Snakebite antivenom shortage at crisis levels

* I have been given permission to use this image by Mike at African Reptiles and Venom

Snake experts are concerned that dwindling supplies of the polyvalent snake antivenom produced in South Africa, will lead to a bigger problem in the coming months.

The Echo spoke to Johan Marais, herpetologist and CEO of the African Snakebite Institute, who said the shortage of antivenom and production backlog at the SAVP is a major crisis for doctors and veterinarians throughout much of Africa.

“The shortage has been ongoing for years, but has worsened and has become a crisis in the last eight months,” he said.

Mr Marais estimates that there are 10-12 snakebite deaths per year in South Africa.

The polyvalent antivenom (SAIMR Polyvalent Snakebite Antiserum SAVP) produced in Johannesburg by the South African Vaccine Producers (SAVP), a subsidiary of the National Health Laboratory Service (NHLS) is the gold standard for the treatment of venomous snake bites.

This antivenom treats snakebites from the Black Mamba, Green Mamba, Jameson’s Mamba, Cape Cobra, Forest Cobra, Snouted Cobra, Mozambique Spitting Cobra, Rinkhals, Puff Adder, Gaboon Adder, Mr Marais said.

Mike Perry, the founder of African Reptiles and Venom, supplies the SAVP with the raw snake venom used to produce the polyvalent antivenom.

Mr Perry explained to the Echo that they keep 500 venomous snakes and extract venom from them monthly, this venom is freeze-dried at African Reptiles and Venom and the dry powder venom is delivered to SAVP.

“This dry venom is used to immunise horses to produce antibodies against the snake venom. The antibodies are the antivenom manufactured by SAVP,” Mr Perry explained.

But doctors and veterinarians, however, are unable to obtain the life-saving snakebite treatment very easily, which was the case when Steve Meighan, owner of Deep South Reptile Rescue, responded to a call about a cape cobra at a Noordhoek residence.

“When I received the call, I rushed through and upon arrival saw the snake had bitten the dog which was paralysed. I then spoke to the owner who told me her dog had been bitten on the lip,” Mr Meighan said.

It was the first time Debbie Munro's dog was bitten by a cobra, she told the Echo.

“ I had no idea whether it was a poisonous snake or not. I kept track of the snake, and when it was safe, put a pool net over it, took a picture, and sent it to Mr Meighan,” who she says arrived within 10 minutes and was so professional.

Mr Meighan instructed Ms Munro to immediately take her dog, Zoe, to the nearest vet, which was Noordhoek Veterinary Clinic.

On arrival, Zoe was kept calm and put on a drip. She was given one vial of antivenom but needed more, which the Noordhoek vet did not have.

Understanding the urgency Mr Meighan began calling around to locate antivenom and soon discovered that there was very little stock on hand.

“I called Fourways Veterinary Clinic to see if they had but no luck. I called Panorama Veterinary Clinic & Specialist Centre because I had previously organised for two other dogs that were bitten to get antivenom there, but they also did not have it. I reached out to my network and one of them found some at Bellville Animal Hospital.”

Ms Munro rushed Zoe to Tygerberg Animal Hospital where she was given another dose of antivenom and was kept overnight.

“This was an incredibly frightening and stressful experience,” she told The Echo. “I didn't know whether my dog would get the medication she needed in time.”

Ms Munro reports Zoe is doing great and is back to her happy self, but is concerned about antivenom shortages.

“A vial of antivenom at each of the veterinary clinics costs around R3000 each. We live in the deep south, where snakes are plentiful. What if I had been bitten? Where do I get antivenom, and what will it cost me?” she said.

NHLS spokesperson Mzimasi Gcukumana told the Echo that the SAVP is “working around the clock” to reduce and ultimately eradicate the backlog of antivenom production.

“Antivenom operations have been, and continue to be, affected by external factors such as erratic power supply, imported consumables and raw material availability. Despite this, we have upscaled our production and improved our processes, and during December, we were able to supply some provincial health departments and some private facilities, including 13 veterinary practices, ensuring an adequate supply across the country,” he said.

Going forward, Mr Gcukumana said the NHLS will roll out antivenom banks to be strategically positioned in high-risk areas for accessibility throughout the country.