Join 3,433 readers in helping fund MetaFilter (Hide)


Free Market Makes Asp of Itself?
October 1, 2012 11:46 PM   Subscribe

If you're thinking about being bitten by a coral snake in the United States, you may want to do so before the end of the month. October 31, 2012 is the extended-extended-extended-expiration date for batch 4030026 of the only FDA-approved antivenin for coral snake bites. (Antivenin shortages are not uncommon, surprisingly enough.)

FDA-approved coral snake antivenin has not been available new since 2003, as Wyeth Pharmaceuticals ceased its manufacture, citing a lack of profit. Antivenin from non-FDA-approved sources exists, but the $3-5M estimated cost of FDA approval (borne by the manufacturer) and the few doses used per year mean it's a non-starter for the manufacturer of Coralmyn, for example.

Coral snakes are shy and would rather flee than bite the roughly 100 people per year in the US they do. But about three quarters of those bites introduce venom, and that's Serious Business; there is little localized pain, but death by respiratory failure can follow anywhere from 2 hours to a couple of days later. Untreated bites have a mortality rate of roughly 10%.
posted by maxwelton (69 comments total) 16 users marked this as a favorite

 
(I should note I saw a nice picture of a coral snake a couple of days ago, wanted to learn more about the creatures, and ended up scratching my head over this issue. Whatever the opposite of a subject-matter-expert is on coral snakes--or antivenin, for that matter--is, that is me.)
posted by maxwelton at 11:51 PM on October 1, 2012 [1 favorite]


why doesnt the gov just make it itself? isnt government there to prevent market failure?
posted by facetious at 11:52 PM on October 1, 2012 [1 favorite]


There's a coral snake antivenom produced in Mexico that's more effective than the Wyeth product, and costs about a tenth as much, but the FDA isn't interested in effectiveness or cost, only profitability. Get your drugs in Mexico -- a more civilized country than the US in many ways.
posted by Fnarf at 11:52 PM on October 1, 2012 [27 favorites]


So, the obvious questions arise :

1. What does one do, post-Halloween-2012, if they're bit by a coral snake?

2. How long will the current supply last?

3. How readily available will the non-FDA-approved sources be in the (apparently sparse) areas where coral snakes are relatively common?

4. (probably a dumb question) Is there a reason the FDA doesn't just approve the currently non-approved versions mentioned in the OP?
posted by revmitcz at 11:54 PM on October 1, 2012


Is there a reason the FDA doesn't just approve the currently non-approved versions mentioned in the OP?

Big snakebite won't allow it, sheeple!
posted by cmoj at 12:01 AM on October 2, 2012 [21 favorites]


why doesnt the gov just make it itself? isnt government there to prevent market failure?

Interestingly, the US government (via the NIH) funds basic research into using venom-derived products as chemotherapeutic agents, to fight cancer.
posted by Blazecock Pileon at 12:03 AM on October 2, 2012


why doesnt the gov just make it itself? isnt government there to prevent market failure?

"Whoa boy that's socialism that you're talking about there and we don't take kindly to those sorts of things around here."

In all seriousness though the obvious approval vector is the insurance companies themselves. If they got together and backstopped the FDA approval they could get the entire cost (assuming 100 bites a year, 10% of which need hospitalization at an average of $100,000 a stay) of approval back within 18-36 months.

But that would require an inordinant amount of co-operation, foresight and out-of-the-box thinking.
posted by Talez at 12:05 AM on October 2, 2012 [3 favorites]


So what will probably have to happen is that veterinarians in areas where the bites are known will have to stock the Mexican version. Then when someone is bitten, the veterinarian will coincidentally pop by for an unrelated house call to the victims cat, and happen to leave a syringe filled with it lying around purely by accident, after first having a completely innocent conversation about injection sites and other such unimportant gossip with the victim's spouse / child / parent or neighbor.
posted by George_Spiggott at 12:08 AM on October 2, 2012 [17 favorites]


Let me see now,
is it "red next to black, you're okay Jack, red next to yellow you're a dead fellow"?

