Dancing with the black widows

Toxicologists are conducting a study to test a promising new form of antivenin to treat black widow spider bites. The drug that was first made in horses is now being made in sheep and processed differently. Jackson Landers gives a first hand account.

I lay on my back with my teeth clenched and my hands gripping the sides of a hospital bed. A crowd of strangers in white coats filled the tiny room. Waves of pain lapped from my abdomen into my chest as the venom worked its way toward my heart. An experimental antivenin drug was about to be injected into my bloodstream, and while I waited for the needle to go in, I reflected that if anyone in the world was the right person to be bitten by a black widow spider, I was that guy.

As a professional outdoorsman, I spend a lot of time around things that can bite, claw, stab or otherwise attack me. I have been lucky with snakes and reckless with bears. I have had some close calls with lionfish. It figures that the thing to finally nail me would be living on my own front porch — the black widow spider.

Despite their fearsome reputation, black widows are surprisingly shy and retiring. Over the course of your life, you have probably walked past hundreds of black widows without even realising it. Each one packs enough venom to lay out a heavyweight boxer for days, yet globally only a few people each year are killed by widow bites. Widow webs are easy to identify, messy and close to the ground. The perimeter of my house turned out to harbour a village of black widow webs.

I racked up as many as a dozen little black-and-red trophies a day. Fascinated by our proximity, I sought to learn more about these deadly neighbours.The black widow is unfairly named. Female spiders rarely kill the male after mating, and possibly only in captivity. The male looks very different from the mature female; he is smaller and brownish. (The hourglass marking is quite variable in both sexes.)

Both sexes carry the same venom, but the females have more of it and their fangs can inject it deeper.

One warm spring afternoon, I was bitten on the second toe of my left foot by a spider. I sat on a rock and removed the shoe. The squashed remains of a spider were smeared across the insole. I realised instantly what must have happened: a black widow from the porch had made its home in my shoe. For a long moment, I stared at my throbbing toe and wondered what to do. Some people are more affected by the venom than others. Most healthy adults experience a lot of pain and recover on their own. But others become incapacitated, and some die.

I decided to wait to find out what would happen. I dipped my foot into the cool water and decided I might as well pass the time by fishing. Meanwhile, the symptoms were progressing. I felt a warmth in my abdomen. This turned into pressure, which became a painful cramping. There could be no more denial and I headed for the University of Virginia hospital, in Charlottesville.

I knew the emergency room might not be able to do much. My research had taught me that while an antivenin exists, few patients actually get it. The medicine has changed very little since 1895, when it was discovered by a French physician, Albert Calmette. By injecting spider or snake venom into a horse, Calmette induced symptoms of a bite, causing the body to produce antivenin.

Blood could be drawn from the horse, and the substance could be isolated and stored for later use. While the antivenin has saved many lives, it carries dangers of its own. Some patients turn out to have a life-threatening allergy to horse proteins. So the medicine is given only if the victim seems to be at death’s door; most patients are expected to tough it out, an ordeal that can take days.

I wondered where the good medications were. Where was the morphine? The muscle relaxers? My answer arrived in the person of Dr Christopher Holstege, a toxicologist. Holstege finally explained what was on his mind. The hospital was one of several conducting a study to test a new form of antivenin, and wanted me to be a guinea pig. The drug, Analatro, was made in sheep rather than horses, and was processed differently, so it had fewer impurities to which the body could react.

It sounded promising, but there were risks. First, I could not take pain medications that would mask the drug’s effects: no muscle relaxers to fight the spasms that already gripped my rib cage like a vise. Second, the side effects were not well understood.

Finally, there was a 50 per cent chance that I would not get the antivenin at all but a placebo. I would be only the fourth patient to participate. Two of my predecessors had received the placebo. It all sounded so interesting that I could not bear not to volunteer. My symptoms progressed as I waited. My biceps cramped. I shivered and twitched uncontrollably.

At midnight, the mysterious substance was ready. It had been six hours since I was bitten. The room was crowded with doctors, nurses and medical students who were silent as the substance was injected. I felt a warm sensation in my upper arm, followed by a kind of rush. A wonderful warm flow spread from my left arm into my chest, then myabdomen. “This definitely wasn’t the placebo,” I said in a dreamy voice.

It could take years of study before the drug is ready, but if Analatro is approved, it could completely change the way black widow bites are treated. Instead of making patients wait through days of pain to avoid an allergic reaction to the equine proteins, doctors could administer antivenin immediately and discharge them within hours. When I got home at 4 am, I limped up the stairs and collapsed into bed. The next afternoon, I spied a little brown spider on the kitchen floor. I dropped a jar over it and took a series of photographs, and then it, too, met its end.