Bites and Stings

The bites and stings by venomous animals constitute medical states of emergencies.  Without fast, competent treatment they can result in considerable injury and even in death.

Snakes

There are about 2,300 kinds of snakes in the world, classified into 13 families, 5 of which families are venomous snakes.  In Israel 3 of the venomous families are prevalent, representing 8 species: Israeli viper, viper, horned viper, burrowing asp, black adder, large Sahara sand viper, small Sahara sand viper and Palestinian viper.

The bites of the Israeli viper, viper and burrowing asp are the most significant, both with respect to the number of occurrences and their severity.   In the last year there have been 2 reports of viper bites in Israel

The bites of snakes in the viperous family (asps, adders and vipers) offer identical local symptoms of extreme pain and swelling at the site of the bite, and systemic symptoms such as lowered blood pressure, swelling in the respiratory tracts, and trouble with blood coagulation.  The severity of the venom poisoning depends on several factors, starting with the amount of venom released in the bite.  In about 25 percent of venomous snake bites, no venom is released.

The first aid treatment recommended in any snake bite are simple: have the person lie down, perfectly still, help him to calm down, immobilize the affected limb and keep it lower than the heart, and get the victim to the nearest hospital as soon as possible.

If there is a doctor or paramedic present, they can also give medications to sedate the victim and alleviate the pain, and install an intravenous drip.  In any case it is crucial to get the victim to a hospital immediately.

There are many popular superstitions about treating snakebites, none of which work, and all of which are extremely dangerous, including:  cutting the skin around the bite, sucking out the venom, freezing or burning the bite area, pouring hot liquids or alcoholic liquids, which will increase the flow of the venom through the victim’s blood.

Treatment is based on symptoms—primarily the decision to give or not to give antivenin serum.  The serum is given usually when there is a fast and violent onset of symptoms, or evidence of systemic symptoms.

There is an antivenin for venom of the Israeli viper and viper, but not for the burrowing asp.

Scorpions

Scorpions are venomous insects belonging to the arthropod family.  There are about 1000 known types of scorpions in the world.  21 kinds are prevalent in Israel, but only 5 belong to the family that are dangerous to people.

The most dangerous scorpions:

-Yellow scorpion.  The most dangerous of all scorpions of Israel, are prevalent in almost all parts of the country.

-Southern scorpion.  Found in northern Africa and in the southern Sinai.:

- Tunisian fat-tail scorpion.  Prevalent in the all areas of Israel, and its sting is almost as bad as the sting of the yellow scorpion.

Scorpions whose stings hurt, but are less dangerous:

- Black fat-tail scorpion.  Prevalent mainly in central Israel and in the south.

- Bicolor scorpion.  Prevalent from the sandy coastal plain to the Negev and also in Sinai.

- Black Judea scorpion.  Prevalent in the country from Beit Guvrin to the northern border.  This scorpion is less dangerous than those previously mentioned.

The venom of the scorpion has an effect on the nervous system, heart and blood vessels.  The sting itself is very painful, and when a lot of venom is injected, the effects on the body will be seen very quickly.  The reaction to the venom is restlessness, muscle cramps, lots of sweating and tearing of the eyes, faster pulse rate, and increasing damage to the heart until failure is possible. 

The treatment of a scorpion sting is similar to that for snake bite—calming the victim, immobilizing the affected limb, and quick transport to a hospital—and it is also advisable to put some ice on the sting, which will alleviate the pain, and slow the progress of the venom.

In the Emergency Room the scorpion sting victim is treated according to symptoms, and when the sting is serious, antivenin is administered.  Generally, the physicians will keep the victim under observation for six to eight hours.

As in the case of snakes, the best thing to do is prevent the sting in the first place:

- Be very careful when approaching places where venomous animals like to hide, such as underbrush, inside corners of buildings, and piles of wood or stones.

- Avoid putting your hands in these places, and if you need to move a pile of wood or stones, use a rod or pole to shift the materials before picking them up.

- When camping, take great care when you wake up, to check the tent and the sleeping back, and to shake clothes and shoes (outside the tent) before putting them on.

Spiders

Spider bites most often occur when a spider becomes caught in clothes, and then the clothes are worn.  Spiders do not go out of their way to bite, but only bite to defend themselves.  We will examine only two here.

Brown Recluse Spider  This is a small brown spider with long legs.  The bite itself in general is not felt at the time, and its affects felt only after several hours.  The bite causes a mild injury at the site, but sometimes becomes serious.  In rare cases the bite can cause serious problems with blood coagulation.  This toxic action is a result of the enzymes in the venom of the brown recluse.  The bite is treated according to its symptoms, with local treatments and more supportive treatment when there is systemic involvement.

Black Widow Spider  This is not a painful bite, and often is not felt when it happens.  The reaction to the bite usually develops within minutes, but can take up to several hours to develop.   The reaction usually takes the form of pain and burning in the area of the bite, then as the venom spreads through the body the victim experiences cramping, restlessness and anxiety, muscle rigidity in the stomach.  Advanced symptoms can affect major muscle groups in the chest, back and shoulders.  Other symptoms incude heavy sweating, high blood pressure, weakness in the legs.  All of this can last three or four days, but the patient will have weakness for several months after.

Treatment of the bite will include treating symptoms with pain medication, muscle relaxants, etc.  In the case of serious poisoning, an antivenin may be given.