Achievements
The National Antivenom and Vaccine Production
Centre had finished establishing its production plant and are now operating in
the processing and filling of ampoules of antivenoms. As stated before, the
plant was designed and constructed according to the European standards of GMP. The
plant was visited by his excellency the minister of health who appraised the
plant and the center. A specialized inspection committee from the ministry of health
had registered the plant and stated that �it is constructed and operating according
to GMP�. The plant has the capacity to supply all
the requirement of the kingdom of antivenom. It also has the potential of
supplying the gulf states with specialized antivenoms if the demand arises.
Antivenoms against all saudi venomous snakes and all of the
highly dangerous saudi scorpions are prepared from immune sera raised mainly in
horses. The antivenom is raised also in goats to be used in victims who are
sensitive to horse sera. This procedure is unique for saudi arabia. The only
place, other than saudi arabia is England, where limited quantities of goat
antivenom against the European viper �vipera berus� can be obtained in addition to the equine antivenom.
The antivenom are prepared using hyper immunizing protocols
and plasma processing methodology developed over 25 years of research and being
extensively modified and improved at National Antivenom and Vaccine Production
Center. The different steps involved in antivenom production, therefore, can be
considered part of the assets of the antivenom and vaccine production center.
Antivenom in its final dosage form in a sufficient amount is
now available in the antivenom center cold stores. They have been formulated in
their final pharmaceutical dosage form in the late 1997 and the products are
already registered by the ministry of health in the kingdom. At the same time
further production and refinement of hyper immune plasma against the various
snakes and scorpions in the kingdom is proceeding at a constant rate to keep a sufficient
amount of antivenoms and to supply expected demand from neighboring countries.
The National Antivenom and Vaccine Production Center had
developed enzyme-linked immunosorbent assay (ELISA) that can specifically
identify all Saudi snakes and scorpions. Developing a sensitive and specific (ELISA)
technique was aimed to serve two purposes:
Identification of the causative culprit from a sample of
blood or tissue fluid. This would help selection of the specific antivenom and
the adjunctive therapy.
Titration of the antivenom in the severely intoxicated
victims until their blood is free of venom. This helps in saving lives and
avoiding consequences of inadequate therapy in particular strokes, myocardial
infarction and renal failure. Two very sensitive (ELISA) techniques were
developed in antivenom center at King Fahad Hospital against the two most
dangerous snakes walterinnesia aegyptia and cerastes. The
detection level in blood of experimental animals was 100 pg� (The international level for other venoms is
5 ng or 50 times greater). ELISA procedures for the other saudi scorpion and
snake venoms are developed but effort is till needed to reduce the time needed
for developing the colour to be less than 30 min to allow for rapid
administration of antivenom before severe toxicity occurs.
The development of sensitive ELISA for the saudi venoms will
allow the establishment at King Fahad National Guard Hospital, a center of
excellence for the treatment of severely envenomed victims all over the country
based on controlled serotherapy and properly selected adjunctive therapy. It is
to be mentioned that the only place in the world in which treatment of victims
of snake bites are accomplished with antivenoms and assessed by ELISA is in
Paris, France against limited European vipers. In Australia ELISA tests are
used to identify different species of jelly fish before giving antivenom.