If I ever see one of these things, I'll probably get it backwards and say
"This must be a King or Milk snake. No problems. I don't even think they have Coral snakes in the US (or do they)? ....Ouch!"
posted by eye of newt at 12:12 AM on October 2, 2012


Anyway, getting involved in risky business ventures — particularly where expensive and complicated technology like immunoglobin biosynthesis is involved — is fraught with political danger, cf. Obama's loan to Solyndra. And who needs some anti-vaxing Tea Party know-nothing like Bobby Jindal or Sarah Palin getting in front of a TV camera and telling the public that the volcano/fruit fly/etc. scientific research their taxes are paying for is a waste of money, especially when roughly half the country still thinks evolution is "just a theory" and humans were created in the last 10,000 years? Along the risk-reward continuum, it's probably easier to risk a very rare snake bite killing a few people than to commit a specific dollar amount to something your political opponent can twist into wasteful pork and use against you in the court of public opinion.
posted by Blazecock Pileon at 12:20 AM on October 2, 2012 [3 favorites]


According to the American College of Medical Toxicology (advice for institutions housing venonous animals) :-
2. Antivenom Acquisition: When antivenom is available, it should be obtained prior to the institution's acquisition of the venomous animal. When an FDA approved species-specific antivenom is available, the institution should procure an amount adequate to treat a moderately to severely envenomated victim. When FDA approved antivenom is unavailable, an antivenom that is approved for use in another country is preferred over antivenom with no governmental regulatory approval. Decisions regarding which antivenom to obtain and in what amounts should be made by the physician or clinical toxicologist identified below. When only non-FDA approved species-specific antivenom(s) are available, it is the responsibility of the institution to obtain an importation permit and FDA investigational new drug (IND) application for appropriate antivenom. Replacement antivenom should be obtained prior to expiration of old stock.

3. Antivenom Storage: Antivenom may be stored at the institution where the venomous animal is housed or at the intended medical receiving facility. If the antivenom is to be stored at the institution, storage conditions should meet manufacturers' recommendations and standards of hospital pharmacy storage (i.e., refrigeration with back-up power supply, temperature monitoring, and expiration date surveillance).
So presumably Mexican coral snake anti-venom can be imported with a permit, and stored in a nearby hospital, if you're a zoo housing coral snakes. If it's good enough for a zoo, presumably ordinary hospitals in coral snake country can follow the same procedure?

Though given the entirely fucked-up-iness of the US health system compared to basically everywhere else, I wouldn't be surprised if in fact, they could not.
posted by ArkhanJG at 1:03 AM on October 2, 2012 [1 favorite]


If you're thinking about being bitten by a coral snake in the United States

I WAS THINKING ABOUT IT

you may want to do so before the end of the month.

THANK YOU FOR THE INFO I WILL RESCHEDULE
posted by krinklyfig at 1:04 AM on October 2, 2012 [102 favorites]


That really screws up my Halloween pary.
posted by lumpenprole at 1:21 AM on October 2, 2012 [7 favorites]


This is a good opportunity to link to one of my favorite recent evolutionary biology stories: Batesian mimicry in scarlet king snakes and coral snakes.

tldr: scarlet king snakes appear primarily in places where coral snakes appear. In those places, predators do not attack either snake. In other places, where predators have not learned to avoid them, they will attack. This supports Bates' 19th century theory that mimicry of poisonous species by non-poisonous species is an evolved protective adaptation.

As an ecologist working in places where there are coral snakes, I hope they get this figured out soon.
posted by hydropsyche at 3:42 AM on October 2, 2012 [3 favorites]




If you're thinking about being bitten by a coral snake in the United States

I WAS THINKING ABOUT IT

you may want to do so before the end of the month.

THANK YOU FOR THE INFO I WILL RESCHEDULE


Me: Siri, please move forward my aqua-juggling lesson with Slithery McToxic and his cousins to this tuesday morning.

Siri: Sir, that clashes with your scheduled hornet nest poking, sir

Me: Contact the hive. Tell them our chat must wait till November 3rd.
posted by lalochezia at 3:51 AM on October 2, 2012 [6 favorites]


So is it crazy to try to immunize yourself against snake venom if you think you'll come in contact with them?
posted by BrotherCaine at 4:05 AM on October 2, 2012


I was laboring under the delusion that coral snakes were only native to the Florida Keys and the Everglades south of Miami, so I was very surprised to learn that 100 people managed to get bitten each year. I would have guessed that you would be very hard pressed to find one, much less have 100 people find one each.
posted by halfbuckaroo at 4:23 AM on October 2, 2012


