VENOMOUS SNAKE BITES: ANTIVENOMS, WHAT TO DO AND NOT DO

SNAKES AND HUMANS

snakebite

It is pretty to safe to say that most people dislike or hate snakes. Even ones who have a fondness for them arguably like them because there is an element of danger associated with them. For a long time snakes have been regarded as symbols of evil and the devil and been linked with qualities and emotions like lust and deceit. It was a snake after all that tempted Eve in the Garden. Even Albert Schweitzer, who went out of his way not to step on insects, had no compunction about shooting a snake.

Tropical biologist Alexander Skutch wrote "the serpent is stark predication, the predatory existence in its boldest, least-mitigated form. It might be characterized as an elongated, distensible stomach, with the minimum of accessories...not even teeth that can tear its food." Many scientist think that a fear of snakes may instinctual and related to the dangers presented by poisonous snakes and large constrictors to our human, or even primate, ancestors. Harvard biologist E. O. Wilson said, "The brain appears to have kept its old capacities, it channeled quickness. We stay alert and alive in the vanished forests of the world."

Snakes usually go out of their way to avoid humans. Few species are aggressive. Most instances of aggressive behavior occur if a snake is cornered, surprised, harassed or attacked. To avoid an encounter with a snake look before stepping over logs and don’t poke around crevices, hollow logs or burrows. It is also a good idea to wear sturdy boots, thick socks and long pants if walking in an area with snakes.Snakes can be helpful to humans by eating pests such as rats. They also be a nuisance, sneaking into hen houses and eating eggs. Some great medical discoveries have come from snake poison. Merck sells a blood thinner based on the venom of the deadly saw-scaled viper. A protein from another Asian viper has shown great promise in inhibited the spread of melanoma cells.

Sometimes snakes are killed for their skins, which are used to make boots, purses wallets, amulets and charms Snake bones and body parts are taken as cures for a variety of ailments. Most snakes in zoos and snake farms have been bred in captivity and are used to being handled. If they appear nervous they might have a cloth hood placed over their heads. Some are quite happy to crawl into their darkened crates.

People who handle snakes a lot often use a special curved rod that looks like a golf club shaft attached to a hook. With these handlers can pick snakes and keep them at a safe distance. Snakes are often caught and handled with these “snake hooks”, which keeps the snake beyond striking distance. When transported they are placed first in a thick sack and then placed into darkened crates.

Websites and Resources on Snakes: Snake World snakesworld.info ; National Geographic snake pictures National Geographic ; Snake Species List snaketracks.com ; Herpetology Database artedi.nrm.se/nrmherps ; Big Snakes reptileknowledge.com ; Snake Taxonomy at Life is Short but Snakes are Long snakesarelong.blogspot.com; Websites and Resources on Animals: Animal Diversity Web animaldiversity.org ; BBC Earth bbcearth.com; A-Z-Animals.com a-z-animals.com; Live Science Animals livescience.com; Animal Info animalinfo.org ; World Wildlife Fund (WWF) worldwildlife.org the world’s largest independent conservation body; National Geographic National Geographic ; Endangered Animals (IUCN Red List of Threatened Species) iucnredlist.org

Venomous Snake Bites

There are 250 to 400 venomous snakes depending on how they are counted. They include true vipers, pit vipers, cobras, and sea snakes . Even snakes like garter snakes that are not regarded as venomous actually are. Garter snakes produce a small amounts of venom, just enough to slow down prey such as frogs so they can immobilize and swallow them. The development of venom was seen as key to snake evolution, allowing them to shed their muscles and become more mobile and quick by negating their reliance on constriction as a means of subduing their prey.

Nearly 3 million people worldwide are poisoned every year after experiencing a venomous bite. According to Live Science: Only a fraction of these bites are fatal, but toxins in snake venom can trigger serious medical emergencies that occur within hours; they can cause organ failure, uncontrollable bleeding, severe tissue destruction and paralysis that may restrict breathing, according to the World Health Organization (WHO). With some types of snakes, like rattlesnakes, redness and pain at the bite site develop within minutes, while with other venomous snakes, such as copperheads, the symptoms may take longer to appear, Kman said.[Source: Mindy Weisberger, Live Science, June 2, 2019]

Bites from venomous snakes don't always deliver a payload of toxins. At least 25 percent of venomous snake bites are so-called dry bites; if 8 to 12 hours elapse with no symptoms, the bite was likely venom-free, according to UW Health, the network of health and medicine facilities at the University of Wisconsin. Nevertheless, it's impossible to know immediately after a bite if venom might have been injected, and victims should not wait for symptoms to appear before seeking treatment, the CDC warns.

