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" In May I wrote about a critical coming shortage in coral snake antivenom, known as Micrurus fulvis, the only FDA-approved cure or coral snake bite available in the U.S. By some bizarre and slightly macabre coincidence, the expiration date for the existing vials of coral snake antivenom is October 31st, Halloween. Since the manufacturer of the antivenom, Wyeth (now owned by Pfizer) stopped making the drug back in 2003, the expiration of the existing stock would mean that there will be no drugs at all that can stop the effects of a coral snake bite in the U.S. For those who didn&amp;#039;t read my original article, it&amp;#039;s worth a reminder of exactly how coral snake bite works.  Corals are among the deadliest snakes native to the U.S. They are different from pit vipers (rattlesnakes, cottonmouths, etc.), which strike fast and inject hemotoxin into a bite, causing immense pain and swelling at the site. Instead, corals inject a potent neurotoxin by grabbing hold of their prey and gnawing for 20 to 30 seconds with their little teeth to work in the venom\u2014people who have been bitten liken the experience of removing a coral to that of peeling Velcro. The neurotoxin causes little pain, but takes effect on the victim usually within hours, causing slurred speech, droopy eyelids, and eventually a complete shutdown of the lungs. Victims who don&amp;#039;t get antivenom usually need to be placed on a ventilator or they will die. As I mentioned in my original article, Wyeth stopped making the antivenom because, with fewer than 100 bites per year, treating coral snake bites just wasn&amp;#039;t a good business, but before the company shut down its factory, they made a five year supply. That supply was supposed to last through 2008. When no other manufacturers stepped forward, the expiration date of the stock was extended to 2009, then again to 2010. So it turns out that the FDA has extended the expiration date on the antivenom again to October 31st 2011\u2014that&amp;#039;s good news for anyone who get&amp;#039;s bitten after this Sunday. The bad news is that, according to Leslie Boyer, M.D., the director of the VIPER institute at the University of Arizona, there is probably not enough remaining stock to last until next October. (Ironically, to extend the expiration date, the agency needed to sacrifice several vials of the precious stuff to test its efficacy.)  Nobody seems to know exactly how much coral snake antivenom is left, since many local hospitals in potentially affected regions are not always forthcoming about how much they have. &amp;quot;You&amp;#039;ll begin to see local shortages first,&amp;quot; Boyer says, &amp;quot;and the role of poison control centers will be increasingly important in the next couple of years, as the doctor taking care of such a patient or the ambulance driver or the patient himself will want to know where the nearest antivenom is. Will your hospital be the one with the antivenom? Probably not.&amp;quot; Boyer&amp;#039;s VIPER Institute is playing a unique role in the venom crisis. She took the lead several years ago when Arizona faced a critical shortage of scorpion antivenom, bringing foreign antivenom into the U.S. through an FDA experimental drug program. Now, the VIPER Institute has secured an FDA grant for $1.6 million to work with Mexican drug manufacturer Instituto Bioclon to import that company&amp;#039;s coral snake antivenom on a research basis. This will get the drug into the States, on a very limited basis, but the research aspect of it may be difficult at best. &amp;quot;The problem is that FDA rules as well as the practical and ethical issues involved in studying a rare and potentially fatal emergency make it very, very difficult to do a scientifically valid study in human beings,&amp;quot; says Boyer. Boyer hopes to be able to have some of the Bioclon antivenom available by springtime, which should help to alleviate any shortages that come as snakebite season ramps up\u2014as cold-blooded creatures, snakes aren&amp;#039;t that aggressive in winter\u2014but she warns that her program isn&amp;#039;t big enough to cover the eventual need.  &amp;quot;That is beyond the scope of the grant we&amp;#039;ve received,&amp;quot; she says. &amp;quot;We hope to cover a critical number of hospitals\u2014hopefully five or ten will be up and running in our study within a year or so. But our project does not have the funding or the capability to cover the entire U.S. need. And I think it&amp;#039;s a sure thing that people will go without antivenom within the coming year.&amp;quot; "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.popularmechanics.com/science/health/a6131/coral-snake-antivenom-crisis/>