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Snakes
in San
Diego: Potent, Powerful
Venom Cause for Concern UC San
Diego Toxicologist
For the
second year in a row, UC San Diego Medical Center
toxicologists are reporting unusually powerful snake bites
and unusually extreme patient reactions to those bites.
Since January, several patients have suffered bites with
severe symptoms, such as difficulty breathing, often after a
bite from the Southern Pacific Rattlesnake.
“Our
victims are showing symptoms of severe weakness, trouble
breathing and low blood pressure this year,” said Richard F.
Clark, M.D., director of the division of medical toxicology
at the University of California, San Diego and medical
director for the California Poison Control System (CPCS),
San Diego Division, UC San Diego Medical
Center.
Symptoms
can include: extreme pain at the location of the bite,
nausea, and sometimes diarrhea, followed by swelling in the
mouth and throat, making it difficult to breathe. Within
minutes, the victim can get lightheaded, collapse and go
into shock. With some rattlesnake bites, no venom is
injected into the wound, but because it is impossible to
know if venom has or has not been injected, getting medical
treatment quickly is important.
Clark
emphasized
that while San
Diego County
is seeing
a rise in snake bite cases each year, the more alarming
factor recently is the toxicity of the bite. Toxin levels in
rattler venom vary from year to year and season to season
but – typically- venom is weaker in winter and stronger in
summer because snakes are more active, fighting for food and
for survival.
“We really
don’t know why the venom is becoming increasingly potent.
Some speculate that with the modern world encroaching on
nature it could be survival of the fittest. Perhaps only the
strongest survive,” said Clark
. “UC San
Diego will be conducting clinical trials later this summer
with a new antivenom for rattlesnake bites.”
The
majority of the injuries are on hands, fingers and feet, and
the most typical result is swelling and tissue damage that
looks like blisters or frost bite.
“What
exacerbates the problem is that most bite victims are bitten
on their dominant hand,” Clark
pointed
out. “They’re reaching down a hole, perhaps trying to move
the snake or handle the snake in some way, and they do that
with their dominant hand. When a person’s hand or leg is
bitten, any movement is extremely painful: swelling occurs
and the patient can’t bend the fingers, sometimes for months
after the incident. It can really affect daily life. The
patient can’t sign a check, write a paper for school, or
hold a coffee cup.”
What to
Do?
Get to the
emergency department or a nearby health care facility
immediately if you are bitten by a snake. Administration of
antivenom is the most important treatment. Traditional first
aid treatments such as applying ice, using a tourniquet, or
applying suction to the wound have little value and may
cause more injury.
If the
victim is in a remote area when bitten by a rattler, first
immobilize the wounded area, especially for a hand or arm
bite, then proceed slowly to a vehicle. Moving slowly will
keep the heart rate low and help prevent the venom from
spreading. If bitten on the leg or foot, it might be
necessary to use that limb to get to the vehicle, unless
someone can carry the victim. If walking is necessary, it is
very important to move slowly. Drive to the nearest phone,
call 911 and wait for assistance. If there is no phone
nearby, proceed to the nearest hospital.
Other
Concerns: Bee Stings
Yearly
reminders about bee stings are always part
of UCSD
Medical
Center
and
California Poison Control System’s public outreach.
Recently, Africanized bees have proven to be a larger player
than in previous years.
“Africanized bees are
more aggressive than other bees so we advise people to stay
away from wild bee colonies,” added
Clark
.
Africanized bees like
to move around. They are often seen traveling together,
coming out of a water main or a bird house or from under the
eave of a home. The main difference between these bees and
others is that they respond to a threat with more bees.
What to
Do?
If
attacked, the person being threatened should run and seek
shelter away from the swarm, in a car with the windows
rolled up, a house, a building, or any place that is not
exposed to the outside.
If someone
is stung, and is allergic, get the victim to a healthcare
provider immediately. Even if the victim is not allergic or
unsure, but receives multiple stings from the swarm, seek
healthcare immediately to be on the safe
side.
Black
Widow Spiders
There are
thousands of different kinds of spiders in the world and all
of them have some amount of venom with varying degrees of
potency. Fortunately, most spiders are not dangerous to
humans because their fangs are either too short or too
fragile to penetrate human skin.
Severe
muscle pain and cramps may develop in the first two hours,
usually first felt in the back, shoulders, abdomen and
thighs. Other symptoms include weakness, sweating, headache,
anxiety, itching, nausea, vomiting, difficult breathing and
increased blood pressure. Young children, the elderly and
those with high blood pressure are at highest risk of
developing severe symptoms from a black widow spider
bite.
What to
Do?
Getting
medical help is very important, but keep in mind, black
widow bites are rarely if ever fatal. Analgesics are the
most important therapies for the pain associated with most
black widow bites, but black widow antivenom is available at
many emergency departments and can be effective in treating
the most severe bites.
Within the
next few months, UCSD
Medical
Center
toxicologists will be
starting a study with a new antivenom specifically developed
to treat black widow spider bites.
Mosquitoes
and Ticks
They are
seemingly insignificant pests, but, oh, the damage they can
bring. Clark
advises
anyone who is going to be in wilderness areas to consider
using a repellant containing “DEET.” It is the best
protection from biting insects.
“We want
to remind campers, walkers, hikers, and the public in
general, that San
Diego does have occasional
cases of West
Nile virus and Lyme
disease,” said Clark
.
West
Nile is spread through the
mosquito’s bite and Lyme disease is carried by
ticks.
What to
Do?
If someone
develops unusual symptoms such as fever and other flu-like
symptoms after participating in wilderness activities, seek
a healthcare provider immediately.
Sting
Rays
The
San
Diego division of the
California Poison Control System receives many calls from
beachgoers who report being stung by venomous marine animals
such as jellyfish, scorpion fish or stingrays. If this
occurs, the stinger should be removed and the wound washed
with soap and water. Clark
said hot
water has proven to be very effective in decreasing or
eliminating the pain caused by string ray
venom.
What to
Do?
Clark
recommends
placing the affected area in water that is as hot as the
sting victim can tolerate without burning the skin. Using
this therapy, the victim should feel better within 30
minutes. If not, see a healthcare provider
immediately.
If
redness, drainage or swellings appear, there is likely an
infection. It is important to see a healthcare provider for
treatment if an infection develops.
The California Poison Control System (CPCS) is available at
1-800-222-1222, 24 hours a day, seven days a week for immediate
expert help and information in case of poison
exposure.
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