Spider Bites: Black Widow, Brown Widow and Brown Recluse Spider Bites
Guest: Dr. Bill Simpson – Family Medicine, MUSC
Host: Dr. Linda Austin – Psychiatry, MUSC
Dr. Linda Austin: I’m Dr. Linda Austin. I’m talking with Dr. Bill Simpson, who is Professor of Family Medicine here at the Medical University of South Carolina. Dr. Simpson, one of your areas of interest is spider bites. Tell us a little bit about which spiders we are most concerned about here in South Carolina, and what those bites look like.
Dr. Bill Simpson: The most likely to be problematic are the black widow and the brown widow. The one that we hear an awful lot about is the brown recluse. The brown recluse is not native to South Carolina. Only a small area in the most northwestern part of South Carolina might have a few brown recluse spiders, so we don’t see many bites from brown recluse spiders. It’s possible to bring a brown recluse into the area from outside, in household goods, but it’s very unusual for that to happen. They are reclusive. They stay away from us for the most part.
The black widow and brown widow are two that are in the area. The black widow has been here for hundreds of years, maybe thousands; I don’t really know, the brown widow, only for the last 15. It came over in household goods from Australia, into Florida, about 15 or 20 years ago, and has gradually made its way up the eastern coast of the United States.
Those two bites are not very prominent. You don’t see very much. They make a small injection. Their fangs are so close together, you can’t see two spots; just a red spot. You don’t really feel anything. They’re not painful. But, about two to six hours later, you develop severe muscle cramps, abdominal discomfort, nausea, vomiting, sweating, paleness; those sorts of things. And it can be severe enough where people have been diagnosed with appendicitis, and have undergone surgery for appendicitis, because of the board-like abdomen that the black widow, or the brown widow, bite gives. It’s a neurotoxin. It causes injury to the nerve, and is transmitted to other nerves sites and causes muscle spasm.
Dr. Linda Austin: Well, it sounds, then, as if a person may not even have any idea that they have had a black widow spider bite, or a brown widow spider bite.
Dr. Bill Simpson: Right. They may not. Usually, the spider is visible. They’re a good-sized spider; about the size of a quarter, if you count the body and the legs. So, they’re there. And the black widow is bright black, shiny black, with the red hourglass marking on the abdomen, usually; not always a fine hourglass, sometimes multiple spots. The brown widow is a little bit less distinctive looking, with a geometric design on the abdomen, and an orange hourglass.
Oftentimes, someone will have been working in an area where black widows, or brown widows, live. And that would be an area that’s not well-traveled by humans; the back of a woodpile, in a box at the back of the closet that’s not been disturbed for months at a time, outside in the carport, in an area that’s not disturbed very often, where you’re cleaning, or something like that, and you’ve reached in without looking, and now have a red spot on the back of your hand, then developed abdominal pain.
I’ve seen people who’ve opened up their boats for the first time after a winter, with a tarp over it. Many times, a black widow has built a nest in there. Black widows and brown widows build disorganized webs; not beautiful like orb weavers, banana spiders. They’re disorganized; very ugly-looking, webs, so you don’t really see the web. You just see the spider out and looking for prey, or sitting in the corner of the nest.
Dr. Linda Austin: So, if you know you’ve been bit, but you’re in that six-hour time period, and have not developed any symptoms, what should you do?
Dr. Bill Simpson: There are antivenoms for the black and brown widow. So, if you’re very elderly, or otherwise debilitated, an antivenom can be used to decrease the severity of symptoms; or if you’re very young. It can also be used in young individuals. For the normal person, they’re going to have pain and discomfort, but it can be treated in the emergency room or in your physician’s office. They should still go to see the doctor to follow up.
Dr. Linda Austin: Always, if you’ve had one of those bites?
Dr. Bill Simpson: Right.
Dr. Linda Austin: And, why wouldn’t you treat a middle-aged person, say a 30-year-old, with the antivenom?
Dr. Bill Simpson: Right. It’s made in horses, so there’s the possibility of a systemic allergic reaction to venom because of the horse serum that’s used. So, it’s not used lightly, usually. It’s used for people who are very ill, or otherwise very old, or very young.
Dr. Linda Austin: Untreated, could this be a deadly bite?
Dr. Bill Simpson: It could be in a very old or very young person, usually not in a normal adult.
Dr. Linda Austin: But you just get sick as can be, it sounds like.
Dr. Bill Simpson: Right. It’s not a fun experience for sure.
Dr. Linda Austin: Any special risk if this is your second black widow spider bite?
Dr. Bill Simpson: No. It’s a neurotoxin. The venom is neurotoxic, and there’s not an allergic response.
Dr. Linda Austin: How long does the sickness last?
Dr. Bill Simpson: A matter of days, usually; two to three days.
Dr. Linda Austin: Wow. So, that sounds like it’s quite serious.
Dr. Bill Simpson: It’s significant, definitely. It’s something where you don’t want to stick your hand out and let the black widow give you a chomp.
Dr. Linda Austin: Now, if you’re out camping, let’s imagine, 12 hours or so from the nearest hospital, should you, nonetheless, leave your campsite and try to get back to a city where you can be near a hospital?
Dr. Bill Simpson: If you’ve recognized; if you’ve seen, the spider, and seen the bite, then it probably is a good idea to get to medical attention. Twelve hours away, that’s a long hike. But that would be one of those times when you’d like to get closer to medical assistance.
Dr. Linda Austin: Any other spider bites that are commonly mistaken for a black widow or brown widow bite?
Dr. Bill Simpson: The brown and black widows are distinctive enough so that they’re not likely to be mistaken. The brown recluse bite is oftentimes over-diagnosed by physicians. Many physicians have diagnosed brown recluse bites on the basis of the appearance of the bite; a little bit of necrosis, death of tissue, a deep little pocket of dying tissue. That can occur with brown recluse bites. Because we have so few in South Carolina, there are many more things diagnosed as a bite that are probably not a bite by the brown recluse spider. They’re more than likely a skin or soft tissue infection.
Dr. Linda Austin: So, in a city the size of Charleston, let’s say, how many per year might come into the emergency room that actually are brown recluse? Any guess about that?
Dr. Bill Simpson: It would more than likely one or none.
Dr. Linda Austin: So, quite rare.
Dr. Bill Simpson: Right. We’ve had it diagnosed by physicians, I think, in a five-year span more than 500 times in South Carolina, which is a lot, as far as the number of bites that actually occurred. More than likely, it was more like five.
Dr. Linda Austin: Dr. Simpson, thank you so much.
Dr. Bill Simpson: Thank you.
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