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Snakebite envenoming

  • Nature Reviews Disease Primers 3, Article number: 17063 (2017)
  • doi:10.1038/nrdp.2017.63
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Abstract

Snakebite envenoming is a neglected tropical disease that kills >100,000 people and maims >400,000 people every year. Impoverished populations living in the rural tropics are particularly vulnerable; snakebite envenoming perpetuates the cycle of poverty. Snake venoms are complex mixtures of proteins that exert a wide range of toxic actions. The high variability in snake venom composition is responsible for the various clinical manifestations in envenomings, ranging from local tissue damage to potentially life-threatening systemic effects. Intravenous administration of antivenom is the only specific treatment to counteract envenoming. Analgesics, ventilator support, fluid therapy, haemodialysis and antibiotic therapy are also used. Novel therapeutic alternatives based on recombinant antibody technologies and new toxin inhibitors are being explored. Confronting snakebite envenoming at a global level demands the implementation of an integrated intervention strategy involving the WHO, the research community, antivenom manufacturers, regulatory agencies, national and regional health authorities, professional health organizations, international funding agencies, advocacy groups and civil society institutions.

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Acknowledgements

The authors thank J. Bravo (Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas (CSIC)) for assisting in the elaboration of the structural models shown in Figure 3.

Author information

Affiliations

  1. Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, PO Box 11501–2060, San José, Costa Rica.

    • José María Gutiérrez
  2. Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas (CSIC), Valencia, Spain.

    • Juan J. Calvete
  3. College of Health Sciences, Bayero University, Kano, Nigeria.

    • Abdulrazaq G. Habib
  4. Alistair Reid Venom Research Unit, Liverpool School of Tropical Medicine, Liverpool, UK.

    • Robert A. Harrison
  5. Charles Campbell Toxinology Centre, School of Medicine & Health Sciences, University of Papua New Guinea, Boroko, National Capital District, Papua New Guinea.

    • David J. Williams
  6. Australian Venom Research Unit, Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia.

    • David J. Williams
  7. Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK.

    • David A. Warrell

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  2. Search for Juan J. Calvete in:

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Contributions

Introduction (J.M.G.); Epidemiology (A.G.H.); Mechanisms/pathophysiology (J.J.C. and J.M.G.); Diagnosis, screening and prevention (D.A.W.); Management (D.A.W.); Quality of life (D.J.W.); Outlook (J.M.G., R.A.H. and D.J.W.); Overview of the Primer (J.M.G.).

Competing interests

The authors declare no competing interests.

Corresponding author

Correspondence to José María Gutiérrez.

Supplementary information

PDF files

  1. 1.

    Supplementary information S1 (box)

    Clinical and pathophysiological disturbances caused by snake venoms1,2,​3,​4,​5,​6

  2. 2.

    Supplementary information S2 (box)

    Supplementary file 2