Nope. The Eastern Coral Snake's range is from North Carolina down through Louisiana. Texas and Arizona both have their own species, too.
posted by Slap*Happy at 4:29 AM on October 2, 2012


My understanding is that, if you want to get bitten by a coral snake, you need to stick your fingers in its mouth and wiggle them around and just generally work really hard to piss them off before they finally get around to biting. Krinklyfig, that seems kind of forward of you.
posted by ChuraChura at 4:50 AM on October 2, 2012


Having seen a coral snake trapped on a trail, irritated and striking at every hiker and their dog that walked past and ignored my warnings about an aggressive toxic snake, I am actually surprised that I haven't met 25 of last year's 100 people.
posted by Seamus at 5:01 AM on October 2, 2012 [5 favorites]


Wow. We're actually losing technology. This does not bode well for us as a society.
posted by fiercecupcake at 5:03 AM on October 2, 2012 [6 favorites]


BrotherCaine, I thought for sure that link was going to be about iocane powder.
posted by echo target at 5:20 AM on October 2, 2012 [2 favorites]


I'm slightly skeptical of the figure given above. Coral snakes are extremely shy and they're one of the more famous and easily-identifiable venomous snakes. How are 100 people/year getting bitten by them? Also I was taught in my herpetology class that their envenomation rate is more like 25% rather than 75%, due to their fixed fangs which don't inject as quickly as those of vipers (which do have an envenomation rate of around 75%). Of course, my professor could've been wrong.

I can't find a source for the statistics on the page linked in the OP. I've tried to find a better source of statistics but I quickly ended up looking at pictures of children with gangrenous necrosis due to untreated snakebites, which was not what I wanted to look at over breakfast. (I'm awake now though, thanks WHO.) You'd think the CDC would have a table somewhere that you could look at, but I can't find it, alas.
posted by Scientist at 5:25 AM on October 2, 2012 [1 favorite]


Next time you are visiting Disney World and need a break from the mouse, check out this place. Watching the guy milk venomous snakes with his bare hands is freaking wild. It's 2012 and the apparently the best technology we have for acquiring snake venom is one dude crazy enough to grab a cobra by the neck.
posted by COD at 5:55 AM on October 2, 2012 [1 favorite]


Given the way I have seen visitors behave around nurse sharks in the Florida Keys (cause c'mon, how dangerous can a nurse shark be?), I am entirely surprised that the number is only 100 bites from coral snakes.

"Oh, you have to be really aggressive to make them bite you!" is just the kind of thing I can imagine some tourist saying as he tries to pick up a coral snake for a photo op.
posted by bilabial at 6:03 AM on October 2, 2012 [3 favorites]


Considering the population of the U.S., finding 100 people/year that manage to do anything shouldn't be terribly difficult.
posted by ersatz at 6:07 AM on October 2, 2012 [3 favorites]


La la la la la...oh how sad for other people......

Nope. The Eastern Coral Snake's range is from North Carolina

Fuuuuuuuuck. We have snakes both here at the house and on the nearby bike trail. Neither Dave nor I have ever gotten bit but the dog got bit by a Copperhead a couple of years ago, and thank god for the anti-venom stocked by our vet. I can't imagine either one of us coming into contact with a Coral snake, on the other hand we do try to keep the yard Copperhead-- free because we fear for the pets.

Interestingly, the US government (via the NIH) funds basic research into using venom-derived products as chemotherapeutic agents, to fight cancer.

This was interesting to me because I recently watched Elephant in the Living Room which is a really poorly made documentary about exotic pet trafficking in the US. At one point Tim Harrison, who works for the state of Ohio in some sort of official animal control capacity, goes to an exotic pet show and buys a Very Dangerous Snake (sorry, can't remember what kind) and then donates it to a snake venom lab. Because this was such a half-assed documentary the viewer never finds out what funds Tim used, and what lab the snake is given to, and what the lab does. But now I know that it might be cancer research.
posted by Secret Life of Gravy at 6:13 AM on October 2, 2012 [1 favorite]


Nurses fight each other to be the one to mix the antivenin before it's administered.

Water Moccasin antivenin is also quite expensive per vial.

