Snake Antivenom Immunoglobulins
Snake antivenom immunoglobulins (antivenoms) are the only specific treatment for envenoming by snakebites. Antivenoms can prevent or reverse most of the snakebite envenomings effects, and play a crucial role in minimizing mortality and morbidity. These preparations are included in the WHO List of Essential Medicines and should be part of any primary health care package where snakebites occur. Currently, there is an urgent need to ensure availability of safe, effective and affordable antivenoms, particularly to those in developing countries and to improve the regulatory control over the manufacture, import and sale of antivenoms.
The risk of snakebite envenoming is a public health hazard that many people in the rural tropics face on a daily basis. In these areas, snakebite envenoming is a common cause of occupational injury affecting agricultural workers and hunters with important socioeconomic implications. Open-plan housing and the practice of sleeping on the floor, common in tropical regions, also exposes people to bites from nocturnal snakes. Overall women, children and farmers are the most common victims of snakebites. Children often suffer more severe effects than adults, due to their smaller body mass.
Bites by venomous snakes can cause severe paralysis that may prevent breathing; bleeding disorders that can lead to fatal haemorrhage; irreversible kidney failure; and severe local tissue destruction that can cause permanent disability and may result in limb amputation.
A knowledge of which species of venomous snakes present the greatest risks to human populations in any particular region or country is essential to addressing snakebite problems. If venom from the wrong species is selected, the antivenom produced may not be effective against the effects of bites by snakes in the countries or regions where the product is marketed.
The WHO Guidelines and global database
The WHO Guidelines on Production, Control and Regulation of Snake Antivenom Immunoglobulins presented in this website cover all steps in the production and regulatory control of snake antivenoms and contain an Appendix which lists the worldwide distribution of venomous snakes, clinically relevant for the production of venoms and antivenoms.
This document is intended to guide national control authorities and manufacturers in their efforts to improve the worldwide production of safe and effective antivenoms. Furthermore, a WHO global database, including maps and image library, has been created to raise awareness of the geographical representation of the venomous snakes included in the Appendix.
This effort has been undertaken to support public health officers, procurement agencies, regulators and manufacturers involved in decision making related to the preparation and use of appropriate antivenoms and to assist care workers in their clinical management of snake bite envenomings.