Snakebite crisis: KZN faces antivenom scarcity as snake season intensifies

Published Oct 6, 2024

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Durban — The KwaZulu-Natal legislature portfolio committee on health chairperson has raised concerns over the shortage of antivenom.

In a statement, Dr Imran Keeka expressed his concern over the reduction of antivenom which he says places “lives in grave danger”.

The chairperson expressed these concerns after a report by African Snakebite Institute (ASI) CEO John Marais in the Farmer’s Weekly publication in which he states that “no snake antivenom is being produced in South Africa at the moment by South African Vaccine Producers”, a situation which he claims has led to the death of thousands of dogs.

“While snakebite is not among the most common casualties seen in our health facilities, the reality is that KZN’s topography and terrain have a variety of venomous snakes, for example, black and green mambas, puff adders, rinkhals and cobras etc. which are often encountered on hiking trails. Antivenom availability is not only vital to saving human lives but equally important when our pets, especially dogs, encounter snakes,” Keeka said.

He committed to sending questions to the KZN Health MEC Nomagugu Simelane to establish the stock levels in our 68 hospitals, which he claims the process will be tedious, and can take weeks to get a response.

In the interim, Keeka said he had sent his concerns to the parliamentary portfolio committee on health chairperson Sibongiseni Dhlomo.

He said this is because managing the production and distribution of antivenom to provinces is the competency of the National Health Laboratory Services.

“This matter needs to be looked into urgently and certainly prioritised lest we find ourselves in a situation where one loss of life will be too much,” Keeka added.

Keeka’s statement comes days after IPSS Medical Rescue spokesperson Samantha Meyrick said the emergency service received reports of a worker who had been bitten by a snake while working on a railway line in the Tugela area in KwaZulu-Natal, on Friday.

A man was bitten by a black mamba while working on a railway line in the Tugela area on Friday. | IPSS Medical Rescue

“On arrival of paramedics, it was established that a 57-year-old man was bitten by a snake that has been positively identified as a black mamba,” Meyrick said.

“Due to the critical condition of the man, the decision was made to activate the AMS helicopter to airlift the man to an appropriate facility for further care.”

In an update, the emergency service said the snake was safely relocated and the man was receiving antivenom and was currently stable in the hospital.

In the April ASI newsletter, Marais said that in recent years we have experienced a severe antivenom shortage in southern Africa.

“Various reasons including power outages have been blamed for this shortage. Note that it is a shortage of antivenom and not of snake venom. There is more than enough snake venom available for the immunisation process. This has resulted in a variety of foreign antivenoms being imported and are sold under section 21 of the South African Health Products Regulatory Authority. It is quite a vigorous process where several documents need to be completed and submitted for each and every treatment,” Marais said.

He said several of these imported antivenoms do not cover the venom of all our highly venomous snakes and most of them have not been subjected to clinical trials. One therefore must rely on the manufacturer’s recommendations on dosages and such recommendations are often untested and inaccurate.

“For some of these imported antivenoms, you may require as many as 60-80 vials for a serious black mamba bite. As no hospitals stock such quantities, these antivenoms are largely ineffective.”

A man was bitten by a black mamba while working on a railway line in the Tugela area on Friday. | IPSS Medical Rescue

Following the incident, snake rescuer Neville Wolmarans said the season is gathering momentum. Snake sightings and incidents are on the rise.

He said a man was bitten by a black mamba and was airlifted to a nearby medical facility.

“By far the greatest common factor in snakebite incidents is wilful and deliberate interactions with the snakes!”

Wolmarans explained that less than 20% of laypeople can identify more than five common snake species. He emphasised that it's safer and more cost-effective to call professionals for assistance rather than risking a snakebite.

“Remember accidents are a reality but provoked biting responses are still the main contributors!”

He said that for snake-related incidents between the Umdloti River and the Tugela river the Ndlondlo Reptile Rescue Unit is on standby to assist at all hours every day. Please call Neville on 082 561 4969.

“I will ensure that we get the closest available team member to ensure your safety and that of the snake.”

Wolmarans added that this week he has been experimenting with lighting and setting up a little “filming set” and got a stark reminder not to become complacent. While running two stationary "locked off" cameras and doing the wrangling on his own, he was reminded why Mozambique spitting cobras are the largest contributors to southern Africa's snakebite statistics.

Meanwhile, last week Monday, September 30, Dingo Dinkelman’s wife, Kirst said Dingo had a venomous snakebite which, unfortunately, due to his allergy to snake venom, sent him straight into anaphylactic shock.

“Fortunately, we were able to rush him straight to (the) hospital. He is currently in ICU, on a ventilator and in an induced coma. The doctors are keeping him heavily sedated to give his body as much of a fighting chance to fully recover. We have a very long road ahead of us,” Kirst said.

She said an incredible team of amazing doctors and nurses whom they are grateful for is caring for Dingo.

“We have been blown away by the level of support we have received from people, and are so grateful for every single message of encouragement and support, and every prayer sent our way; we are needing each and every single one of them,” Kirst said about the support they have received.

“My husband is the toughest, bravest and strongest man I know, and TJ, Maddy, Rex and I are so thankful that he has fought so hard to stay with us, and are really praying and trusting for a huge miracle!!”

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