The funnel web and common spider bites
Reprinted from Australian Family Physician Vol. 33, No. 4, April 2004
extremities. Children are especially at riskdue to their lower body weight and thepotential for multiple bites to occur if spidersare handled. However, considering the largepopulation at risk, effective envenomation isvery uncommon. The male species is consid-ered to be the most venomous, and all13 funnel web spider fatalities documentedbefore the introduction of antivenom in 1980have been attributed to the male spider.
Sydney funnel web spiders are usually easilyidentifiable to the trained eye, but any largedark spider found in the geographic distribu-tion area should be treated with suspicion.
Other funnel web spiders
There are 12 described species and at least20 unnamed species in the more widely dis-tributed genus Hadronyche.
They are alsoaggressive spiders with at least six speciesdescribed as having a similar envenomationsyndrome to the Sydney funnel web spider.
As the potency of
venomappears variable in relationship to sex, size,health, feeding habits and geographical dis-tribution, all bites from these spiders shouldbe managed as for the Sydney funnelweb spider.
Although most funnel web spider bites arethought to be ineffective or ‘dry’, the clini-cal syndrome can be devastating and hasbeen lethal in both adults and children.While the causative venom is multicompo-nent, the key neurotoxins are the
-ACTXs actby slowing sodium current inactivationresulting in spontaneous repetitive firing ofaction potentials.
This triggers the releaseof excessive – and eventual exhaustion of –predominantly sympathetic neurotransmit-ters leading to the characteristic biphasicclinical syndrome.
Symptoms and signs of envenomation
The initial bite is usually painful and fangmarks are generally seen. The envenomationsyndrome is generally characterised by twophases: the first begins within minutes of thebite, and the second when the secretionssubside – typically many hours later.
Historically deaths have occurred in eitherphase of envenomation.Phase 1 is characterised by:
•bite site may be painful for days to weeksbecause of direct trauma and acidity of venombut no local necrosis has been recorded•local swelling, erythema and occasionallysweating.
•numbness around the mouth and spasms/ fasciculation of the tongue•nausea and vomiting, abdominal pain,acute gastric dilatation•profuse sweating, salivation, lacrimation,piloerection•severe dyspnoea as a result of noncardio-genic pulmonary oedema•mental status can rapidly progress fromconfusion to irrationality or coma•hypertension, tachycardia and vasocon-striction (hypotension may occur later)•local and generalised muscle fasciculationand spasm which may be prolonged andviolent (facial, tongue or intercostalmuscles, trismus) and difficult to manage.Phase 2 is characterised by:•hypotension•hypoventilation and apnoea•continuing acute noncardiogenic pul-monary oedema•coma, and, finally•irreversible cardiac arrest.
First aid and treatment
A summary of the recommended first aid andmedical treatment for funnel web spider biteis presented in
. The key points are:•ensure airway, breathing and circulation(ABCs) are maintained•prompt application of pressure immobilisa-tion bandage (PIB) to the affected limb•transfer to hospital, ideally whereantivenom, resuscitation equipment andmonitoring is available•intravenous access should be obtained•PIB should be removed only in an areawere appropriate resuscitation can occurand antivenom is available. (If PIB hasbeen removed and the patient deterio-rates it should be re-applied)•local tissue enzymes may inactivate thevenom, therefore the use of PIB may notonly be helpful in delaying the onset ofsymptoms, but may allow for a degree ofinactivation of the venom•administer antivenom as per protocol in
Figure 1. Geographical distribution of funnel webspidersFigure 3. Female Northern funnel web spider
Photo courtesy Vern Daffin
Figure 2. Comparison of size and appearance of male (left) and female (right) Sydney funnel webspiders
Photo courtesy Vern Daffin