The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites

Snakebite envenoming (SBE) is a priority neglected tropical disease, which kills in excess of 100,000 people per year. Additionally, many millions of survivors also suffer through disabilities and long-term health consequences. The only treatment for SBE, antivenom, has a number of major associated problems, not least, adverse reactions and limited availability. This emphasises the necessity for urgent improvements to the management of this disease. Administration of antivenom is too frequently based on symptomatology, which results in wasting crucial time. The majority of SBE-affected regions rely on broad-spectrum polyvalent antivenoms that have a low content of case-specific efficacious immunoglobulins. Research into small molecular therapeutics such as varespladib/methyl-varespladib (PLA2 inhibitors) and batimastat/marimastat (metalloprotease inhibitors) suggest that such adjunctive treatments could be hugely beneficial to victims. Progress into toxin-specific monoclonal antibodies as well as alternative binding scaffolds such as aptamers hold much promise for future treatment strategies. SBE is not implicit during snakebite, due to venom metering. Thus, the delay between bite and symptom presentation is critical and when symptoms appear it may often already be too late to effectively treat SBE. The development of reliable diagnostical tools could therefore initiate a paradigm shift in the treatment of SBE. While the complete eradication of SBE is an impossibility, mitigation is in the pipeline, with new treatments and diagnostics rapidly emerging. Here we critically review the urgent necessity for the development of diagnostic tools and improved therapeutics to mitigate the deaths and disabilities caused by SBE.

Is the elusive Gymnothorax polyuranodon really a freshwater moray?

Analysis of 36 records of the rarely encountered moray Gymnothorax polyuranodon indicate that juveniles and adults inhabit fresh and mildly brackish habitats (salinity < 5) in streams of the Australian Wet Tropics Eighty-one per cent of these records were from freshwater streams and collectively demonstrate that this species inhabits fresh water throughout all seasons. A survey of fish researchers, each with at least 100 h of field experience in Australia's Wet Tropics, revealed that 33% of researchers working in fresh waters (nine of 27 researchers) had encountered the species and 15% of researchers with substantial experience working in estuaries (two of 13 researchers) had encountered the species. The species was not sampled or observed in the nearshore marine environment. The only record of an elver of this species was, however, found in an estuary at a salinity of 33·4. This preliminary evidence suggests adult G. polyuranodon occupy freshwater habitats, but further research is required to understand the complete life cycle, including movements, habitat use and reproductive ecology of the species.

First record of quadruplets in the musky ratkangaroo Hypsiprymnodon moschatus

THE musky rat-kangaroo (Hypsiprymnodon moschatus) is endemic to the tropical rainforests of north-east Queensland (Johnson and Strahan 1982). It is the smallest (510 ? 530 g) and most unusual member of the marsupial superfamily Macropodoidea (Dennis and Johnson 1995). Unlike other macropodoids, H. moschatus is frugivorous, diurnal, has an opposable first digit on the pes, a running quadrupedal gait and possesses a relatively unspecialised digestive tract (Johnson and Strahan 1982; Dennis 2002). It also differs from all other macropodoids in typically giving birth to multiple young, usually twins ? although single young and triplets are regularly reported both in the wild and in captivity (Troughton 1967; Johnson and Strahan 1982; Johnson et al. 1983; Dennis and Marsh 1997; Lloyd 2001). However, the birth of more than three young has not previously been observed in H. moschatus or any other macropodoid, even though all species possess four teats.