Don't ask me how I know these things.
posted by RolandOfEld at 6:36 AM on October 2, 2012


I am the Purchasing Manager at a veterinary pharmacy, my manufacturer's backorder list is several dozen items long, and includes at least two or three items that have been officially or effectively discontinued, in some cases because the market for the product is now only $10 million annually, whereas before it was $12 million. Due to mergers and acquisitions over the past 5 to 10 years, the number of drug manufacturers in the US has fallen dramatically, and before where you might have 3 or 5 facilities manufacturing a certain drug you now have one. If there is a problem with that plant, all supplies of the drug are now gone. It is becoming increasingly frustrating, and is beginning to affect patient care.
posted by Rock Steady at 6:41 AM on October 2, 2012 [12 favorites]


A related story is the woman who was charged $80,000 for scorpion anti-venom.
posted by dances_with_sneetches at 6:43 AM on October 2, 2012 [3 favorites]


My understanding is that, if you want to get bitten by a coral snake, you need to . . . work really hard to piss them off . . .

"The doctor said, 'You gonna die, boy!'"
 
posted by Herodios at 7:27 AM on October 2, 2012 [2 favorites]


This post's has been featured over at the New Statesmen (Meta)
posted by fearfulsymmetry at 8:33 AM on October 2, 2012


eye of newt, the version I heard when I was a kid was "red and yellow, kill a fellow, red and black, venom lack." I like your version better.

Why I would have heard that jingle when I grew up in Pennsylvania, far from any coral snakes, is beyond me. However, as the climate gets warmer, who knows but the little suckers might eventually make their way up to New England!
posted by Currer Belfry at 8:41 AM on October 2, 2012


revmitcz: 4. (probably a dumb question) Is there a reason the FDA doesn't just approve the currently non-approved versions mentioned in the OP?

I'm no expert on snake anti-venom and the FDA, but I'd guess it's due to liability. They have to run it through the necessary tests, which take time. Here's an article from the FDA on how drugs get approved for public use.

Related: The FDA has approved antivenom produced in Mexico, but it was a scorpion-related antivenom. More on how that particular antivenom was made, including the use of horses to produce said antivenom. Fascinating stuff.
posted by filthy light thief at 8:41 AM on October 2, 2012


Homer Simpson: "Let's seeee. Hmm. Red meets black, get off his back. Red meets yellow, hey there little fellow! .... DOH"
posted by crapmatic at 8:45 AM on October 2, 2012


Let me see now,
is it "red next to black, you're okay Jack, red next to yellow you're a dead fellow"?


My version was "yellow next to red, you'll be dead, black next to red, you won't be dead", much easier to remember I mean what can possibly go wrong.
posted by EndsOfInvention at 8:47 AM on October 2, 2012 [7 favorites]


I would assume that the company has stopped producing the antivenin and the FDA is just extending the due date based on stability studies of the last batch. As the batch ages, it will eventually fall out of range for some characteristic (pH, potency, &c.) and they will no longer be able to extend the expiration date.
posted by kamikazegopher at 8:48 AM on October 2, 2012


Leaves of three, let me be; leaves of four, eat some more. Red on yellow, something something, hello?
posted by subbes at 8:48 AM on October 2, 2012


More on how that particular antivenom was made, including the use of horses to produce said antivenom. Fascinating stuff.

Google Premarin.

Wow. We're actually losing technology. This does not bode well for us as a society.

On the flip side we've all but lost our ability to manufacture Tritium for nuclear weapons.
posted by Talez at 8:56 AM on October 2, 2012


What does one do, post-Halloween-2012, if they're bit by a coral snake?

Die, it would seem.
posted by asnider at 9:03 AM on October 2, 2012 [2 favorites]


From the resident herpetology nerd in my old Boy Scout troop, who would cackle it in the worst cajun accent imitation imaginable -

Red touch black, poison lack.
Red touch yellow, kill a fellow!


Good enough to get me through the examination for the First Aid merit badge and the board of review for my next rank.
posted by Slap*Happy at 9:09 AM on October 2, 2012


However, as the climate gets warmer, who knows but the little suckers might eventually make their way up to New England!

Maybe we can train the incoming armadillo onslaught to eat the coral snakes and keep their population down.
posted by Copronymus at 9:20 AM on October 2, 2012


RolandOfEld: Nurses fight each other to be the one to mix the antivenin before it's administered.

Huh? Why?

