Durban - MAY is when mambas mate and other snakes tend to hibernate. It’s also the month that the World Health Organisation launched a global strategy to halve the number of snakebite-induced deaths and disabilities by 2030.
The organisation recently noted that snakebite envenoming (the symptoms after being bitten by a poisonous snake) is a neglected tropical disease responsible for enormous suffering, disability and premature death.
It said more than 5.8 billion people are at risk of encountering a venomous snake, that almost 7400 people are bitten every day, and 220 to 380 die as a result.
The Independent on Saturday spoke to local herpetologists for their insights into bites in the province.
Snakebite expert at Netcare St Augustine’s Hospital Kevin McEwan recalled that about 15 years ago, he sent anti-venom for a boomslang bite to eManzimtoti, south of Durban, to treat a Scot who had collapsed on the apron of the old Durban airport, ready to fly out of the country.
The story emerged that he was a snake thief and smuggler, who had jumped into the milking pit at the old FitzSimons Snake Park to make a snatch and was bitten.
“Boomslang venom is slow-acting,” said McEwan.
“It took 24 hours before he felt any kind of oozing. He thought he was fine.”
McEwan said had the man made his flight home, he would most certainly have died.
Four months later, he returned to get up to his old tricks and was caught on close circuit television.
More recently - about seven or eight years ago - an eMkhomazi woman was rushed to St Augustine’s with a paralysed leg, believing she had been bitten by a black mamba.
“It was a stress reaction. She had not been bitten by a mamba,” he said, adding that it was a species that did not need an anti-venom.
“You have to be very careful with anti-venom,” McEwan stressed. “High doses are needed for mamba bites but there is the risk of a highly allergic reaction.”
It is a horse serum product, containing antibodies that humans are not used to, he said.
Most snake bites in Durban were from stiletto snakes, which do not require anti-venom treatment. They are mildly cytotoxic, damaging body cells, first causing swelling and later tissue destruction.
“It’s a cheeky little snake, with lots of fangs,” McEwan said.
He said it was important to establish the type of snake by asking what the victim remembered and watching their symptoms.
“Lots of people rush in, saying ‘it was a mamba’.”
Many recent bites had resulted from people trying to handle snakes, he said.
McEwan said St Augustine’s was no longer the only hospital that stocked anti-venom and now it was the norm for private and state hospitals in KZN to have it in store. However, he said recently there had been shortages.
“I am not sure what has driven this. I have had calls from other hospitals, wanting to tap into our supply.”
Deaths from snake bites that are either not reported, or word of them did not reach hospitals, probably because they happened in rural areas, he said.
“A black mamba, giving an aggressive bite, can cause respiratory paralysis in less than 20 minutes. The problem in outlying areas is that there may be little access to transport.”
Back to urban areas, McEwan said more and more people appeared to be encountering snakes, especially in places where habitats had been disturbed, such as complexes that were recently sugar cane fields and properties close to forests.
Snake catcher Nick Evans spoke of how he had been recently summoned to catch a cobra that had reportedly bitten somebody in eThekwini Municipality.
“He had tied plants to himself (to act as traditional medicine) but we couldn’t find where it had bitten him,” he said.
“It turned out that he had not been bitten, but was trying to get off work.”
Jason Arnold, also a snake catcher, said he was frequently called to residential complexes north of uMhlanga that were, until recently, “extremely wild habitat, an extension of the Hawaan Forest.
“Nobody called for snakes to be caught while the building was going on,” said Arnold. “But now that things are calm, the snakes are coming back to what was their home.”
He said most were seen in gardens but some would make their way into garages, wendy houses, pool pump covers and tops of boundary walls.
The largest he had caught there this year were a 2.4m black mamba and a 1.6m green mamba.
Another snake catcher, Byron Zimmerman, added that abandoned building sites were also attractive to a range of snake species, particularly those that feed on rats and frogs.
Evans, who himself was recently treated for a bite, said informal houses in newly cleared areas were vulnerable.
“There are more and more houses going up in the beautiful Inanda Valley,” he said, having caught a black mamba there last weekend.
“On Sunday night, a guy was cooking in a room and saw it coming through a hole in the wall.”
Out in the broader world, the WHO strategy focuses on a combination of community empowerment and engagement, improved access to safe and effective treatments, measures that strengthen health systems and move countries closer to achieving universal health coverage.
Most cases occur in Africa, Asia and Latin America. In Asia up to 2 million people are bitten each year, while in Africa there are an estimated 435 000 to 580 000 snake bites annually.
Envenoming affects women, children and farmers in poor rural communities in low- and middle-income countries. The highest burden occurs in countries where health systems are weakest and medical resources sparse.