ANTIVENOMS: USE AND ADVERSE REACTIONS OVER A 12‐MONTH PERIOD IN AUSTRALIA AND PAPUA NEW GUINEA

Abstract

All case reports of antivenom usage over a twelve-month period, from July, 1978, to June, 1979, were followed-up, in particular to determine the incidence of delayed reactions. Of 327 cases of red-back spider brte in which antivenom was used, adequate further information was obtained in 200 cases. No acute severe reactions were reported, and only two minor acute reactions occurred. The seven cases of delayed reactions occurred in older persons (average age, 40.7 years), which suggests that they were more susceptible possibly because of prior exposure to equine protein. In 16 cases, antivenoms were used to treat patients envenomed by the box jelly fish, the stonefish, or the bush tick. Mild immediate reactions occurred after the use of canine protein (tick antivenom) in one patient, and after infusion of sheep protein (box jelly fish antivenom) in another. The case reports on the use of snake antivenom were more vigorously followed-up, with the result that adequate details of 181 out of 203 cases (89%) were obtained. Untoward reactions occurred in 24 cases (12.9%), and five of these patients experienced both immediate and delayed reactions. Polyvalent antivenom was involved in 79% of recorded reactions. Patients who received polyvalent antivenom had a 10% risk of significant delayed reactions.