Oh, and the PROPER rhyme goes like this:
Red and yellow, kill a fellow. Red and black, friend to Jack.
That's the way I learned it, anyway, and I still remember it. I looked up 'coral snake' early in the thread, and the instant I saw one, that old rhyme surfaced. Rhymes really, really work, as mnemonic devices -- it's been at least thirty years since I learned it, and the knowledge is still instantly accessible, without having to think about it at all.
posted by Malor at 9:54 AM on October 2, 2012


In my zip code the resident snake guy Clint Pustejovsky (who is an entertaining public speaker go see him if you ever get a chance) says the Coral is by far the least dangerous of the four poisonous snakes that live near me. Coral snake anti-venom is a drug. If there aren't massive profits to be had the drug companies are not going to prioritize it.
posted by bukvich at 10:13 AM on October 2, 2012


I know it's Socialism blah, blah, blah, but why wouldn't the US and Mexico pool their resources to manufacture an FDA-approved antivenin to the benefit of both countries?

I don't fear that we're losing technology, but we might be giving up a big hunk of common sense.
posted by sneebler at 10:15 AM on October 2, 2012 [1 favorite]


At least coral snakes have the decency to just want to be left alone. Copperheads wake up every day with the intent of finding someone innocent and fucking their shit up. Coral snakes avoid you, rattlesnakes warn you, but copperheads? They have a vendetta.
posted by BitterOldPunk at 10:50 AM on October 2, 2012 [3 favorites]


Oh, and the PROPER rhyme goes like this:
Red and yellow, kill a fellow. Red and black, friend to Jack.


The way I learned it was:

Liquor before beer, all is clear.
Beer before liquor, also awesome.
posted by FatherDagon at 11:11 AM on October 2, 2012 [7 favorites]


Let me see now,
is it "red next to black, you're okay Jack, red next to yellow you're a dead fellow"?


As a kid I was an insufferable know-it-all. One day I saw my brother swat away a cat and pick something up he ran over to me carrying a red, black, and yellow-banded snake. I said the rhyme in my head, and since red was touching yellow I told him to put the snake down because it was a coral snake. He ignored me, wrapping it around his neck and showing it off to everyone in the neighborhood. I knew I was right and ran and grabbed my parents. They came outside but were skeptical, since we lived in western Washington state, not exactly coral snake territory. They confiscated the snake, put it in a box and took it to a pet store run by some family friends.

The clerk took a look at the snake, got out a big book and got on the phone with someone. He flipped through the book and described the snake for 20 minutes, and eventually determined the bands were white instead of yellow, and that the snake was harmless. I was dubious, and he offered to take the snake off our hands for store credit my dad agreed and that was that.

About a month later we got a call from the family friend. The store supplied reptile food for the local zoo, and when the reptile keeper came to pick up an order she noticed the snake and asked why they were selling a coral snake labeled as something harmless. The clerk explained to her that they were white bands, then realized how silly he was being and handed the snake over. The keeper said sometimes people keep venomous snakes as pets and they escape or get released, which would explain the coral snake showing up in Washington. I was right all along!

The store let people handle the reptiles, so for a month kids had been coming in and playing with a coral snake.
posted by edeezy at 11:19 AM on October 2, 2012 [14 favorites]


I am a pharmacist and work in a large academic medical center. Over the years I've been involved in the treatment of several serious snake bites.

Here's how this works:

There are two types of poisonous snakes in North America: Crotalids (rattlesnakes, copperheads, water moccasins/cottonmouths) and Elapids (coral snakes). CroFab (Nycomed) is the antivenin for all crotalids and Coral Snake Antivenin (Wyeth) is,obviously, for coral snakes.

In the US 75% of all envenomations are from rattlesnakes and probably less than 1% are from coral snakes. There are plenty of good reasons to call out the greed and avarice of US Pharma but this isn't one of them. If you believe the statistics that maxwelton pointed to (and they seen be be in line with what I have seen before) then were talking about an antivenin that will be used only 10 or so times a year.

However, it IS possible to import non-FDA approved antivenins. Our hospital carries CroFab and has a supply of South African Polyvalent antivenin for the local zoo. There are also a number of regional antivenin banks that carry exotic snake antivenins. The Miami-Dade Fire Rescue Antivenin Bank is one example. I presume that the antivenin banks will begin importing the Mexican-made antivenin in the future.