Venomous Snake Bite Affects and Symptoms

snake bite tissue necrosis

Bites by venomous snakes can result in a wide range of effects, from simple puncture wounds to life-threatening illness and death. Snake venom is a complex mixture of generally two types of proteins, each distinguishable by its activity. One category of venom is the neurotoxins. These venoms affect the nervous system, causing destruction or paralysis of the nerves that regulate heartbeat and respiration. The other major group is the hemotoxic venoms, with proteins that attack blood cells and also destroy both muscular and vascular tissue. Hemotoxic venoms allow blood to escape into the surrounding tissue, causing severe swelling, pain, and discoloration at the site of the snakebite. All snake venom has both neurotoxins and hemotoxins. [Source: U.S. Army, Center for Health Promotion and Preventive Medicine (Usachppm) Entomological Sciences Program, Aberdeen Proving Ground, Maryland]

Symptoms of poisoning arise in only about half the people bitten by venomous snakes and many of those that do have symptoms recover with no treatment at all. Of those who get poisonous bites, children are more likely to die of suffer an injury than adults because they are not as strong as adults and they are injected with larger amounts of poison in relation to their body size. Since the venom takes approximately a month to replenish itself, a snake while not strike a human being unless it feels it has to.

The severity of snake bite has a lot do with the amount of venom injected. About 25 percent of all snake bites are dry (meaning no venom is injected) and another 25 percent involve the injection of only small amounts of venom. About 25 percent are severe but not life threatening. The remaining 25 percent are potentially lethal and require antivenom.

Snakes Bite Fatalities and Injuries

Snakes kill more people than any other animal — many times more than all the people killed by sharks, crocodiles, elephants, tigers, hippos, pit bulls and rottweilers combined. Doctors Without Borders (MSF) says an estimated 100,000 people worldwide die from snake bites each year, and around 400,000 people who are bitten suffer disfigurement or disabilities that last for the rest of their lives. The Centers for Disease Control and Prevention said nationally there are 7,000 to 8,000 people bitten by venomous snakes annually in the U.S, resulting in about five deaths per year. This means one out of every 50 million people in the U.S. will die from a venomous snakebite. Globally, around 2.4 million people are bitten by venomous snakes each and higher percentages die because many don't have access to antivenoms and good medical care. Bites can be fatal if the recommended steps aren't taken once the incident occurs. [Source: Marlisse Cepeda, Popular Mechanics, May 14, 2016; Live Science, Miles Blumhardt, Fort Collins Coloradoan, July 16, 2022]

Poor people living in rural areas with limited access to health care are most at risk. Most snakebite victims in Asia are barefoot or sandal-wearing farmers in tropical countries like Myanmar, Thailand and India, where there are large populations of rodents and rodent-consuming snakes and large numbers of poor farmers who sleep on the ground and work in rice fields that attract rodents and rodent-eating snakes. Population pressures have increased the number of snake bites while rubber boots and antivenom have reduced the number of fatalities. Most of the MSF's patients come from South Sudan, Yemen, Ethiopia and Central African Republic. [Source: Mindy Weisberger, Live Science, June 2, 2019]

It is often impossible to know exactly which snake species was responsible for a bite; identification is particularly difficult in developing countries as the majority of snake-bites are inflicted at night in rural communities that do not have electricity or artificial lighting. Then the victim, who often lives in an impoverished remote place, has to find suitable medical treatment before the toxic venom leads to permanent disfigurement or death. [Source: BBC, February 22 2011]

Victims of neurotoxins may die from asphyxiation or heart failure. Victims of hemotoxic venoms may die from kidney failure or shock. People bitten by saw-scaled vipers, responsible for more snake bite fatalities than any other snake, have localized swelling and pain in the area, followed by potential hemorrhage. Since the venom affects a person's ability to clot blood, it can lead to internal bleeding and ultimately acute kidney failure, according to the educational society Understanding Animal Research. Hydration and antivenom (there are nine types of antivenom for this snake) should be administered within hours of the bite for a person to survive, Understanding Animal Research said. [Source Jeanna Bryner, Live Science, August 31, 2021]

