SA well stocked with antivenom, say experts as snakebite season looms

17 Nov 2023

Stakeholders say health facilities have sufficient supplies of antivenom heading into summer following a shortage earlier this year.

In April, the National Snakebite Advisory Group wrote a letter to Health Minister Dr Joe Phaahla, appealing for him to ensure funding and emergency upgrades of equipment and backup power supply at the South African Vaccine Producers’ production plant amid concerns over a shortage of antivenom.

Read more in Daily Maverick: Grave warnings from snakebite experts as minister of health is asked to intervene in antivenom crisis

The SA Vaccine Producers, part of the National Health Laboratory Service (NHLS), produces snake antivenom for sub-Saharan Africa.

Shortage resolved

On Tuesday, 14 November, Professor Timothy Craig Hardcastle, the spokesperson for the National Snakebite Advisory Group and one of the experts who signed the letter to the health minister, told Daily Maverick that the antivenom shortage had been resolved.

Mzimasi Gcukumana, the senior communications manager at NHLS, said more than 6,100 vials had been distributed across 302 medical institutions in South Africa between 1 January and 16 November, with 76 public and private health facilities in the Western Cape securing antivenom.

Western Cape Department of Health and Wellness spokesperson Byron la Hoe told Daily Maverick the antivenom situation in the province was “under control” as the Cape Medical Depot had secured 242 vials of antivenom at a cost of R495,465 from 1 October 2022 to 30 September 2023.

“There are no stock shortages in the Western Cape at the moment, no stock constraints. As of 9 November 2023, there are a total of 98 vials in stock at hospitals across the Western Cape,” La Hoe said.

Netcare’s general manager of emergency, trauma, transplant and corporate social investment, Mande Toubkin, told Daily Maverick, “This year, we have seen only 27 snakebites, but with most snakebites occurring during the summer months from December to March, it is still early.”

Types of antivenom

Two types of snake antivenom are produced in South Africa. Polyvalent antivenom is used to treat bites from the black mamba, green mamba, Jameson’s mamba, Cape cobra, forest cobra, snouted cobra, Mozambique spitting cobra, rinkhals, puff adder and gaboon adder. The second type is the monovalent vaccine made to treat the bite of a boomslang.

A newsletter published by the African Snakebite Institute in February said monovalent boomslang antivenom costs R6,800 per vial while polyvalent antivenom costs R2,130 per vial.

“In boomslang bites, patients usually receive two vials of monovalent boomslang antivenom, but in some cases a third vial may be necessary.

“In cytotoxic bites, such as a bite from a puff adder, doctors will usually start with five or six vials of polyvalent antivenom but in serious neurotoxic bites, such as a bite from a black mamba or Cape cobra, the patient will initially receive around 10-12 vials of polyvalent antivenom. Patients are monitored and may require more antivenom later,” the newsletter reads.

‘Prevention is better than cure’

Steven Meighan, the owner and founder of Deep South Reptile Rescue and chairperson of the Herpetological Association of the Western Cape, emphasised the significance of raising awareness in the ongoing snake season.

“Prevention is better than cure. It looks like things are okay, but we don’t know because the snake season has just started, and we don’t want to waste resources unnecessarily,” Meighan said.

“It is important that people take time to be aware of snakes. There are certain things that you can do to be careful. When you’re going out hiking, keep your dog on the leash until you get to places where you can let them off.

“Keep your garden clean and tidy. Don’t attract mice because mice are going to attract snakes to your house.” DM

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South Africa

Shortage resolved

Types of antivenom

‘Prevention is better than cure’