Snakebites are considered a significant health issue. Current antivenoms contain polyclonal antibodies, which vary in their specificity against different venom components. Development and characterization of next generation antivenoms including nanobodies against Naja naja oxiana was the main aim of this study. Crude venom was injected into the Sephadex G50 filtration gel chromatography column and then toxic fractions were obtained. Then the corresponding fraction was injected into the HPLC column and the toxic peaks were identified. N. naja oxiana venom was injected into a camel and specific nanobodies screening was performed against the toxic peak using phage display technique. The obtained results showed that among the 12 clones obtained, N24 nanobody was capable of neutralizing P1, the most toxic peak obtained from HPLC chromatography. The molecular weight of P1 was measured with a mass spectrometer and was found to be about seven kDa. The results of the neutralization test of crude N. naja oxiana venom with N24 nanobody showed that 250 μg of recombinant nanobody could neutralize the toxic effects of 20 μg equivalent to LD50 × 10 of crude venom in mice. The findings indicate the potential of the developed nanobody to serve as a novel antivenom therapy.

As the landscape becomes more urbanized, snakebites have increasingly become uncommon presentations to the emergency departments in Singapore, while snakebites causing significant envenomation are even rarer. In this case report, we discuss a 55-year-old man who had significant envenomation from a Shore Pit Viper (Trimeresurus Purpureomaculatus) and who was successfully treated with haemato-toxic polyvalent antivenom (HPAV). He initially presented with pain, swelling and bleeding over his wound. Due to a deterioration in his coagulation profile, he was given two doses of HPAV which is typically reserved for viperid snakes instead. Following administration of the anti-venom, the patient\'s coagulation profile improved, and the local soft tissue effects of the venom resolved. He did not manifest any adverse effects and was discharged uneventfully about 72 h after the snakebite. The cross-neutralization potential of HPAV for Shore Pit Viper (Trimeresurus Purpureomaculatus) venom in this case study suggests that there may be a possible common underlying chemical structure and pathophysiology among the venom proteins of various snake species. Given that Trimeresurus-specific antivenom is unavailable in most countries, this cross-neutralization strategy deserves further consideration and evaluation in similar circumstances.

UNASSIGNED: In 2023, a group of experts proposed that a definition of major bleeding in pharmaceutically anticoagulated patients be used in all snakebite trials. This includes bleeding that results in death, is life-threatening, causes chronic sequelae, or consumes major healthcare resources, including bleeding into a major area or hemoglobin concentration decrease ≥20 g/L. We hypothesized that a decline in hemoglobin concentration ≥20 g/L is common but rarely clinically significant in our population of Arizona rattlesnake bite patients.
UNASSIGNED: Poison center records of rattlesnake bites in humans from 2018 through 2022 were retrospectively reviewed and assessed for major bleeding by the above criteria.
UNASSIGNED: Four hundred and eighty-one patients met the inclusion criteria, of whom 265 (55.1%) had a hemoglobin concentration decrease ≥20 g/L. No patients died, and there was no evidence of bleeding into a critical organ. Three patients (1.1%) received blood transfusions. A decrease in hemoglobin concentration ≥20 g/L was 100% sensitive for identifying the major bleeding-associated outcomes; however, specificity was only 45.2%. Measures of healthcare utilization and chronic sequelae were somewhat higher in patients with a decrease in hemoglobin concentration ≥20 g/L.
UNASSIGNED: Laboratory manifestations of hemotoxicity were common in this population, but hemorrhage was rare. While over half of patients met the major bleeding criterion of a decline in hemoglobin concentration ≥20 g/L, only 1.1% had bleeding that was potentially life-threatening as measured by receipt of a red blood cell transfusion. None died or had bleeding into a critical area. While nonspecific for major bleeding, a drop in hemoglobin concentration correlated with worse envenomation severity: these patients received more vials of antivenom, had a higher medical bill, a longer hospital stay, and were less likely to report full recovery at 90 days.
UNASSIGNED: A decrease in hemoglobin concentration ≥20 g/L should not be used as evidence of major bleeding for Arizona rattlesnake envenomation studies, but it may have a role as an indirect marker of envenomation severity.

Understanding how environmental factors affect the performance of predators can provide profound insights into predator-prey interactions from evolutionary and ecological perspectives and the global distributional patterns of each taxon. Almost all venomous predators are ectotherms, with muscle contraction properties depending on temperature. For predators having venom transportation systems driven by muscle contraction, temperature may have quite large effects on envenomation performance for prey subjugation. Here, we used videography and enzyme-linked immunosorbent assay to examine thermal effects on envenomation kinematics and venom expenditure in predatory strikes of a venomous snake, the Mamushi Gloydius blomhoffii, to its main rodent prey at various body temperatures under both field and laboratory experimental conditions. Unexpectedly, we found that the thermal effects on envenomation performance are limited over nearly the entire ecologically relevant range of temperature (from 13.2°C to 26.2°C). Although temperature statistically significantly affected the mass of venom injected under field conditions, temperature explained only a minor proportion of the variation in venom expenditure. These findings suggest that the Mamushi is able to maintain prey subjugation performance across a wide range of temperatures, which is highly advantageous for ectothermic predators. Further studies should examine the underlying mechanisms of the limited thermal effects and their ubiquity across venomous predators.