Snakebite Prevention

Assume that any snake you encounter is venomous. Leave snakes alone. Many people are bitten because they try to kill a snake or get a closer look at it. Miles Blumhardt wrote in the Fort Collins Coloradoan: Snakes are sometimes heard before they are seen. If you hear a snake, freeze in place until you or a companion can locate the animal. Attempting to move away from a snake you can’t see may lead you closer to it. Even if the snake can be seen, not moving will reduce the threat you pose to the snake and help you calmly assess the situation. [Source:Miles Blumhardt, Fort Collins Coloradoan, July 16, 2022]

Once you assess the situation, establish a safe distance. Generally, snakes can strike to a distance of half their body length. A good rule of thumb is to put at least five feet between yourself and the snake. Move by slowly backing the way you came. Move around the rattlesnake at a safe distance. Do not under any circumstances try and catch, kill, provoke or move a rattlesnake. Fully one-third of people who suffer snakebites were bitten as a result of trying to handle or kill the snake.

Wearing thick boots that go up to at least the ankles is a good preventative measure. The feet and ankles are usually in the closest proximity to snakes and account for most bites. Watch where you place feet and hands at all times, especially around logs and rocks where snakes shelter. Snakes sometimes rest in shoes and clothes. It is a good idea to carefully shake your clothes and shoes before you put them on. There are antivenoms for most poisonous snakes but they are not always available. If you are really concerned you may want to bring snake anti-venom for the snakes you might encounter. These sometimes need to refrigerated.

Snakes are mainly active at night. Be especially aware of snakes around dusk. That is when many snakes become active hunting and human visibility drops. Do not recreate with headphones or ear buds as a some snakes give off warning if you are too close by making a sound. If the snake coils up you are too close and should move away slowly. Stepping back just a few feet can be enough to convince the snake that you are not a threat. Most snakes will not strike at people unless they feel threatened or are deliberately provoked.

When camping or staying in a wilderness area avoid high risk snake habitats. Locate bivouacs away from piles of brush, rocks or other debris. Avoid swimming in coastal areas where sea snakes abound. Remediate conditions which attract snakes. Remove woodpiles, rock piles, construction debris, dumps, dense undergrowth and similar shelter for snakes. Store supplies elevated off the ground. Practice good sanitation. Control rodents. Practice “snake smart” behavior. Shake out bedding and clothes before use. Sleep off the ground, if possible. Know that thick leather boots offer the best foot protection. Avoid walking alone. Keep to clear paths. Be alert in areas where snakes may be hiding or sunning. Don’t reach or place parts of body into uninspected places, especially in high grass or among rocks. Keep hands off of rock ledges. Never sit on or step over large rocks or logs without first checking to see what is on the other side. In the unit compound, keep doors, windows and vents closed whenever possible. Block holes in foundations, crawl spaces, ceilings and roofs. Source: U.S. Army, Center for Health Promotion and Preventive Medicine (Usachppm) Entomological Sciences Program, Aberdeen Proving Ground, Maryland]

What to Do When Bitten by a Venomous Snake

In the the case of a snake bite: Avoid panic! If bitten by a pit viper, such as a rattlesnake, copperhead or water moccasin get away from the snake in case it strikes again. Rinse spitting cobra venom out of eyes with clean water as soon as possible. Move victim out of danger and place at rest. Reassure and calm the patient. Remove rings and constrictive items. Lightly immobilize injured part in functional position. Victims of snake bites are recommended to stay warm. Get to a hospital for antivenom quickly. Antivenom must be administered within hours. If you can do it safely, take a photo of the snake for identification.

1) The victim should keep quiet and try not to increase your heart rate. 2) Find a place where the victim can lie flat and rest comfortably. 3) If in a group, send one member to notify local emergency staff and the nearest hospital. Do not leave the victim alone in order to get help. Carry a cellphone with you while you recreate. 4) Allow the bite to bleed freely for about 30 seconds and then cleanse and disinfect the bite area with Betadine (iodine) or soap and water. 5) After administering first aid, take the victim to the nearest hospital or medical facility. If not done previously, get someone to call ahead to the nearest hospital so that it will be prepared for the victim’s arrival. 6) If hospital treatment is more than 30 minutes away and the bite is on a hand, finger, foot or lower arm or leg, a wide elastic bandage can be used as a pressure dressing. [Source: National Safety Council, Reuters; Miles Blumhardt, Fort Collins Coloradoan, July 16, 2022]

