Ophiophagus Hannah

Red Cross Snake Antivenin

Snake Venom Serum Production by Red Cross

Manufacturing of Snakebite Serum: How does the Red Cross Produces Snake Antivenom Serum

The Red Cross Snake Farm produces various types of serum for snakebite victims, and is has been supplying for almost decade 6 types of snake antivenin to treat bites from cobras (Ophiophagus Hannah), king cobras (Ophiophagus Hannah Snake), banded kraits (Bungarus fasciatus Snake), Russell's vipers (Daboia Russelli Siamensis), Malayan pit vipers (Calloselasma Rhodostoma), and Green Pit Viper (Trimeresurus Albolabris).

Antiserums are normally prepared from blood plasma from horse immunized by injection of antigen. The purpose is to let the horse’s immune system generate "Immunoglobulin" that has neutralization activity and antigen specificity.
For snake antivenom production, the snake venom has been injected into a horse and after injection, the horse's immunoglobulin will be generated until it reaches required level, then its blood will be collected and the hemoglobin are separated from plasma to be turned back to the horse.

The plasma fraction, containing the immunoglobulin are used for antivenom production.
The plasma consist of many proteins but only immunoglobulin can neutralize snake venom.

Unrelevant proteins such as albumin, fibrinogen and others are removed in the purpose of the reduction of allergic reaction when injected.

Red Cross antivenin is always produced following the same process explained here step by step:

First, antivenin is produced by injecting snake venom into a horse and the weekly dosage is gradually increased until the horse is able to produce its own natural antivenin. To ensure that the product has the required strength, blood is drawn from the horse and tested at intervals.

When the antivenin meets the required strength, some blood is drawn from the horse (without causing any harm to the animal) and preserved in a clean, safe container.

Then the antivenin is purified: by means of sedimentation and sifting, non-antibody-related proteins (which tend to cause allergy when administered to patients) are extracted from the compound that has most direct effect against snake venom.

The serum is bottled and dehydrated to make it easy to transport and store for long periods.

Snake antivenin is now ready but to ensure the serum's effectiveness and safety many quality control tests are also conducted on animals under laboratory conditions in compliance with World Health Organization standards to be sure that Red Cross antivenin is proper for human use.

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King Cobra Antivenin to Neutralize 0.8 mg/ml of Ophiophagus Hannah Snake Venom

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King Cobra Antivenin to Neutralize 0.8 mg/ml of Ophiophagus Hannah Snake Venom

The Red Cross produces 7 kinds of Monovalent snake antivenin that separate into 2 major group that are snake antivenin against the neurotoxic snake (King cobra antivenin, Cobra antivenin, Banded Krait antivenin and Malayan Krait antivenin) and hematotoxic snake (Malayan pit viper antivenin, Green pit viper antivenin and Russell’s viper antivenin). The polyvalent snake antivenom are also produced against such 2 group of snake.

Administration

The freeze-dried antivenin must be reconstituted with the solution supplied (or 10 ml of sterile water for injection) prior to the administration.

Dosage of Neurotoxic snake antivenin King Cobra antivenon

Initial dose 100 ml. The reconstituted antivenin should be given by slow intravenous infusion (approx. 2 ml/min). Subsequent dose can be given every 12 hours according to the clinical symptoms.

Contraindication

None, unless the patient is known to be hypersensitive to constitutions of the product, appropriate precautions must be taken.

Side effects

Occasionally, transient tenderness at the injection site, cutaneous reaction and alterations in temperature may occur. In some cases nausea, vomiting and also circulatory reactions (e.g. tachycardia, bradycardia, hypotension, sweating, vertigo) and allergic reactions (e.g. with flush, urticaria, dyspnea) have been observed, extending in isolated cases as far as shock. Therefore, the patient should be monitored for an extended period of time.Therapeutic measures depend on the nature and severity of side effects. Antihistamines, if necessary adrenaline, high doses of corticosteroids, volume replacement, oxygen.

Special precautions

In cases of Cobra respiratory support may be essential. Since the antivenin is prepared from horse serum, sensitization to heterologous protein may occur in some individuals. To avoid serious allergic reactions, skin test should be performed prior to the administration by injection of 0.02 ml of 1:100 antivenin dilution intradermally. It should be noted that the skin test may not predict the anaphylaxis nor delay serum sickness reactions.

Storage and stability

Keep in tightly closed container and store below 25-degree Celsius. The product shall have a shelf life of 5 years from the manufacturing date.

The manufacturing plant of QSMI has developed to meet the GMP requirement and get the GMP certificated from Thai FDA since 2003.

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