Travel Reference
In-Depth Information
CHAPTER
33
ENVENOMATIONS
James A. Wilkerson, M.D.
Principal Contributors
A wide variety of animals employ venoms aggressively or defensively. Best known are
venomous snakes and lizards and arthropods such as spiders, scorpions, and insects.
However, cartilaginous and teleost fish and jelly fish are venomous. The box jelly fish is
considered by many to be the most venomous creature in the world. Even a few mammals
are venomous. Some species of shrew are capable of delivering venomous bites, and male
platypuses have a venomous spur on their hind legs.
VENOMOUS SNAKEBITES
Venomoussnakebitesareunquestionablyserious,potentiallydeadlyaccidents.Nonetheless,
the danger from a single bite has been greatly exaggerated, particularly in the United States,
where approximately five to ten people (some of whom have refused therapy) die each year
as the result of bites by venomous snakes. Less than 1 percent of venomous snakebites in
theUnitedStatesarelethal.Inotherpartsoftheworld,wheremanysnakeshavemuchmore
toxicvenomandsophisticatedmedicalcareisnotavailable,venomoussnakebitesareamore
serious problem.
Worldwide the treatment of venomous snakebites remains a subject of controversy and
confusion. (Even the material used to treat snakebites is referred to variously in the English
literature as antivenom, antivenin, or antivenene.)
No venom is injected in approximately 25 percent of venomous snakebites (reportedly
80 percent of king cobra bites). In another 25 percent venom has been injected but the en-
venomation is mild. Individuals with such bites recover regardless of how they are treated
(unless they are killed by the therapy or complications such as an infection). In addition,
many nonvenomous snakes are incorrectly identified as venomous. Recovery of individuals
from bites with which little or no venom was injected, or bites by nonvenomous snakes fol-
lowing many types of therapy, some of which—like electrical shock—seem bizarre, has led
to acceptance of some ineffective or unnecessary treatments as beneficial. A sensationalist
press has aided the wide dissemination of misinformation.
Families of Venomous Snakes
Theworld'svenomoussnakesaredividedintothreefamilies.Withinthefamily
Elapidae
are the North American coral snakes (eastern, western, and Sonoran); the Indian krait found
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