7) Wrap the bandage quickly from an area just above the bite past the knee or elbow joint, immobilizing it. Wrap no tighter than for a sprain. The goal is to restrict the movement of venom into the bloodstream without cutting off circulation to the affected limb. Check for pulse above and below bandage and rewrap if too tight. 8) Apply direct pressure to the bite using a 4x4 gauze pad folded in half twice. Soak the pad in iodine and tape it in place. 9) Remove all rings, watches, jewelry and tight-fitting clothing as the bite area, as most of the bitten appendage will swell. 10) Immobilize the bitten extremity as much as possible, using splints if necessary. 11) Try to keep the bite location even with the heart. Raising it above the heart will increase the spread of venom into the body and swelling will increase if kept below heart level. 12) Every 15 minutes keep track of swelling on the skin by marking the skin and noting the time the mark was made.

Dr. Nicholas Kman, professor of emergency medicine at The Ohio State University Wexner Medical Center, told Live Science: "Immediately seek medical treatment, because these symptoms can progress rapidly. We watch for redness, swelling, blistering, warmth and then signs of nausea, vomiting, muscle pain and low blood pressure," Kman told Live Science. "If we start to see those, we administer the antivenom." Before the patient reaches a medical facility, the wound should be kept clean and the affected limb should be elevated to reduce the effects of the venom. If the victim or a bystander has a fitness tracker, they can use it to monitor heart rate, Kman said. [Source: Mindy Weisberger, Live Science, June 2, 2019]

Doctors are told that the following steps should be taken in case of snake bite, until the patient is taken to hospital: 1) It is important to re-assure the patient and keep the bitten part immobilized to prevent absorption of venom and reduce the pain; 2) The patient should be given paracetamol 1000 mg to relieve pain.

If you are in some remote place and don’t have access to antivenoms and Western-style medical treatments it could be worthwhile trying local remedies. Mashaw-ti is a local herbal cure for snake bites in northern Myanmar. Kachin that have used it claim no one ever died from a snakebite after taking it. Joe Slowinski, a famous American herpetologist, refused to take it and died.

What Not To Do When Bitten by a Venomous Snake

In the the case of a snake bite:1) Do not try to suck out venom with your mouth because such action has the potential to introduce harmful bacteria into the wound that could cause sepsis.. A suction device can only remove up to 30 percent of the venom if done within three minutes of the bite. 2) Do not make cuts over the bite mark. This will only increase trauma to the bite location. 3) Do not constrict the flow of blood. Restricting blood flow with a tourniquet such as a belt, shoelace or cord puts the bitten extremity at a high risk for amputation. 4) Do not engage in strenuous physical activity. This will only speed the spread of venom to vital organs. 5) Do not apply ice, hot or cold packs to the bite. These have no proven beneficial effects and may compound tissue damage through burns or frostbite. 6) Do not give Aspirin or aspirin containing analgesics or alcohol. One should not allow the victim to take or use any medication. 7) Do not assume that a bite is not serious or that treatment can be delayed. 8) Do not give the victim anything to eat or drink unless approved by a physician. 9) Do not remove pressure dressings until antivenom is available. 10) Do not waste time or take any additional risks attempting to kill or capture the offending snake. [Source: Miles Blumhardt, Fort Collins Coloradoan, July 16, 2022; National Safety Council, Reuters]

Doctors used to recommend applying a tourniquet or immersing the swollen area in ice water to stem the spreading of venom to the rest of the body. These techniques are no longer recommended in part because the resulted in needlessly lost digits and limbs. The tourniquet cut off blood circulation and the ice water caused frostbite. Cut-and-suck methods are also no longer in vogue.

Mindy Weisberger wrote in Live Science: Despite what movie and TV Westerns would have you believe, victims of snake bite shouldn't try to suck out the venom from the bite site or release it by cutting themselves, Kman said. After a bite, venom floods the body's tissues and is impossible to remove through suction. Cutting is equally useless for venom extraction and can result in serious injury, he added. "I've seen cases of hand bites where someone cut their hand and cut through a tendon," he said. "Venom is going to be absorbed into the body right away, so all you're going to do is cause more trauma. You shouldn't ice the bite, steroids shouldn't be used, there's a lot of things people do that aren't going to help a snakebite, and are probably going to make the patient worse." [Source: Mindy Weisberger, Live Science, June 2, 2019]

And if you're bitten by a snake that's native to North America, you should never apply a tourniquet, said Dr. Dan Brooks, medical director of the Banner Poison and Drug Information Center in Phoenix, Arizona. Most North American snakes deliver a type of venom that causes excessive bleeding and can lead to tissue and muscle necrosis, so any action that restricts circulation is going to aggravate the damage, Brooks told Live Science. "Putting a tourniquet on can actually increase local injury, and people can lose fingers or toes or need skin grafts," Brooks said.

