By Johan Marais
It’s been a particularly busy snakebite season, with the main culprits being the Mozambique Spitting Cobra (Naja mossambica), the Puff Adder (Bitis arietans arietans) and the Stiletto Snake (Atractaspis bibronii). As snakebites are not reported anywhere it is always difficult to obtain information about bites unless something appears in the popular press or on one of the social networks. I am also in touch with a number of doctors and hospitals that feed through information.
The biggest culprit when it comes to snakebites in southern Africa is the Mozambique Spitting Cobra. This is mostly because it’s a very active snakes that goes hunting for food and often ends up in suburban gardens. Disturbingly, many get bitten in their houses, often while asleep. Nobody quite knows why – its’ most likely that the snakes end up indoors by accident. They hunt for food, get to a wall and turn right or left, then get to a gap under a door and accidentally enter. But the real puzzle is why so many people are being bitten while asleep. One theory is that people move around a lot while sleeping and that the snake then bites in self-defence. Another theory is that the cobras smell people in the dark, not quite knowing how big a warm-blooded prey they are dealing with, the bite is a feeding–response bite. Such bites are always worse as a fair amount of venom is injected as opposed to a defensive bite during which the snake may inject no venom or very little.
Not all bites result in death, however. Often, bites like my Puff Adder bite get a lot of press coverage, and people quickly get a skewed picture of the situation. It also taints our approach to first aid treatment.
The vast majority of victims are laborers that work barefoot in fields and have very little access to medical care or ambulance services. It often takes the victims several hours to get to a clinic or doctor and they seldom know what snake was responsible.
Still, the identity of the snake is not vital in treatment. While it helps to know what one was bitten by, the physician should treat the symptoms and not a specific kind of venom.
These rural cases seldom make it into the press, and Black Mamba (Dendroaspis polylepis) bites are also seldomly reported, either because these nervous but dangerous snakes are good at avoiding people, or that victims actually die before they get to major hospitals and such deaths are never properly reported.
Worldwide there are in the region of five million snakebites a year with around 100 000 deaths. One paper talks about 6500 bites annually in southern Africa but that could be much higher – we just don’t have the data.