ENVENOMATIONS - Medicine for Mountaineering and Other Wilderness Activities - page 508

eouslyinafewminutes.Childrenundersixyearsofagemaydeveloprespiratoryproblems
such as wheezing and stridor, and a few may need assisted respiration.
Persons who have been stung typically have an elevated blood pressure, which may be
animportantdiagnosticsignsincehypertensionisrareinchildren.Thebloodpressureusu-
ally returns to normal within four to six hours and becomes life threatening only in infants.
Elderly individuals with preexisting health problems and small children stung by Cen-
truroides speciesshouldbetakentoamedicalfacilitysufficientlysophisticated tohavethe
equipment and supplies necessary to monitor these individuals and deal with any complic-
ations that may arise. No other therapy is possible outside of a hospital. In locations such
as the Grand Canyon, where prompt evacuation is not possible, diazepam (Valium®) can
be given to children to control the purposeless movements.
Until a few years ago an antivenom made in goats was available only in Arizona.
However, problems were associated with administration of that antivenom and production
hasceased.InvestigatorsinArizonaaretryingtogetFDAapprovalforanantivenommade
from horses.
Other countries are home to species of lethal scorpions much more deadly than those
of the southwestern United States. Mexico reportedly has had as many as 76,000 scorpion
stingsresultingin1500deathsinasingleyear.Thestingsofsuchscorpionsmustbetreated
with antivenom, which is rarely available outside of a hospital, particularly for someone
who is not fluent in the local language. Furthermore, scorpion venom is poorly antigenic,
and the antivenoms are largely species specific. Twenty-two different antivenoms are now
being produced.
Death from the stings of such scorpions is often the result of sudden, very severe high
blood pressure. Adrenergic blocking agents such as propranolol may be an effective meth-
odfortreatingsuchstingsandcouldbecarriedbyvisitorstothecountrieswheresuchleth-
al species of scorpions exist.
Fire Ant Stings
Both the black fire ant ( Solenopsis richteri ) and the red fire ant ( Solenopsis invicta )
appear to have entered the United States in the early twentieth century through the port
of Mobile, Alabama. These insects were originally expected to occupy most areas where
the average minimum annual temperature was higher than 10°F (−12°C), but identification
of hybrids that are more tolerant of cold indicates these insects can ultimately infest one-
quarter of the U.S. land area. As recently as 1950 fire ants were limited to the western half
of southern Alabama and the adjacent eastern part of southern Mississippi. In 1989 they
werefoundinmostofSouthCarolina,Georgia,Alabama,Florida,Mississippi,andLouisi-
ana; the southeastern two-thirds of Texas; and parts of Missouri and North Carolina. They
are expected eventually to occupy the rest of Texas, most of California, sparing only the