The Push for Exotic Antivenoms in the United States
In the United States, a variety of institutions, including zoos, laboratories, and private facilities, house venomous snakes from around the world for various purposes. While stringent safety measures are in place to prevent bites, the potential for human error is omnipresent. Native antivenom, such as Anavip and Crofab, is typically stocked in hospitals, yet the same cannot be said for non-native antivenom. For instance, a king cobra bite necessitates antivenom from the Thai Red Cross in Thailand.
Historically, the responsibility of stocking antivenom for exotic snake bites has fallen on the shoulders of local zoos. When a keeper is bitten, the zoo would generously donate antivenom to the patient. However, this approach not only strains the zoos, requiring time to replace antivenom and putting keepers at risk, but it also poses a danger to the patient due to the time-consuming logistics of organizing and executing antivenom transportation. In cases of envenomation, every minute is crucial.
In a positive shift, many responsible private facilities have taken it upon themselves to stock species-specific antivenom. Nevertheless, this undertaking is no small feat, involving navigating bureaucratic obstacles. Non-native antivenom is categorized as an experimental drug, lacking FDA approval. To stock these experimental drugs, a BB-IND# from the FDA is mandatory, involving complex paperwork and a physician's signature to affirm the antivenom's use. Beyond FDA approval, the non-native antivenom is not available for purchase in the U.S., requiring involvement from the USDA to import the drugs. Obtaining a separate permit from the USDA involves additional paperwork, and the process can be further prolonged by the potential months it takes to ship antivenom.
Most physicians in the U.S. rarely treat native envenomations, let alone exotic envenomations with exotic antivenom. In contrast, the physicians at the Asclepius Snakebite Foundation possess a unique expertise, not only in treating native snakebites but also in managing envenomations from species all over the world.
A significant development has been the founding of the Antivenom Support Group (ASG). Collaborating with the FDA and USDA, the ASG has produced comprehensive guides outlining step-by-step procedures for obtaining the necessary permits and contacting manufacturers overseas. This initiative has spurred a notable increase in private facilities independently stocking their own antivenom. The Asclepius Snakebite Foundation has played a crucial role in this process, with physicians offering valuable assistance. This includes Emergency Action Plan recommendations, or antivenom manufacturer and quantity recommendations customized to each situation, as well as facilitating the acquisition of life-saving medications, and providing essential consultation services during emergency situations across the country.
Through a large network of collaborators including ASF, ASG, FDA, USDA, zoos, private keepers, and others, we strive to improve access to quality antivenoms not only in areas such as West Africa, but also here in the United States as well.
If you found this article helpful, please consider donating to ASF today. Every donation is tax deductible and directly impacts the outcome for snakebite victims worldwide.