UNASSIGNED: Rattlesnake (Crotalus spp., Sistrurus spp.) bites in the southwestern United States are associated with significant morbidity. This study aims to describe 25 years of rattlesnake encounters reported to the Arizona Poison and Drug Information Center to identify vulnerable populations and circumstances where encounters occur to create public education to reduce future bites.
UNASSIGNED: Cases of suspected rattlesnake encounters in Arizona reported to the Arizona Poison and Drug Information Center between 1999 and 2023 were analyzed to identify populations and circumstances associated with encounters.
UNASSIGNED: A total of 3,808 cases were analyzed overall and by age subgroups. Most encounters occurred in men (69.9%), during the evening (16:00-21:59; 49.2%), in summer (41.9%), and close to home (38.2%). Most bites occurred to the lower extremity (51%). Children 0 to 12-years-old have more encounters than those 13-years-old and older in rural zip codes (27.7% versus 14.8%; P = 0.005), during spring (31.8% versus 22.3%; P = 0.0005), and during the evening (64.4% versus 48.1%; P < 0.001).
UNASSIGNED: Rattlesnakes are encountered when rattlesnake and human behavior patterns overlap. Many people spend time outside during evening hours in the summer, and valuable resources like food, water, and shelter can be found near houses where humans spend much of their time. Most age groups have similar encounter circumstances but encounters among children 0 to 12-years-old differ in time of day, season, and urbanization level than encounters of those 13-years-old and older. Limitations of this study include underreporting of encounters, incomplete case details, potential reporting bias, potential snake misidentification, and geographic coverage of the poison center.
UNASSIGNED: Prevention of rattlesnake bites by reducing encounters is the most effective way to reduce suffering and healthcare costs. Future steps include creating and disseminating targeted public health education using the data collected.

UNASSIGNED: Snake bite is a neglected public health issue in many tropical and subtropical countries of the world. About 5.4 million snakebites occur each year, resulting in 1.8 to 2.7 million cases of envenomation yearly. Hepatic markers have been reported to rise 3-6 hours after injection of venom in experimental animals. This study aims to biochemically assess ALT, AST and GGT levels as biomarkers of Echis ocellatus envenomation in victims of snake bite presenting at JUTH Comprehensive Health Centre Zamko 6hours post-bite and compare with values in those bitten by non-venomous snakes.
UNASSIGNED: The study was a comparative cross-sectional study where serum levels of AST, ALT and GGT were compared between the study group and the control group.
UNASSIGNED: Of the 150 respondents, 75 from each study group, 90(60.0%) were Male while 60(40.0%) were Female, with a Male to Female ratio of 1.5:1. The most predominant age group was 20-29 years 57(38.0%), the mean age was 39 years. The most predominant occupation was farming 82(54.7%). The majority 82(54.7%) had a secondary level of education. 91(60.7%) were married. A large majority of 123(82.0) had Christianity as their religion. We found a significant increase in the levels of AST (47.45IU/L) and GGT (61.62 IU/L) in the study group compared to AST (25.88IU/L), GGT (29.61IU/L) in the control group at p<0.05, while the level of ALT was similar in both groups at p>0.05.
UNASSIGNED: This implies that serum levels of AST and GGT can be used to diagnose envenomation in snakebite patients.

Poecilotheria spiders are considered theraphosids of underestimated clinical importance, with bites from these species inducing symptoms such as severe pain and intense muscle cramps. However, there is no specific treatment for the envenomation caused by these species, which, while native to India and Sri Lanka, are widely distributed worldwide. The present study reports the case of a 31-year-old man bitten by a Poecilotheria regalis specimen. The patient\'s clinical presentation was similar to Latrodectus envenomation, and patient was treated with an L. mactans antivenom. Most of patient\'s symptoms improved (fasciculations, pain, erythema, and local swelling), except muscle cramps. A toxicological study conducted on mice did not show that L. mactans antivenom has a neutralizing effect on the toxicity of P. regalis. The present report discusses the envenoming process of Poecilotheria species and the possible neutralizing effect exerted by L. mactans antivenom.

