title: Cross reactivity between venomous, mildly venomous, and non-venomous snake venoms with the Commonwealth Serum Laboratories Venom Detection Kit.
abstract: OBJECTIVE
  Studies have noted the relatively common occurrence of positive urine results with the Commonwealth Serum Laboratories Venom Detection Kit (VDK) when testing patients with suspected snakebite who are not envenomed. Possible explanations have been false positive test results or subclinical envenoming. We investigated a third possibility, that there is potential for the venom (or saliva) from mildly venomous and non-venomous snakes to give a positive reading with the VDK.
  
  
  METHODS
  Venoms/saliva from three non-venomous and seven mildly venomous snake species were tested in the laboratory with the VDK, along with control venoms from four of the five major snake genera (Brown snake, Tiger snake, Death adder and Black snake).
  
  
  RESULTS
  Two of the venom/saliva samples, from Gould's hooded snake (Parasuta gouldii), a mildly venomous snake, and the Black-headed python (Aspidites melanocephalus), a non-venomous snake, caused a positive test for the tiger snake genus. There was also cross-reactivity between black snake venoms and the tiger snake well of the VDK.
  
  
  CONCLUSIONS
  This study provides a further possible explanation for 'false positive' VDK results, that is venom/saliva presence or absorption from mildly or non-venomous snakes and cross reactivity with venomous snakes on VDK testing. It has implications for antivenom use should it ever be required for more severe envenoming syndromes from mildly or moderately venomous snakes, and for further research. It reinforces the practice of only using VDK testing in patients who show definite evidence of envenoming.
authors.affiliation: Discipline of Emergency Medicine, School of Primary, Aboriginal, and Rural Health Care, University of Western Australia, Australia. sun_and_smiles6@hotmail.com
authors.forename: George A
authors.initials: GA
authors.lastname: Jelinek
authors.forename: Charles
authors.initials: C
authors.lastname: Tweed
authors.forename: Dania
authors.initials: D
authors.lastname: Lynch
authors.forename: Tony
authors.initials: T
authors.lastname: Celenza
authors.forename: Brian
authors.initials: B
authors.lastname: Bush
authors.forename: Nick
authors.initials: N
authors.lastname: Michalopoulos
mesh_terms: D000818:Animals; D001315:Australia; D004632:Emergency Medical Services / Q000379:methods; D005189:False Positive Reactions; D006801:Humans; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D012909:Snake Bites / Q000175:diagnosis*; D012910:Snake Venoms / Q000032:analysis*; D012911:Snakes / Q000145:classification*; D013045:Species Specificity
chemical_list: D011933:Reagent Kits, Diagnostic; D012910:Snake Venoms