Elsevier

Toxicon

Volume 48, Issue 7, 1 December 2006, Pages 860-871
Toxicon

Struan Sutherland—Doyen of envenomation in Australia

https://doi.org/10.1016/j.toxicon.2006.07.021Get rights and content

Abstract

Struan Sutherland (1936–2002) was the doyen of medical research in the field of envenomation and the ultimate authority on the medical management of envenomated victims in Australia for almost 3 decades. In 1981 as Head of Immunology Research of Commonwealth Serum Laboratories (CSL), he produced an antivenom against the Sydney Funnel-web Spider (Atrax robustus)—an accomplishment that had defied numerous previous attempts. Struan also invented the pressure-immobilisation technique of first-aid for snake bite. This ingenious, simple but safe and effective technique revolutionised first-aid management of snake bite and of some other types of envenomation. It made redundant the use of tourniquets and other dangerous first-aid treatments. Similarly, he helped to develop a snake venom detection kit, which enables doctors working at a victim's bedside to ascertain which snake was responsible and which antivenom should be administered. He had a very wide range of research interests and was a prodigious researcher publishing over 200 scientific and medical articles, numerous chapters in books and the standard Australian medical textbook on the management of envenomation, Australian Animal Toxins. He made major contributions to the understanding of the venoms of Australia's remarkable range of fauna including snakes, spiders, Blue-ringed octopus, ants, jellyfish and stinging fish. Struan served the medical fraternity and the public selflessly. He was always available to doctors, or to anybody, to give advice at any hour of the day or night, on management of envenomated victims. Members of the Australian Venom Research Unit, which he founded in 1994 at The University of Melbourne, now continue this 24-h advisory service.

Section snippets

Research orientation

Born in Sydney, he grew up and received education in the rural town of Bendigo, Victoria where his father was a bank manager. He graduated with a medical degree under somewhat adverse circumstances from The University of Melbourne in 1960 and then completed internship at The Royal Melbourne Hospital. He retained a link with this hospital for many years as an honorary clinical assistant physician. From 1962 to 1965 he served as surgeon lieutenant in the Royal Australian Navy.

Upon commencement of

Blue-ringed octopus venom

In 1967, a young soldier died rapidly in New South Wales after being bitten by a Blue-ringed Octopus (Lane and Sutherland, 1967), now known to inject tetrodotoxin. The creature responsible was freighted to CSL with a simple request to ‘investigate this animal’. This event sparked Struan's interest in venomous creatures. He was astounded that Australia lacked a current facility to study animal toxins. He installed octopus specimens in a suitable tank in his laboratory and set out to study them

Funnel-web Spider antivenom

One of Struan's most significant contributions to medical science was his production of an antivenom to the feared Sydney Funnel-web Spider (Atrax robustus). This creature had killed approximately 10 victims up to 1961, and it instilled fear into all who lived in its range. It is a very aggressive spider and may enter dwellings and inflict painful bites. Research on the venom had been done at CSL since 1956 but was shelved in 1963 because of lack of progress. Envenomation by the Sydney

Pressure-immobilisation first-aid technique

Another major legacy that Struan has left to the World is his first-aid pressure-immobilisation technique for snake bite. Until its invention, the usual first-aid treatment had been washing the wound, the application of a tourniquet, incision of the wound and suction of the wound. Even more bizarre treatments had been witnessed in the early days of European settlement of Australia. These included injections of ammonia or strychnine, oral administration of mercury, chloride of lime, snake venom

Snake venom detection kit

From time-to-time, various tissue samples arrived at CSL with requests to be assayed for snake venoms. These lead to his involvement in venom detection methods and ultimately to production of a venom detection kit designed to be used at the bedside of an envenomated victim as a rapid means of establishing a diagnosis and of identifying a genus of snake involved.

The initial work was the novel use of solid-phase radioimmunoassay (RIA) to detect Tiger Snake and Brown snake venoms and their

Education and leadership

Just as there was a void in envenomation research in Australia in the mid 1960s, so too was there a void in Australian education on envenomation. He improved medical management of the envenomated victim by succeeding in bringing the subject to the medical curriculum.

Over a period spanning nearly 30 years, in addition to scientific articles cited here, he wrote approximately 100 invited and uninvited journal articles, journal letters, case reports, books, book chapters and newspaper articles. In

Epidemiological and antivenom quality assurance

A study of 2144 cases of Red-back Spider bite is still the most comprehensive study of the clinical effects of the venom of this spider, the efficacy of antivenom and of adverse reactions to it (Sutherland and Trinca, 1978).

Quality assurance studies were done of antivenoms (Sutherland and Lovering, 1979; Sutherland and Trinca, 1981; Sutherland, 1992a) and of the rôle of anti-complementary activity in de novo reactions to polyvalent Australian and to exotic snake antivenoms (Sutherland, 1977).

Snake venoms

Struan studied snake venoms and their effects throughout his research career, adding substantially to the body of knowledge. He was a member of a group who determined that the venom of the then recently discovered Small-scaled or Fierce-snake (Parademansia microlepidotus, now Oxyuranus microlepidotus) was more potent than any other Australian snake and possibly of any other World species (Sutherland et al., 1978; Broad et al., 1979a).

With co-workers, a systematic study of the potency of all

Ant venoms

Allergic deaths from Jumper (Myrmecia pilosula) and Bulldog ant (Myrmecia pyriformis) stings are uncommon. Nonetheless, 2.7% of the population of Tasmania have developed allergy to Jumper ant stings (Brown et al., 2003a). No satisfactory treatment existed for these unfortunate victims.

In the early 1990s, Struan contributed to the work of two groups of scientists working on these ant venoms. One group, working at the Department of Pharmacology at Monash University, identified evidence of the

Spiders

In the first edition of his textbook Australian Animal Toxins (Sutherland, 1983a) and in later publications (Sutherland, 1983b, Sutherland, 1983c, Sutherland, 1987), Struan described a painful ulcerative lesion which he speculated might be caused by the bite of the White-tailed Spider (Lampona cylindrata). The lesion was similar to the lesion, which may be caused by the American Brown Recluse Spider (Loxoceles reclusa). He referred to the illness as ‘necrotizing arachnidism’. Considerable

Venoms of marine and aquatic creatures

Struan contributed to several studies of the venoms of jellyfish and fish. Although the Box Jellyfish (C. fleckeri) is probably the most deadly animal in the World, it did not attract his early attention—probably because an antivenom had already been produced at CSL. However, late in his career, he participated in a study of the haemodynamic actions of the venom and of the efficacy of the ovine antivenom, and of verapamil, in their prevention and treatment. Whereas the antivenom prevented the

Post scriptum

His outstanding research work and contributions to education about venomous creatures and their venoms and toxins did not go unnoticed. He was appointed consultant in clinical envenomation to the World Health Organisation in 1979. He was acknowledged by his professional peers with numerous awards and acclamations. He received the Australian Medical Association Prize for Medical Research (1977), the James Cook Medal of the Royal Society of NSW (1984), the Medal for Outstanding Contributions to

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