of that in the blink of an eye. Trousers would not have saved me a trip to hospital.

My advice to taipan keepers is to estimate what you think the strike distance is, and then double that...

Cheers


David
 
Thanks David. Very interesting! Watching that really made me think hard about the fact that handling venomous snakes could one day put me in that situation, and whether I am really prepared for that. Not that I haven't thought about it alot before, but watching you go through it actually made me a bit emotional - you could see the emotions you were going through, and it really hit home for me.

I think I am definately alot more aware of what it would really be like to get tagged, and more prepared for this now (emotionally and mentally). Thankyou for sharing your amazing story, and answering our questions.

Kind regards,
-Jos
 
What a great show David. Im glad you have recovered from the experience well.
Hopefully all the papuan people will have better access to antivenom soon thanks to your work there.
The snake that got you, was it a wild one or a captive?
Baz
 
What a great show David. Im glad you have recovered from the experience well.
Hopefully all the papuan people will have better access to antivenom soon thanks to your work there.
The snake that got you, was it a wild one or a captive?
Baz

Hi Baz,

The snake was a recent captive - by recent I mean about a year or so - and it had never given us any trouble at all until that moment. Basically it came of the bag fighting and tried to do the bolt. I came in from behind it and touched it gently on the back to let it know I was going to hook it and it did a complete 180 degree backflip, landing beside me about 1.5 metres to the right. From there it launched an immediate strike, and actually missed my leg on the forward lunge, going a bit past it, but then as it fell back, it simply hooked its neck sideways, got a grip with the left fang and then drove the right one in about 3 times really quickly before letting go and again trying to bolt ... after that it was bagged uneventfully...

Guess it just woke up on the wrong side of the cage substrate...

Cheers


David
 
Mate that was a great story, would have to bew the best foreign correspondent story i've seen. And a huge kudos to you and the work you do in PNG i think you are a truly lucky man to have such an awesome job and to potentially save so many people despite the risks.

Glad ur ok now, and screw Hoser for laughing at your bite when it nearly killed you. Really shows what kind of a man he is.
 
What is the difference between polyvalent antivenom and other types of antivenom? From what i can gather it sounds like it is a more generic 'one size fits all' treatment.
 
What is the difference between polyvalent antivenom and other types of antivenom? From what i can gather it sounds like it is a more generic 'one size fits all' treatment.

G'day mate,

Polyvalent antivenom is essentially a mixture containing antibodies against all five major Australian venom groups (tiger, brown, black, death adder, taipan) and is for use when the identity of the biting species is unknown. The downside is that it is much more likely to precipitate an adverse reaction than any of the Monovalent antivenoms, simply because of the higher concentration of very diverse antibodies. Officially I think CSL report a 23% reaction rate for Polyvalent AV compared to about 9% for the Monovalent antivenoms.

Unfortunately since about 1996 when CSL stopped selling antivenom direct to PNG, and gave the job to a wholesaler, the proportion of Polyvalent antivenom use has risen here very significantly - from about 49% to 83% - with the sole reason being that the wholesaler makes the greatest profit from Polyvalent antivenom...

Cheers


David
 
The Documentary was excellent mate, So regarding the PNG Taipan and the Coastal, are they very similar in behaviour?
 
The Documentary was excellent mate, So regarding the PNG Taipan and the Coastal, are they very similar in behaviour?

Very similar. In fact from a mitochondrial DNA perspective they are essentially one and the same snake (see Wuster et al, 2005 in Molecular Phylogenetics & Evolution). The reality is that they are both very shy, nervous snakes, and it is their nervousness that makes them especially dangerous, rather than true aggression, because they are not naturally aggressive snakes at all. Both can settle down and become relatively manageable captives, but they retain their nervous disposition and should always be treated with 100% caution.

Cheers


David
 
Ive only ever seen one in the wild a few winters ago here in cairns, sunning itself near a sugar cane field, I walked fairly close but it was too busy trying to get warm to worry about me being there, I just kept walking and it made no attempt to attack me.
 
So has there been any real progress in the management of antivenom or was it all just for show?

Also what are the major impedances for freeze dried antivenom?
 
So has there been any real progress in the management of antivenom or was it all just for show?

The Health Minister has already launched an investigation of companies and individuals concerned, and some specific matters have already been referred to the Police Fraud Squad. A further investigation of links between PNG Health Dept staff and wholesale drug suppliers is also about to commence, and the Health Dept's Medical Supply Branch has been referred to the PNG Government's Parliamentary Public Accounts Committee for an open public inquiry beginning in March.


Also what are the major impedances for freeze dried antivenom?

There are no technical impediments.

We are collecting venom here from which a completely new antivenom product is being made, and subject to the outcomes of pre-clinical and clinical trials, we expect that new product (which will cost under US$50 per vial) could be ready for registration and routine use within the next 3-4 years.

Our major challenges are (1) resolving the corruption issue so that a new non-profit product can enter the marketplace, and (2) continuing to obtain funding for the project over the next four years.

Cheers


David
 
So David do they use the same AntiVenene for both Coastal / PNG Taipans?

Yes they do. The current CSL taipan antivenom and CSL polyvalent antivenom both work very well, especially when given early.

Our issue with them is the cost.

CSL argue that they are the world's best antivenoms, so why would anyone want to change products... My argument is that it is worthless having the world's best product, if the people who absolutely need it the most, cannot obtain access to it, because of that exorbitant pricing.

The new product we are working on is being made by another antivenom manufacturer; one with an excellent record for product safety and efficacy, and a strong social conscience - they want to make affordable antivenoms for developing nations.

Cheers


David
 
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