Establishment and first experiences of the National Serum Depot in the Netherlands

Dijkman, Marieke A.; Zwan, Cees W Van Der; Vries, Irma de

doi:10.1016/j.toxicon.2012.04.334

Cited by 10 publications

(5 citation statements)

References 10 publications

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“…These centers stock antivenom effective against 30 different types of venomous snakes [ 20 , 21 ]. A similar national antivenom depot has been operational in the Netherlands since 2008 [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Non-Native (Exotic) Snake Envenomations in the U.S., 2005–2011

Warrick

Boyer²,

Seifert

2014

Toxins

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Non-native (exotic) snakes are a problematic source of envenomation worldwide. This manuscript describes the current demographics, outcomes and challenges of non-native snakebites in the United States (U.S.). We performed a retrospective case series of the National Poison Data System (NPDS) database between 2005 and 2011. There were 258 human exposures involving at least 61 unique exotic venomous species (average = 37 per year; range = 33–40). Males comprised 79% and females 21%. The average age was 33 years with 16% less than 20 years old. 70% of bites occurred in a private residence and 86% were treated at a healthcare facility. 35% of cases received antivenom and 10% were given antibiotics. This study is compared to our previous study (1994–2004) in which there was a substantial coding error rate. Software modifications significantly reduced coding errors. Identification and acquisition of appropriate antivenoms pose a number of logistical difficulties in the management of these envenomations. In the U.S., poison centers have valuable systems and clinical roles in the provision of expert consultation and in the management of these cases.

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Section: Discussionmentioning

confidence: 99%

Non-Native (Exotic) Snake Envenomations in the U.S., 2005–2011

Warrick

Boyer²,

Seifert

2014

Toxins

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“…However, even for countries with an adequate supply of effective antivenoms, their distribution may be concentrated in major urban cities with low snakebite incidence rather than the rural areas that suffer the highest rates of envenomations [ 165 , 166 , 167 ]. A particularly complicated legal and medical arena is the supply of antivenom for and treatment of exotic snakebites in zoological or private collections, which may be unattainable within a reasonable period and the attending doctors are likely to lack the experience necessary to treat such an emergency [ 168 , 169 , 170 , 171 , 172 , 173 , 174 ].…”

Section: Issues and Controversies In Modern Medical Carementioning

confidence: 99%

“…Included in such a licensing system would be documentation of access to antivenom for the species being kept, whether through private procurement or as part of an antivenom depot. Such antivenom depots have been established in countries with such legislative foresight [ 168 ].…”

Section: Issues and Controversies In Modern Medical Carementioning

confidence: 99%

Snakebite: When the Human Touch Becomes a Bad Touch

Fry

2018

Toxins

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Many issues and complications in treating snakebite are a result of poor human social, economic and clinical intervention and management. As such, there is scope for significant improvements for reducing incidence and increasing patient outcomes. Snakes do not target humans as prey, but as our dwellings and farms expand ever farther and climate change increases snake activity periods, accidental encounters with snakes seeking water and prey increase drastically. Despite its long history, the snakebite crisis is neglected, ignored, underestimated and fundamentally misunderstood. Tens of thousands of lives are lost to snakebites each year and hundreds of thousands of people will survive with some form of permanent damage and reduced work capacity. These numbers are well recognized as being gross underestimations due to poor to non-existent record keeping in some of the most affected areas. These underestimations complicate achieving the proper recognition of snakebite’s socioeconomic impact and thus securing foreign aid to help alleviate this global crisis. Antivenoms are expensive and hospitals are few and far between, leaving people to seek help from traditional healers or use other forms of ineffective treatment. In some cases, cheaper, inappropriately manufactured antivenom from other regions is used despite no evidence for their efficacy, with often robust data demonstrating they are woefully ineffective in neutralizing many venoms for which they are marketed for. Inappropriate first-aid and treatments include cutting the wound, tourniquets, electrical shock, immersion in ice water, and use of ineffective herbal remedies by traditional healers. Even in the developed world, there are fundamental controversies including fasciotomy, pressure bandages, antivenom dosage, premedication such as adrenalin, and lack of antivenom for exotic snakebites in the pet trade. This review explores the myriad of human-origin factors that influence the trajectory of global snakebite causes and treatment failures and illustrate that snakebite is as much a sociological and economic problem as it is a medical one. Reducing the incidence and frequency of such controllable factors are therefore realistic targets to help alleviate the global snakebite burden as incremental improvements across several areas will have a strong cumulative effect.

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“…Each year, the Dutch Poisons Information Center (DPIC) is consulted about 4-6 venomous exotic snakebites. [1] The DPIC offers information on the clinical presentation of envenomations and treatment, including the choice of and criteria for antivenom treatment. The DPIC assists in ordering the antivenom from the Dutch National Serum Depot, part of the National Institute for Public Health and the Environment.…”

Section: Introductionmentioning

confidence: 99%

“…The DPIC assists in ordering the antivenom from the Dutch National Serum Depot, part of the National Institute for Public Health and the Environment. [1] Here, we present a case of an amateur herpetologist bitten by an Aruban rattlesnake.…”

Section: Introductionmentioning

confidence: 99%

Clinical presentation and management of an Aruban rattlesnake bite in the Netherlands

Dijkman

Damhuis

Meulenbelt

et al. 2016

Clinical Toxicology

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Bites by Aruban Rattlesnake (Crotalus durissus unicolor) are rare and not known to induce severe envenomations. Here, we present a case of a 57 year-old man bitten by his pet Aruban Rattlesnake (Crotalus durissus unicolor). He was admitted to hospital within 15 min. Three and a half hours later his fibrinogen concentration decreased to 0.6 g/L (normal: 2.0-4.0). Nine hours post-bite, he was treated with polyvalent snake antivenom covering Crotalus durissus. Three hours later his fibrinogen became undetectable while at that time clotting times were prolonged (PT 38.7 s (normal: 12.5-14.5) and aPTT 40 s (normal: 25-35)). His platelet count remained within normal limits. Creatine kinase (CK) concentrations reached a maximum of 1868 U/L (normal: <200) 16 h post-bite. After a second antivenom dose, 10.5 h after the first antivenom administration, clotting times returned to normal. Fibrinogen was restored to normal within three days. He was discharged from hospital on day five. In conclusion, administration of polyvalent snake antivenom covering Crotalus durissus snakebites shows cross-neutralization and is effective in the treatment of patients bitten by Crotalus durissus unicolor. ARTICLE HISTORY

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Establishment and first experiences of the National Serum Depot in the Netherlands

Cited by 10 publications

References 10 publications

Non-Native (Exotic) Snake Envenomations in the U.S., 2005–2011

Non-Native (Exotic) Snake Envenomations in the U.S., 2005–2011

Snakebite: When the Human Touch Becomes a Bad Touch

Clinical presentation and management of an Aruban rattlesnake bite in the Netherlands

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