OBJECTIVE: To describe a young patient with scorpion sting (SS) with typical lesions of urticaria besides the local SS clinical picture.
METHODS: A systematic screening of articles dating from 1966 to 2021 was conducted in the main databases. All articles included the association between SS and urticaria. A new case report is added to the published list.
RESULTS: The literature search found 5 articles with 29 patients with SS and urticaria/allergic reactions. We performed our analysis by adding our present case, resulting in a total of 30 cases. Most were male, and their ages varied from 29 to 48 years. Regarding SS severity, most were mild or moderate. In two articles, patients had more than one sting. The allergic reaction varied from urticaria, pruritus, flushing, angioedema, wheezing, rhinorrhea, sneezing, consciousness alterations, and gastrointestinal and cardiovascular alterations. In 5/6 (83%) articles, the patients were alive at the study time. One subject died from anaphylactic shock.
CONCLUSIONS: The present article systematically reviewed all published cases of SS and allergic reactions to scorpion venom. It is an infrequent association; most patients are male and in the productive age, and reaction may vary from mild to severe, including death.

BACKGROUND: Snakebite envenomation (SBE) and scorpion sting envenomation (SSE) are significant neglected tropical diseases that primarily affect impoverished communities in rural areas of developing nations. A lack of understanding about snake and scorpion species and their distribution exacerbates the disabilities and fatalities caused by SBE and SSE. In Sudan, particularly in regions affected by ongoing conflicts where healthcare resources are scarce, social media platforms offer a cost-effective approach to addressing public health challenges. Our aim in this study is to highlight the benefits of using social media for data collection and health promotion in such environments.
METHODS: We present a cost-effective communication and data collection strategy implemented at the Toxic Organisms Research Centre (TORC) of the University of Khartoum, focusing on a Facebook group, \"Scorpions and Snakes of Sudan\", as our primary social media platform. Additionally, we discuss the lessons learned and the initial impact of this strategy on enhancing population health literacy.
RESULTS: The group community is composed of ~ 5000 members from 14 countries. During the period from January 2023 to January 2024, we received 417 enquiries about snakes and scorpions belonging to 11 families and composed of 55 species. In addition, 53 other enquiries covered a range of organisms and their tracks (e.g., spiders, skinks, chameleons, foxes, sun spiders, centipedes, lizards, moth larvae, and insect tracks). The first photographic evidence of Malpolon monspessulanus in Sudan was via the group activities. The rare species Telescopus gezirae, the Blue Nile cat snake, is also documented via the group member\'s queries. Recognizing the evolving nature of social media use in public health, we also address the current limitations and evidence gaps that need to be addressed to effectively translate best practices into policy.
CONCLUSIONS: In conclusion, utilizing Facebook as an institutional platform to share scientific information in simple Arabic language underscores the proactive roles that citizens, scientists, and public health stakeholders can play in leveraging social media for eHealth, eAwareness, and public health initiatives. This approach highlights the potential for collaborative efforts, particularly during crises, to maximize the benefits of social media in advancing public health.

Poisoning by widow-spider (genus Latrodectus) bites occurs worldwide. The illness, termed latrodectism, can cause severe and persistent pain and can lead to muscle rigidity, respiratory complications, and cardiac problems. It is a global health challenge especially in developing countries. Equine serum-derived polyclonal anti-sera are commercially available as a medication for patients with latrodectism, but the use of sera imposes potential inherent risks related to its animal origin. The treatment may cause allergic reactions in humans (serum sickness), including anaphylactic shock. Furthermore, equine-derived antivenom is observed to have batch-to-batch variability and poor specificity, as it is always an undefined mix of antibodies. Because latrodectism can be extremely painful but is rarely fatal, the use of antivenom is controversial and only a small fraction of patients is treated. In this work, recombinant human antibodies were selected against alpha-latrotoxin of the European black widow (Latrodectus tredecimguttatus) by phage display from a naïve antibody gene library. Alpha-Latrotoxin (α-LTX) binding scFv were recloned and produced as fully human IgG. A novel alamarBlue assay for venom neutralization was developed and used to select neutralizing IgGs. The human antibodies showed in vitro neutralization efficacy both as single antibodies and antibody combinations. This was also confirmed by electrophysiological measurements of neuronal activity in cell culture. The best neutralizing antibodies showed nanomolar affinities. Antibody MRU44-4-A1 showed outstanding neutralization efficacy and affinity to L. tredecimguttatus α-LTX. Interestingly, only two of the neutralizing antibodies showed cross-neutralization of the venom of the Southern black widow (Latrodectus mactans). This was unexpected, because in the current literature the alpha-latrotoxins are described as highly conserved. The here-engineered antibodies are candidates for future development as potential therapeutics and diagnostic tools, as they for the first time would provide unlimited supply of a chemically completely defined drug of constant quality and efficacy, which is also made without the use of animals.