Antivenoms

Antivenoms (Antivenins) are medicines made from snake venom that are used to treat snake bites. They work by triggering the body’s natural defenses to stops the venom’s harmful effects, and are species specific, meaning that victims have to take antivenoms for the species of snake that bite them. Locally produced antivenoms are better than imported ones because the toxins they fight better match the snakes that are found locally and lesser amounts are needed to cure a victim. Side effects of high does include high blood pressure, breathing problems and itching.

Antivenoms are serums that are produced today pretty much they same way they were half a century ago: by repeatedly injecting venom into horses (and sometimes sheep) until they develop a resistance and then collecting and processing their blood. The venom is milked from snakes every couple of weeks. Giving horses and sheep increasingly higher doses of the venom trigger the production of antibodies. The fortified blood or plasma is then harvested and purified to isolate the serums, which is done through a complicated series of steps that must be overseen by a technician.

The amount of antivenom a victim needs varies from case to case and doctors need to have some experience with snake bites to know what to do. Antivenom contains a great deal of horse or sheep proteins and many people develop rashes or have reactions to these proteins and other impurities. Sometimes people die from anaphylactic shock caused by a reaction.

Many species of deadly Old World snakes — those that are found in Asia, Africa and Australia — produce neurotoxins that can swiftly lead to respiratory paralysis. Bites from these snakes are often triaged with a constricting band and then treated with antivenoms that are species-specific, while bites from most North American species can be treated with the antivenoms CroFab or Anavip. The exception to that rule is coral snakes. Like Old World snakes, they deliver a neurotoxin that can inhibit breathing; those bites require special antivenom, Kman said. However, coral snake bites in the U.S. are exceedingly rare, accounting for only about one percent of annual venomous bites, he added.

Because many antivenoms for Old World snakes are specific to the species, it can be critical for victims to accurately describe the snake that delivered the bite. Even in North America, identifying the snake can help health care officials to better care for the victim, "but the most important thing is to get the antivenom as soon as possible," Brooks said.

Antivenom and Snakebite Treatments

In 2022,The Idaho Statesman reported: The St. Luke’s and Saint Alphonsus health systems carry vials of snake antivenom. According to Scott Milner, regional director of pharmacy for Saint Alphonsus, treatment for a snake bite starts at 10 vials of antivenom. “These antivenom therapies are unique as the doses administered are not adjusted to body weight/size/age of the patient, which is very different,” Milner told the Idaho Statesman via email. “The dose is calculated to match the venom as tracked by expansion of signs/symptoms, but the starting dose is 10 vials at a time.” [Source: Shaun Goodwin, Korie Dean, Kimberly Cataudella,Idaho Statesman, October 15, 2022]

The two main antivenoms for a snake bite are Crotalidae Polyvalent Immune Fab Ovine, or CroFab, and Crotalidae immune F(ab’)2 (equine), which is better known as Anavip. Milner told the Statesman that Saint Alphonsus has recently transitioned from CroFab to Anavip. Anavip has full coverage against the American pit vipers that includes rattlesnakes, copperheads and cottonmouths,” Milner said. “Idaho is really only home to the Western rattlesnake and the prairie rattlesnake, so this therapy covers our population.” You can also find hospitals that stock CroFab online by entering your location into an interactive map.

A vial of Anavip costs $1,220, according to Kaiser Health News, a nonprofit journalistic institute focused on health news. For the minimum dosage of 10 vials, snake bite therapy would cost at least $12,220, plus other associated costs with the hospital visit. CroFab is even more expensive, according to KHN, coming in at $3,198 per vial.

