International forum bolsters UA's poison center, research Male? Been drinking? Watch out for critters

ALAN FISCHER

Published: 08.30.2007

Tucson Citizen

Tucson is a hot spot for poisonous bites, stings and their treatments.

The area boasts the world-renowned Arizona Poison and Drug Information Center, the new VIPER Institute for research, antivenin clinical trials, more poisonous critters than you can shake a rattle at, and Venom Week 2007, a conference that next week will attract 300 of the world's leading experts on venomous creatures.

"We have a huge number of venomous creatures here. Our per-capita bite and sting rate is as high as it gets," said Dr. Leslie Boyer, course director for the Venom Week 2007 conference. "Venom is to make lunch stand still and tenderize the meat."

The Poison and Drug Information Center at the University of Arizona responds to bite and sting queries at a annual rate of 300 calls per 100,000 residents in the center's service area, said Jude McNally, managing director. The center assists about 6,000 people per year who have been exposed to bites and stings. It gets 200 to 300 calls a day for all poison and drug issues.

Venom Week will bolster UA's position as an international leader in information on venomous animals, bites and stings, said Boyer, medical director of the Poison and Drug Information Center and director of the VIPER Institute. "Venom experts from around the world use the expertise here."

UA is also heading a U.S. Food and Drug Administration Phase 3 clinical trial to test the effectiveness and safety of Anascorp, a scorpion sting anitvenin. More than 300 patients at 22 Arizona medical sites - primarily children - have benefited from the drug trial, she said.

Venom Week 2007 is an international conference on land-based venomous creatures, their venom, and the medical effects of venom. It runs Sept. 3-7 at the Hilton Tucson El Conquistador Golf & Tennis Resort and the Arizona-Sonora Desert Museum.

The study of venom includes many scientific disciplines, Boyer said. So it is a challenge to be aware of all the emerging research and treatment developments in the field.

The conference will allow people in fields such as emergency medicine, medical toxicology, veterinary medicine, nursing, pharmacology, herpetology, arachnology, anitvenin manufacturing and captive collection management to exchange ideas and experiences, she said.

Antivenin availability, treatment skill and expertise vary widely around the nation and the world. A big Venom Week goal is developing international standards for drug selection, dosage and safety for treating bites and stings, she said.

"There is an explosion in sciences studying venoms and how to treat people. The knowledge is out there but it is not all in one place," McNally said. "We have to take what has been learned in the lab and apply it to the emergency room setting."

The first two days of the conference will be hosted at the Arizona-Sonora Desert Museum, said Stéphane Poulin, curator of herpetology, ichthyology and invertebrate zoology.

"We will give them a taste of what is involved in keeping venomous animals; how to work with these animals," he said.

The Desert Museum has a special monthlong display featuring all 18 varieties of rattlesnakes found in Arizona, Poulin said.

Conference attendees will also be able to view Wednesday a collection of rare exotic venomous creatures, some confiscated by the Arizona Game & Fish Department, McNally said.

Most of the restricted animals that are prohibited by state law go to the Phoenix Herpetological Society, said Hans Koenig, field supervisor for Game & Fish.

The animals are cared for there until they can be relocated to educational institutions or zoos, Koenig said.

Russell Johnson, president of the Phoenix Herpetological Society, said the Wednesday display will include an assortment of vipers, rattlesnakes, cobras and other venomous creatures.

The Venom Week conference should be a boon to the new Venom Immunochemistry, Pharmacology and Emergency Response, or VIPER, Institute, Boyer said. The institute will be a UA research arm to augment the Poison and Drug Information Center.

VIPER researchers will study how venoms work in biological systems and see how they could alleviate human diseases.

Some medicines, such as one derived from Gila monster venom that helps diabetics regulate blood sugar, are already on the market.

If you've been bitten by a Gila monster or a rattlesnake in an avoidable situation, chances are you're a guy who has had a few drinks.

Most venomous snake bite victims are males, particularly in cases where the victim recognizes the danger and is bitten anyway, instead of leaving the snake alone, said Jude McNally, managing director at the Arizona Poison and Drug Information Center.

All 19 people reported bitten by Gila monsters in the past six years have been males, he said.

Alcohol is frequently a factor in preventable snakebites, said Russell Johnson, president of the Phoenix Herpetology Society.

"The first question they ask you at the hospital is, 'how much you had to drink?" he said. "A high percentage of bites involve alcohol. People do really silly things."

A misguided macho attitude can also lead to bites, he said.

"Males and a lot of alcohol are often related to bites," Johnson said. "When it comes to snakes, women are smarter than men. Women don't do those crazy things."

Even people who exhibit care when working with venomous animals are at risk, said Johnson, who has suffered two rattlesnake bites.

"It's the most painful thing in the world, worse than childbirth," he said of the pain that radiates from the bite site up the stricken limb as the venom courses through the body like a red-hot knife.

The Poison and Drug Information Center assists about 6,000 people per year who have been exposed to bites and stings, McNally said.

Snakebites account for 200 to 300 incidents per year but make up a disproportionate amount of the workload at the Poison and Drug Information Center because of the severity of the injury and length of treatment, he said.

From 50 percent to 70 percent of venomous snakebites occur because the victims put themselves at risk after recognizing the danger, McNally said. About 65 percent of all snakebites are hand bites.

Venomous snakebites are costly, both for health and finances.

About 25 percent of bites result in long-term disabilities such as loss of function, strength, tissue and range of motion, McNally said.

Less than 0.1 percent of bites result in death. "It's not a question of mortality, it's a question of morbidity," McNally said.

Hospital bills for venomous snake bite victims typically exceed $100,000, of which $40,000 to $60,000 goes for drugs, he said.

Extremely serious cases can involve long spells in intensive care and cost more than $320,000, he said.

"We just need to educate people about the dangers. If they see a snake on a trail they should recognize the danger and stop and back up a couple of steps," McNally said. "We can change these statistics with education." additional information