Bay Area doctors create snake bite nasal spray treatment

July 29, 2013 8:14:49 PM PDT
Bay Area doctors have made a breakthrough that could save tens of thousands of lives. In some developing countries, the number of people who die from snake bites is comparable to death rate from AIDS. However, a groundbreaking experiment at UC San Francisco, with collaboration from the California Academy of Sciences and a hospital in India, could revolutionize snake bite treatment.

It's been two years since the California Academy of Sciences launched a major research expedition to the Philippines. Scientists were looking for new species. Dr. Matt Lewin was in charge of keeping them safe and was especially worried about venomous snakes.

"Unfortunately at the California Academy we've had the experience prior to my arrival that one of the scientists died from a snake bite," Lewin said.

That incident occured on an expedition 10 years earlier, but there have been no advances in treating snake bites for decades. If you can't get to a hospital fast the outlook can be bleak. There are an estimated 5 million snake bites a year and more than 100,000 deaths.

"Not only is it a global problem, it is probably the most neglected of neglected tropical diseases," Lewin said.

Lewin made emergency snake bite kits for researchers in the Philippines, but he knew they would be very difficult for someone with no medical training to use.

"What it did have was a lot of needles," Lewin said.

Luckily no one on the expedition was bitten, but on the way home Lewin started thinking he had to come up with something better. And eventually, he thought of the idea of using a nasal spray instead of a needle.

"It's a new trick for an old drug," Lewin said.

When Lewin got back to the Bay Area, he started talking with colleagues and little by little they came up with an experiment.

"We did this all in our spare time. We had no funding and we just kind of invented this as we went," Lewin said.

Some snakes, including cobras and kraits, kill with a neurotoxin that paralyzes the victim and stops them from breathing. A drug called neostigmine has been shown to reverse paralysis, but it's administered with an IV in a hospital. So, would it work as a nasal spray anybody could use?

"Drugs are absorbed through the nose very quickly," Lewin said.

The team had to find a volunteer willing to be paralyzed in controlled conditions. The experiment was done at UCSF with extensive safety precautions. The volunteer was carefully monitored as he was given a drug that paralyzed him, similar to the effect of a cobra bite. Then doctors administered the nasal spray.

"We didn't even need to do the measurements, the change was so dramatic and so obvious," retired State Department Dr. Lance Montauk said.

It worked and the results were so exciting that Lewin gave a talk on it at a medical convention.

A doctor named Stephen Samuel was in the audience and he joined the collaboration. They raised money for further research in India where snake bites are an extreme problem. Samuel was at an Indian hospital when the nasal spray was tried for the first time on a snake bite victim. Then, Lewin got the news a short time later.

"I got an email that said - we've done it. We've had a complete reversal and so I was practically in tears," Lewin said.

That patient in India is now fully recovered. The nasal spray is still in the experimental stage and won't work on every type of snake bite. However, it could be the start of a safe, cheap and easy way to save tens of thousands of lives. Written and produced by Jennifer Olney

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