Research into snakebite treatments has been historically underfunded, but an initiative launched by the Wellcome Trust global health charity in the United Kingdom is addressing this "hidden health crisis," representatives said in a statement. Beginning in 2019, it launched a seven-year project aimed at developing safer and more affordable antivenoms; working together with the WHO, the initiative aims to halve the global number of deaths and injuries from snakebite by 2030, according to the statement. [Source: Mindy Weisberger, Live Science, June 2, 2019]

Drug companies have few incentives to come up with alternatives to antivenom because the market is small and the risks and cost are high. Much of the research into snake bite remedies is taking place in countries that have snake bite problems. Scientist at the Vittal Mallya Scientific Research Foundation in Bangalore, India, for example, have developed an antivenom that is effective in small doses and is made cheaply by injecting snake venom into hens and processing proteins collected from the hens eggs. Not only is method cheap it produces antivenoms that have fewer side effects than traditional horse-serum based antivenom.

Indian peafowl feather extract mixed with water or ash has been used to treat venomous bites of Russell vipers, Indian cobras, and Malabar pit vipers. The extract is high in iron, protein, and steroids, which inhibit harmful enzymes in the venom that cause tissue damage. This is a traditional snakebite remedy in India for those who live far away from hospitals and don’t have access to modern medicine and antivenom. [Source: Erin Fowler, Animal Diversity Web (ADW) /=]

Parents Hit with $300,000 Bill After Two-Year-Old Bitten by Rattlesnake

In October 2024, People.com reported: San Diego toddler Brigland Pfeffer ended up in the pediatric intensive care unit following a rattlesnake bite on his right hand His parents were hit with a nearly $300,000 bill for his treatment — and a third of the cost was for his life-saving antivenom treatment. Although the Pfeffers' insurance company was able to negotiate down the cost, the family still had to pay thousands for the two-year-old's care. [Source Cara Lynn Shultz, People.com, October 31, 2024]

Brigland Pfeffer was playing with his siblings in their San Diego backyard when he ran up to his mother, Lindsay, to show her an injury on his right hand. “I saw a small rattlesnake coiled up by the firepit,” she told KFF Health News via The Washington Post. By the time the family arrived to Palomar Medical Center Escondido via ambulance, the two-year-old’s hand was swollen and purple. When attempts to deliver antivenom intravenously failed, Brigland was given the antivenom Anavip, administered directly into his blood marrow, as the swelling spread to his armpit. Brigland was then transferred to the pediatric intensive care unit at Rady Children’s Hospital, where he received more antivenom treatment over the next few days. The total bill: $297,461 — with antivenom costs accounting for $213,278.80 of the bill.

Brigland received 20 vials of Anavip — $5,876.64 per vial — at Rady Children's. Ten vials at Palomar were $9,574.60 per vial. However, Stacie Dusetzina, a professor of health policy at Vanderbilt University Medical Center, told the outlet that Medicare and most hospitals pay $2,000 for each unit of the medication. “When you see the word ‘charges,’ that's a made-up number. That isn’t connected at all, usually, to what the actual drug cost,” Dusetzina told the publication. Smithsonian reported, up to 70 percent of the cost is “due to hospital markups used in negotiations with insurance companies.”

Why Is Antivenom So Expensive

Antivenom is expensive as you can see from above. A hospital in the United States pays hundreds or thousands of dollars for each vial of antivenom and patients are often charged double that price in addition to other medical expenses. An average patient received 17 vials. Moreover each vial can take a staff member up to 30 to 40 minutes to prepare into the required reconstituted solution, which is required. Because antivenom is so expensive, doctors often try to use other treatments before resorting to it.

According to the Idaho Statesman:Why is snake antivenom so expensive? Several factors contribute to the high prices of antivenom. First, antivenom is complicated to make. The common antivenom used to treat rattlesnake bites, for example, is made by immunizing donor animals such as horses or sheep with snake venom and then harvesting the antibodies produced by these animals, according to the World Health Organization. [Source: Shaun Goodwin, Korie Dean, Kimberly Cataudella,Idaho Statesman, October 15, 2022]

But the cost of making antivenom only accounts for about one-tenth of one percent of the total cost of the treatment, according to research cited by The Washington Post from the VIPER Institute at the University of Arizona. The rest of the sticker price for antivenom is made up of costs such as licensing fees and legal costs, coming in at about 28 percent of the cost, and hospital markups — which are generally discounted by health insurers for patients with coverage — coming in at about 70 percent of the price, according to the VIPER Institute’s research.

Additionally, since snakebites are relatively uncommon — though the CDC says about 8,000 people are bitten by venomous snakes each year — the antivenom market is relatively small, and there isn’t a huge demand or market for the product.

