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https://hdl.handle.net/2440/17349
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Type: | Journal article |
Title: | Funnel-web spider bite: a systematic review of recorded clinical cases |
Author: | Isbister, G. Gray, M. Balit, C. Raven, R. Stokes, B. Porges, K. Tankel, A. Turner, E. White, J. Fisher, M. |
Citation: | Medical Journal of Australia, 2005; 182(8):407-411 |
Publisher: | Australasian Med Publ Co Ltd |
Issue Date: | 2005 |
ISSN: | 0025-729X 1326-5377 |
Statement of Responsibility: | Geoffrey K Isbister, Michael R Gray, Corrine R Balit, Robert J Raven, Barrie J Stokes, Kate Porges, Alan S Tankel, Elizabeth Turner, Julian White and Malcolm McD Fisher |
Abstract: | Objective: To investigate species-specific envenoming rates and spectrum of severity of funnel-web spider bites, and the efficacy and adverse effects of funnel-web spider antivenom. Data sources: Cases were identified from a prospective study of spider bite presenting to four major hospitals and three state poisons information centres (1999–2003); museum records of spider specimens since 1926; NSW Poisons Information Centre database; MEDLINE and EMBASE search; clinical toxinology textbooks; the media; and the manufacturer’s reports of antivenom use. Data extraction: Patient age and sex, geographical location, month, expert identification of the spider, clinical effects and management; envenoming was classified as severe, mild–moderate or minor/local effects. Data synthesis: 198 potential funnel-web spider bites were identified: 138 were definite (spider expertly identified to species or genus), and 77 produced severe envenoming. All species-identified severe cases were attributed to one of six species restricted to NSW and southern Queensland. Rates of severe envenoming were: Hadronyche cerberea (75%), H. formidabilis (63%), Atrax robustus (17%), Hadronyche sp. 14 (17%), H. infensa (14%) and H. versuta (11%). Antivenom was used in 75 patients, including 22 children (median dose, 3 ampoules; range, 1–17), with a complete response in 97% of expertly identified cases. Three adverse reactions were reported, all in adults: two early allergic reactions (one mild and one with severe systemic effects requiring adrenaline), and one case of serum sickness. Conclusions: Severe funnel-web spider envenoming is confined to NSW and southern Queensland; tree-dwelling funnel webs (H. cerberea and H. formidabilis) have the highest envenoming rates. Funnel-web spider antivenom appears effective and safe; severe allergic reactions are uncommon. |
Keywords: | Animals Humans Polyamines Antivenins Health Surveys Prospective Studies Cross-Sectional Studies Species Specificity Adult Child New South Wales Northern Territory Queensland Western Australia Spider Bites |
Description: | The document attached has been archived with permission from the editor of the Medical Journal of Australia (09 January 2008). An external link to the publisher’s copy is included. |
DOI: | 10.5694/j.1326-5377.2005.tb06760.x |
Published version: | http://www.mja.com.au/public/issues/182_08_180405/isb10564_fm.html |
Appears in Collections: | Aurora harvest 6 Paediatrics publications |
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hdl_17349.pdf | Published version | 258.77 kB | Adobe PDF | View/Open |
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