Achievements

The National Anti-venom and Vaccine Production Center had finished establishing its production plant and are now operating in the processing and filling of ampoules of antivenoms.

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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 anti-venom. It also has the potential of supplying the gulf states with specialized anti-venoms 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.