So what happens when you get bit by a venomous snake. Well, it depends:

One time a patient presented to our ER with a water moccasin bite. Well, that's what he though it was but he wasn't sure. To everyone's surprise he brought the snake along in a bag! We had to get someone from the zoo to open the bag and ID the snake. It turned out to be in fact a water moccasin but his bite was not severe enough to even require antivenin.

Another time someone was bit by an African Rhino Viper that he kept in his basement. He was apparently a reptile expert and was using every precaution when he was feeding the snake but got bit anyway. By the time he got to our hospital he was rapidly declining. The toxicologist found the proper antivenin at a zoo about 150 miles away. Obviously by this point it was several hours out from the bite so we sent our lifecare helicopter to pick it up and bring it back. It became clear that he was just too massively envenomated. Even with multiple doses of the antivenin and full ICU life support he died three days later of massive organ failure.

I've always found this an interesting subject and this is my first ever comment on Metafilter.
posted by codex99 at 11:20 AM on October 2, 2012 [71 favorites]


Relevant: Oh god, he's brought a venomous +1 (NSFW)
posted by ersatz at 11:41 AM on October 2, 2012 [2 favorites]


I live in Austin, Texas. About a year ago, I actually saw a coral snake writhing in somebody's driveway, right around the corner from my house. I could not, for the life of me, remember the rhyme, so I stayed well back.

It was really small. Maybe a foot and a half long. Skinny. And it was just hanging out there, writhing.

Not too long after that, I saw a dead one in the road -- about a mile away, as the crow flies. It was about the same size.

I've since read that they're a legitimate risk for gardeners and other people inclined to stick their hands into dirt or dark places -- they bite in the webbing between your fingers. As a gardener, I've started using hand tools more often.

Another story: earlier this year, my husband and I went tent camping with our dog. It was a remote, walk-in campground on a lake. We let our dog off-leash while we hiked around, choosing a site. Walking down the trail, totally oblivious, my Eagle Scout husband grabbed my arm -- hard -- and pointed at a GIANT FUCKING RATTLESNAKE laying across the trail in front of us. Our dog was already on the other side. Cue the scariest 15 seconds of my life, while we called the dog back and prayed that she wouldn't step on the snake. We were probably a 30-minute drive, minimum, to the nearest vet.

Lucky dog that she is, her recall is excellent, and she didn't step on the snake. She didn't even notice it. (I didn't either, which is why I'm glad my husband is an Eagle Scout and looks out for shit like that.)

We proceeded to be thoroughly freaked out for the rest of our camping experience. It didn't help that the guy at the firewood place, later in the day, told us that the local rattlesnakes don't rattle. They've been selected out by boar predation.

Now we have to worry about venomous snakes AND carnivorous, mithridatic boars.

Needless to say, the dog slept in the tent.

Anyway, so yeah, I've lived in Central Texas for ten years and I've seen three venomous snakes. And only two fucking armadillos.
posted by liet at 2:24 PM on October 2, 2012 [3 favorites]


I grew up in Texas as well, and we were taught (in school!) by second grade which four venomous snakes lived near us: rattlesnakes, copperheads, water moccasins/cottonmouths, and coral snakes.

I've been phobic about snakes since I was a two-year-old. I was a curious kid, and talked to animals even then, and my mom was terrified that I'd wander around our rural acreage and try to make friends with a rattlesnake. So, from a very early age, she told me "We don't like snakes." And she's right -- we don't. (Interestingly, she's not afraid of them at all. She just wanted me to be.)

Anyway, the sight of a snake to this day causes an extreme flight response and makes me want to get my feet off the ground as quickly as possible. My dad came in one day -- I was in grade school -- and told us that he'd seen a coral snake out by the shed. I freaked out, predictably. He proceeded to comfort me.

"Don't worry about it," he told me. "Coral snakes don't have fangs like other venomous snakes. They have little teeth instead. So in order to really hurt you, they'd have to chew."

I have no idea whether that's true, but thanks, dad, for driving that phobia a little bit deeper, like a hammer on a nail.
posted by mudpuppie at 3:29 PM on October 2, 2012 [3 favorites]


Oh, and our rhyme was "Red on yellow, kill a fellow; red on black, friend of Jack."

