By Robyn Joubert
South Africa’s stockpile of locally produced anti-venom is empty, leaving farmers and rural communities especially vulnerable to venomous bites.
The National Health Laboratory Service (NHLS) recently confirmed that it had stopped producing snake, scorpion and spider anti-venom due to ongoing loadshedding and renovations at the South African Vaccine Producers (SAVP) facility.
As a result, veterinarian clinics and hospitals – especially rural state hospitals – have run out of locally-produced anti-venom products, with the exception of boomslang anti-venom.
Johan Marais, CEO of the African Snakebite Institute (ASI), described the situation as “a mess”.
“The SAVP currently has no stock and claim that they will be back in production in April. Time will tell,” said Marais.
While neighbouring Eswatini produces a snake anti-venom, it is not cleared for use in South Africa. “Eswatini has far less venomous species and their product does not have approval from the World Health Organisation (WHO),” Marais explained.
An alternative, Pan African Premium, is being imported from India under Section 21 of the South African Health Products Regulatory Authority (SAHPRA).
“Panaf Premium is now being stocked by several state and private hospitals. Vets are also using it. So for now the crisis seems to have been overcome but we still have no scorpion or spider anti-venom,” said Marais.
Initial results of Panaf Premium are positive and it has WHO approval, but it has not undergone clinical testing.
“Panaf Premium needs to be administered in higher dosages than the SAVP Polyvalent anti-venom and is therefore more expensive. Like SAVP Polyvalent anti-venom, it is around R2 000 per vial, but patients need more ampules,” Marais said.
SAVP Polyvalent anti-venom is made using the venom of 10 local species: puff adder, Gaboon adder, rinkhals, green mamba, Jameson’s mamba, black mamba, Cape cobra, forest cobra, snouted cobra and the Mozambique spitting cobra.
Michele Clarke, Democratic Alliance Spokesperson on Health, said the NHLS’ failure to ensure supply has reportedly led to deaths.
“South Africa, once an exporter of anti-venom, is now forced to import substandard alternatives. This places thousands of lives at risk, especially in rural communities,” said Clarke.
South Africa records approximately 4 000 snake bites annually, with around 900 hospitalisations and 100 patients requiring anti-venom.
“Without urgent access to treatment, severe complications or death can occur. A single snake bite can kill within hours – without access to anti-venom, lives and limbs are being lost unnecessarily,” Clarke said.
Anti-venom may only be administered in a hospital by a medical doctor, and not even in a local doctor’s office. This is because many patients have an allergic reaction to anti-venom and require immediate treatment.
Preventing snake encounters
With no sure end in sight to South Africa’s anti-venom crisis, awareness of snake behaviour and preventive measures remain key defences.
Southern Africa is home to 176 snake species: 77 harmless and 20 deadly poisonous, according to ASI. September and October are peak snake season, with most snakebites occurring in the warm summer months.
“The biggest misconception people have is that snakes will attack them. This is not true. Snakes are generally shy and usually strike in self-defence. People get bitten when they step on snakes, try to handle them, or threaten them,” said Marais.
People are usually bitten on their lower legs when they accidentally step on snakes. In South Africa, 90% of snakebites are from Mozambique spitting cobras, puff adders, night adders, and snouted cobras, Marais said.
Dogs are particularly vulnerable to snakebites because of their instinct to attack. “When a dog sees a snake, it wants to kill it. Snakes rarely bite cats because cats are highly intelligent,” said Marais.
While livestock such as cattle and horses are occasionally bitten – usually on the face while grazing -fatalities are rare, he said.
Tips to reduce snake risk
- Snakes are territorial. Learn which dangerous snakes are common in your area and the type of venom they carry.
- Eliminate hiding places by keeping your property clear of clutter and long grass. Store firewood in closed boxes and fill rodent burrows.
- No plant, repellent or chemical – including Jeyes Fluid – will effectively keep snakes away.
- Snakes are mainly attracted by food such as rodents and dog food, so manage food sources.
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