Funnel-web spider bite: a systematic review of recorded clinical cases

Geoffrey K Isbister, Michael R Gray, Corrine R Balit, Robert J Raven, Barrie J Stokes, Kate Porges, Alan S Tankel, Elizabeth Turner, Julian White and Malcolm McD Fisher
Med J Aust 2005; 182 (8): 407-411.


Objective: To investigate species-specific envenoming rates and spectrum of severity of funnel-web spider bites, and the efficacy and adverse effects of funnel-web spider antivenom.

Data sources: Cases were identified from a prospective study of spider bite presenting to four major hospitals and three state poisons information centres (1999–2003); museum records of spider specimens since 1926; NSW Poisons Information Centre database; MEDLINE and EMBASE search; clinical toxinology textbooks; the media; and the manufacturer’s reports of antivenom use.

Data extraction: Patient age and sex, geographical location, month, expert identification of the spider, clinical effects and management; envenoming was classified as severe, mild–moderate or minor/local effects.

Data synthesis: 198 potential funnel-web spider bites were identified: 138 were definite (spider expertly identified to species or genus), and 77 produced severe envenoming. All species-identified severe cases were attributed to one of six species restricted to NSW and southern Queensland. Rates of severe envenoming were: Hadronyche cerberea (75%), H. formidabilis (63%), Atrax robustus (17%), Hadronyche sp. 14 (17%), H. infensa (14%) and H. versuta (11%). Antivenom was used in 75 patients, including 22 children (median dose, 3 ampoules; range, 1–17), with a complete response in 97% of expertly identified cases. Three adverse reactions were reported, all in adults: two early allergic reactions (one mild and one with severe systemic effects requiring adrenaline), and one case of serum sickness.

Conclusions: Severe funnel-web spider envenoming is confined to NSW and southern Queensland; tree-dwelling funnel webs (H. cerberea and H. formidabilis) have the highest envenoming rates. Funnel-web spider antivenom appears effective and safe; severe allergic reactions are uncommon.

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  • Geoffrey K Isbister1
  • Michael R Gray2
  • Corrine R Balit3
  • Robert J Raven4
  • Barrie J Stokes5
  • Kate Porges6
  • Alan S Tankel7
  • Elizabeth Turner8
  • Julian White9
  • Malcolm McD Fisher10

  • 1 Menzies School of Health Research, Charles Darwin University, Darwin, NT.
  • 2 Australian Museum, Sydney, NSW.
  • 3 NSW Poisons Information Centre, Sydney, NSW.
  • 4 Queensland Museum, Brisbane, QLD.
  • 5 University of Newcastle, Newcastle, NSW.
  • 6 Gosford Hospital, Gosford, NSW.
  • 7 Coffs Harbour Base Hospital, NSW.
  • 8 Tasmanian Museum, Hobart, TAS.
  • 9 Women’s and Children’s Hospital and University of Adelaide, SA.
  • 10 Royal North Shore Hospital, Sydney, NSW.



We thank the following for additional clinical information on spider bites: Dr Dean Powell, Dr Rochelle Facer (Concord Hospital); Dr Elizabeth Swinbourne (Mona Vale Hospital); Dr Alan Giles (Liverpool Hospital); Dr Bartrim (Ipswich Hospital); Dr Henry Kilham (Children’s Hospital at Wesmead); Dr David Lee (Blue Mountains Hospital); Dr Betty Chan (Prince of Wales Hospital); Dr Jeffrey Lui (St George Hospital); Professor Ian Whyte (Newcastle Mater Hospital); Dr Mark Miller (John Hunter Hospital); Dr Robert Dowsett (Westmead Hospital); Graham Wishart, David Hirst (South Australian Museum); Dr Lisa Boutin (Queen Victoria Museum in Launceston); Dr Richard Faulder (Yanco Agricultural Institute); and Dr Ken Walker (Museum Victoria).

Competing interests:

Associate Professor White is employed by the Women's and Children's Hospital, Adelaide, which is paid by CSL Ltd to provide a consultant clinical toxinology service for users of CSL antivenom and venom detection products.

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