Stonefish (Synanceia trachynis) Antivenom: In Vitro Efficacy and Clinical Use

Certain species of fish have long been recognised as venomous. Although venomous fish do not represent a substantial source of human mortality, they are responsible for a number of envenomations each year that are serious enough to warrant clinical treatment. To the author's knowledge, the only fish antivenom still commercially available is the stonefish antivenom produced by CSL Ltd. in Australia. This antivenom consists of the purified F(ab)2 fragment of equine IgG antibodies raised against the venom of Synanceia trachynis. The antivenom is cheap, and effective in neutralising all known clinical effects of serious S. trachynis envenomation. In addition, there is experimental evidence that stonefish antivenom neutralises the pharmacological effects of other fish venoms, particularly those of the lionfish (Pterois volitans) and the soldierfish (Gymnapistes marmoratus), as well as displaying cross‐reactivity with them in Western immuno‐blotting. The potential therefore exists for the use of stonefish antivenom in the treatment of severe envenomations by species of fish other than Synanceia spp.