BOSTON GLOBE (Massachusetts) 14 September 05 An increase in poisonous snakebites feared - Officials check antidote supply (Ross Kerber)
Adding to worries along the Gulf Coast, officials fear an increased number of snakebite victims in the aftermath of Hurricane Katrina, and they are watching supplies of antidotes for venom.
Water moccasins are the most common threat, along with copperheads and rattlesnakes.
''Snakes leave the rising water just like people do," said Tom Arnold, medical director of the Louisiana poison control center in Shreveport. ''It's a matter of mixing people and snakes in proximity, and the outcome is bites."
Tales of snake sightings and bites are circulating in the area, prompting the Food and Drug Administration to alert makers of the venom antidotes. In Shreveport, La., drug wholesaler Morris & Dickson Co. said it has distributed 1,200 vials of CroFab, a costly antidote made by the British biotechnology company Protherics PLC, to hospitals since Katrina struck Aug. 29. Normally, it ships about 60 vials monthly.
''The last time we saw anything close to this was when Houston was flooded three or four years ago," said the company's vice president, Dale Kelley.
The demand for CroFab is one part of an effort by drug companies and government officials to bring in medical supplies. A list from a drug-industry trade group, known as PhRMA, in Washington, D.C., names 35 companies that are sending products. They include antibiotics from GlaxoSmithKline and tetanus and influenza vaccines from Sanofi-Aventis.
Pfizer Inc. said it has sent 300,000 bottles of its Purell hand sanitizer for emergency workers exposed to toxic flood waters.
In Cambridge, Biogen Idec Inc. said it has sent free doses of its multiple sclerosis drug Avonex to 100 people displaced by the storm, and in Rockland, Serono Inc. is supplying replacement MS and fertility drugs in the Gulf Coast.
Executives and federal officials said they are less concerned with shortages than ensuring patients have the proper prescriptions.
For example, the FDA has set up a Web page for diabetics to learn how long insulin supplies maintain potency without refrigeration. An agency spokesman, Yier Shi, said the FDA has also worked with Eli Lilly & Co., Aventis, and Novo Nordisk to help patients switch insulin brands.
Supplies of CroFab are another concern. The drug's name is derived from Crotalinae, the subfamily of pit vipers that threaten Gulf Coast residents, including water moccasins and copperheads.
Snakebites kill only a half-dozen people in the United States every year because of CroFab and an earlier antivenom product that Wyeth Pharmaceuticals started selling in the 1950s. In less-developed nations, snakes such as the saw-scale viper kill 100,000 people a year, said Sean P. Bush, a doctor and a snakebite specialist at Loma Linda University in California.
Molecules of snake venom can literally digest the tissue of a victim for as long as two weeks after an attack.
Antivenom serums consist of an immune molecule that neutralizes the venom molecule. The Wyeth product, Antivenin, was derived from blood of horses that built up resistance from being exposed to venom from North and South American snakes.
CroFab is distributed in the United States by Fougera of Melville, N.Y., a division of the German drug maker Altana Pharma AG. It comes from sheep, and it is more effective because it is derived only from North American snakes.
It is also expensive. Depending on the severity of a bite, doctors are advised to treat patients with as many as 12 vials of CroFab powder, at about $1,000 per vial. Because of the cost, and because it needs refrigeration, many hospitals stock just enough to treat the occasional victim.
As FDA officials watched news reports after the hurricane, however, they were struck at how often residents mentioned snakes in interviews, said Jay Epstein, director of the FDA's office of blood research and review.
Many spoke of seeing water moccasins, which are also known as cottonmouths because they expose the white lining around their teeth when threatened. They account for many of the roughly 450 venomous snakebites reported annually in Louisiana.
Epstein said the agency had contacted Wyeth and Protherics soon after Katrina struck.
The treatment has not been needed yet, because distributors and hospitals such as the University of South Alabama Medical Center at Mobile stocked up prior to the storm, and the US Centers for Disease Control and Prevention in Atlanta supplied enough CroFab to treat 33 people in Mississippi, an official said.
Since then, Bush, of Loma Linda University, who consults with Fougera, said he has heard from many doctors in the region who are concerned about snakebites. A snake specialist, Bush has also received dozens of e-mailed photos from rescue workers in the region; some show snakes slithering along debris or down wet roadsides.
Bush said, ''People aren't the only ones displaced."
An increase in poisonous snakebites feared