But seriously, you come across one of those snakes, how much time are you going to spend trying to figure out which order the colors are in? Me? I'm fucking out of there.
posted by mudpuppie at 3:31 PM on October 2, 2012 [1 favorite]


Metafilter: venomous snakes AND carnivorous, mithridatic boars.
posted by Slap*Happy at 4:00 PM on October 2, 2012


So presumably Mexican coral snake anti-venom can be imported with a permit, and stored in a nearby hospital, if you're a zoo housing coral snakes.

Nearby hospital? Not so much.

My wife's cousin works in the herpetology dept. of the local zoo and he took us on a tour of one of the "bunkers" (Basically giant 10' tall boxes on either side of the building with dozens of enclosures on each wall). A surprising number of the enclosures had a little plastic box glued to the back of them with a vial of lyophilized protein, a vial of WFI and a syringe sitting in them.
posted by Kid Charlemagne at 4:02 PM on October 2, 2012


So the Wikipedia article says that deaths due to coral snake venom are due to respiratory failure.

Lacking an antidote, is it possible to keep the victim on life support until the venom wears off? See also tetrodotoxin.
posted by tss at 4:27 PM on October 2, 2012


But seriously, you come across one of those snakes, how much time are you going to spend trying to figure out which order the colors are in? Me? I'm fucking out of there.

Exactly. My rhyme goes "Red then yellow, kill a fellow. Red then black, maybe I've fucked up the rhyme so I'm outta here."
posted by Rock Steady at 6:07 PM on October 2, 2012 [8 favorites]


I used to work at the NC Museum of Natural Sciences, until June 2011. The herpetology folks there said that a coral snake has not been seen in North Carolina in about 10 years. Whether you consider that to be a bad or a good thing is up to you. I think it's sad.
posted by Coatlicue at 8:04 PM on October 2, 2012 [1 favorite]


Lacking an antidote, is it possible to keep the victim on life support until the venom wears off?

From the Popular Mechanics link:
"Nobody in this situation is being a bad actor," says Eric Lavonas of the Rocky Mountain Poison and Drug Center. "We just don't have a system set up to deal with it." With no adequate replacement for coral snake antivenom, hospitals are likely to appeal to local zoos, many of which maintain small stocks for their staff. But zoos are under no obligation to provide the medicine.

If and when shortages do occur, many hospitals will have no other option but to intubate coral snake bite victims on ventilators for weeks until the effects of the toxin wear off--potentially costing hundreds of thousands of dollars per bite. "It's probably going to end up costing us far more not to deal with this than to deal with it," Lavonas says, "both in human suffering, and in dollars and cents."
posted by homunculus at 9:12 PM on October 2, 2012 [1 favorite]


As an Australian I think it's adorable you have rhymes about your snakes. Our national snake anthem is "FUCK IT'S A SNAKE, GET ME A SHOVEL!" and depending on drunkenness, testosterone and how many people removed from Saint Irwin we are, the fight, flight or photo response.
posted by geek anachronism at 11:31 PM on October 2, 2012 [7 favorites]


Superb first comment, codex99! Just goes to show that the best strategy is to lie in wait for a thread that demands you pour out your specialized knowledge. Hmm, I oughta try that sometime.

All I've got to add here, venom and herpetology-wise, is the bizarre and unsuccessful 1970s murder plot against a local roofer/slumlord by his trophy wife and her college professor. Although other methods were considered, they eventually settled on the prof going up to the zoo in Madison to try to get snake venom that would simulate a heart attack. Naturally, the zoo expert decided this was an exciting new adventure in his mundane life to call in the police and turn informant.
posted by dhartung at 11:44 PM on October 2, 2012


Quick tangent on drug shortages: I was impressed in May of last year when the hospital pharmacist explained we had a national shortage of zinc. This December, zinc backorders should start to get fllled. Sure, the limiting factor here is not really the Zn2-, it's probably the FDA-certified sterile production line, but wow.
posted by away for regrooving at 12:54 AM on October 3, 2012


Quick tangent on drug shortages: I was impressed in May of last year when the hospital pharmacist explained we had a national shortage of zinc

Drug shortages are a huge problem in this country and one that is not appreciated by the public. To get an idea of how many drugs are affected, lists from the FDA and the American Society of Health-System Pharmacists are available. An overview of the problem is here. It is not just low-demand drugs like anti-venom, but other drugs, usually with a low profit margin, especially generics. We recently had to switch to a different form of morphine because our usual form was affected by a shortage; its not like morphine is an exotic drug that is rarely used. And even though we are still able to use morphine in our patients, changing the concentration can easily lead to dosing errors, so it becomes a patient safety issue. This is compounded in a pediatric hospital (where I work) because in children and infants it is already easy to give an overdose if you are not careful.
posted by TedW at 6:51 AM on October 3, 2012


Oh my god, "mithridatic" is an amazing word.
posted by Sokka shot first at 9:35 AM on October 4, 2012 [1 favorite]


For the record, don't rely on the rhyme in Mexico, Central America or South America. A lot of coral snake species down there don't follow it.