Snakes Venom and Drugs

Herpetologist and toxinologist Zoltan Takacs studies animal venoms, usually from snakes. Such toxins "are the source of over a dozen medications," Takacs said, "including drugs to treat high blood pressure, heart failure, heart attack, diabetes and chronic pain." They have evolved to be perfect killers, he said, "but the same snake that can kill you, can cure you." [Source:University of Chicago News, May 19, 2010]

According to the University of Chicago News: Cobra receptors have a unique sugar molecule that acts as an umbrella, blocking the toxin from binding to the receptor. Remove that molecule and the cobra becomes toxin-sensitive. Add it to a mouse, and the mouse becomes toxin-resistant. The ability to act on vital targets with that degree of precision makes toxins an ideal model for new drugs. But isolating a specific toxin to fight a specific disease is an extremely tedious, multiyear process, largely due to the small number of toxins that can be isolated from any given venom-until now.

At the University of Chicago, Takacs along with biophysicist Steve Goldstein, have developed the state-of-the-art "Designer-Toxin" technology allowing the creation of "toxin libraries" with a potential to contain up to millions of toxin variants ready to screen. "By screening the variants," he said, "you can determine which one will specifically act on the vital target that determines the outcome of a disease. That knowledge is a powerful tool in converting a toxin into a drug." "Our technology lets you make millions of different keys, try them all at once and isolate the single one that fits the lock. Problems with side effects occur because drugs are acting on more than one target. With our method, your key will open one lock, but not any others."

Takacs predicts the technology will be useful in developing toxin-based drugs for various diseases, from cancer to circulatory disorders. "The particular toxin we're working with now looks promising for autoimmune diseases like multiple sclerosis, arthritis and diabetes," he said.

Medicines from Snake Venoms

Jennifer S. Holland wrote in National Geographic:“The science of transforming venoms into cures took off in the 1960s, when an English clinician named Hugh Alistair Reid suggested that the venom of the Malayan pit viper might be used against deep-vein thrombosis. He’d discovered that one of the snake’s toxins, a protein called ancrod, saps a fibrous protein from the blood, preventing clotting. Arvin, a clot-busting drug derived from pit viper venom, reached clinics in Europe in 1968. Today Arvin has been replaced by other viper venom anticoagulants. [Source: Jennifer S. Holland, National Geographic, February 2013]

“The Brazilian pit viper’s venom led to the development in the 1970s of a class of drugs called ACE inhibitors, now widely used against hypertension. Researchers began by asking why Brazilian banana plantation workers bitten by these snakes collapsed with crashing blood pressure. The researchers then teased out the key pressure-lowering component in the venom. But drug-company managers needed convincing that what comes from snake fangs would save human lives. And you can’t just put venom in a pill and hand it to patients, so the useful component of the venom had to be modified at the molecular level—resized and tinkered with to survive the harsh effects of the human digestive system. Eventually a synthetic version made it to human trials, and in 1975 the first oral drug for hypertension, captopril, was approved for use. The ACE inhibitor class of drugs pioneered by captopril now treats tens of millions worldwide, with multibillion-dollar sales.

“The molecular gifts of toxic animals offer hope in the fight against a host of debilitating diseases. Heart patients owe gratitude to the Eastern green mamba, a deadly African tree snake whose venom impairs its victim’s nerves and blood circulation. Researchers at the Mayo Clinic fused a key peptide from the venom with a peptide from cells in the lining of human blood vessels to make cenderitide, the subject of clinical trials. It is intended not only to lower blood pressure and reduce fibrosis (the growth of excess connective tissue) in a failing heart but also to shield the kidneys from an overload of salt and water. “That’s the beauty of this drug,” says Mayo cardiovascular researcher John Burnett. “It’s designed to cover both things.” The closely related black mamba, a snake whose open mouth resembles a coffin and whose venom can quickly put you in one, holds a toxin with huge potential to be a powerful new painkiller.

Image Sources: Wikimedia Commons

Text Sources: National Geographic, Natural History magazine, Smithsonian magazine, Wikipedia, New York Times, Washington Post, Los Angeles Times, Times of London, The Guardian, Top Secret Animal Attack Files website, The New Yorker, Time, Newsweek, Reuters, AP, AFP, The Economist, BBC, and various books and other publications.

Last updated February 2025