Snakebite is arguably the most neglected of neglected tropical diseases. It is a disease of poverty with numbers of fatalities comparable to that of AIDS in some developing countries. Predominantly killing young and otherwise healthy individuals, neurotoxins paralyze their victims --resulting in death by respiratory failure. Most of these victims would likely survive with early access to emergency care. There is currently little funding to devise new approaches to address this problem, but with a volunteer, collaborative effort with colleagues at UCSF we have made the first inroad to solving a part of this ancient scourge and persistent modern tragedy.
Anticholinesterases are a group of commonly used, heat stable and inexpensive drugs that have been used for decades to reverse chemically- induced paralysis in operating rooms and, in intravenous form, to treat snakebite when antivenoms are not available or not effective. They have also been used with experimental success in animal models. We argue that developing inexpensive, heat-stable, easy-to-administer anti-paralytics could facilitate early treatment of snakebite and save lives. We recently made the first successful attempt to create a human model for neurotoxic paralysis specifically designed to test whether anticholinesterases can reverse paralysis caused by a drug that mimics neurotoxic snakebite paralysis. Our finding suggests a novel strategy for field treatment that could substantially decrease the worldwide burden of neurotoxic envenomation.