Regarding their fangs, coral snakes are in the same family (Elapidae) as cobras, mambas and all the fun snakes in Australia, which is to say that their fangs are not nearly as long or as mobile as vipers' or pitvipers' fangs, but they'll do. They'll do.

Another fun fact about coral snakes: they're considered next to impossible to keep alive in captivity. They apparently don't adapt well to caging, refuse to eat (and they only eat other snakes) and starve to death.

I vaguely recall an argument that says that tricolored harmless snakes aren't practicing Batesian mimicry, largely because there's a whole whack of tricolored milk snakes and mountain kingsnakes that are hundreds of miles from the nearest coral snake. The idea is that all of these snakes are practicing startle coloration: they're fossorial or they're hiding under leaf litter, they get uncovered and BOO. Wish I could remember where I read that.
posted by mcwetboy at 9:57 AM on October 4, 2012 [1 favorite]


In other news: Black mamba venom is 'better painkiller' than morphine
posted by homunculus at 12:04 PM on October 4, 2012


I was recalling a recent family vacation at Disneyworld when my folks agreed to watch the kids at the room so the Mrs. Plinth and I could at least go out and walk and have a little precious private time. We walked out the room (which was a Disney hotel) and along a sidewalk to a place where for the love a god we could get a beer. I saw a snake heading across the walk and stopped Mrs. Plinth short because there's something about general shape of a pit viper that does that to me. She gave me a funny look. "Copperhead," I said while motioning to the snake now mostly off the sidewalk. Her eyes went wide. Yeah, that beer was calling even louder.
posted by plinth at 12:40 PM on October 4, 2012


A couple of years ago I was cycling the Great Ocean Road and heading for Cape Otway. I was cycling the bush tracks through the Great Otway National Park. Up ahead I spotted a round brown shape in the path and as I got nearer I realised it was a brown snake. I slammed on the brakes, skidded on the undergrowth and (yep! you guessed it) drew to a halt with my pedal foot just inches away from the snake. I took off at such a clip, Lance Armstrong would have had a job catching me.
posted by unliteral at 7:20 PM on October 4, 2012


Interestingly, I went on facebook this morning to find a post by my 74 year old sister (former biology teacher living in Florida) informing us that she had been bitten by a cottonmouth:

"First of all I am fine. Yesterday I heard my dog, Storm, doing his "I found a snake bark" so i went out to check, he had a cottonmouth cornered, so I ran and got the shovel and Storm went into protective mode and grabbed the snake (4ft long) in the middle and proceeded to shake it. As he was whipping it around the snakes mouth was open and as it passed my ankle the fangs got me. He finally dropped it and I killed it with the shovel. I caught the dog and tied him up. Time now to look at the wound. I called 911 and fire rescue arrived, hooked up iv, oxygen and taking blood pressure. One of them tried to tell me it was not posionous ( they should have known better than to argue with me) I had to prove it had fangs and was poisonus). Now the ambulance arrives, and they take over, checking who has antivenom. A hospital was finally found and off we go. The er must have been slow as all workers had to come see 74 old snake bite victim. Dr comes in and again tries to tell me its not poisonous, but we had pics on the iphone. Its now a waiting game to track the symptoms, after 3 hours the poison control people authorized my release

The interesting parts were that she had to convince both the Para Medics and the Dr. that she had correctly ID'ed the snake (at one time when she was still living at my mother's house and teaching science, she had over 100 snake cages in the basement), and that they had to call all the local hospitals to find out which one had the anti-venom on hand.
posted by HuronBob at 6:58 AM on October 6, 2012 [1 favorite]


« Older "A blue cloud of smoke wafted over the Famous Five...  |  Copyright Criminals... Newer »


This thread has been archived and is closed to new comments