Concerns over low antivenom supply

IT WILL take at least two months for the South African Vaccine Producers (SAVP) to get up to speed with the availability of antivenom supply. This is according to Foster Mohale, the national spokesperson for the Department of Health.

Mohale said the department had noted the concerns of some sections of society regarding the supply of snake antivenom, which was reportedly running short.

Antivenom is produced by the SAVP in Sandringham, Johannesburg.

“We are doing everything possible to ensure sufficient supply of this treatment, just like any other essential other health products. The matter is being monitored and the national department has had meetings with the SAVP. The supply is being monitored.

“Although the SAVP is doing partial deliveries due to supply constraints, it has assured the department that supply to hospitals is prioritised over the veterinary wholesalers.”

Mohale said there was no alternative supplier.

“The SAVP is the sole supplier. Special authorisation through a Section 21 application from the South African Health Products Regulatory Authority is not recommended as there is a risk of sub-standard antivenoms being procured, which will pose a safety risk.

“The antivenom from SAVP is produced from African snakes. The department is working closely with entities such as the National Health Laboratory Service to increase the supply level of life-saving treatment for snake bites available to everyone.”

Nick Evans, a snake catcher in Durban, said it was rare for humans to be bitten by venomous snakes.

“The only time your chances of being bitten increase is when you try to catch or kill a snake. This should be avoided as much as possible. If you don’t do anything to a snake, chances are it won’t do anything to you.

“I generally catch non-venomous snakes. But some venomous snakes prevalent in Durban include night adders, Mozambique spitting cobras and black mambas.”

He said the shortage of antivenom in Durban was manageable.

“The likelihood of snake venom being fatal is rare.

“This depends on the species of the snake, how far the venom was injected and the human body’s reaction to the venom.

“Most hospitals in Durban will generally have a supply of antivenom. Our current challenge is getting antivenom for dogs.”

He said dogs were most likely to be bitten because they attacked snakes. “The snakes then defend themselves by biting the dogs.”

Evans said hot spots for snakes included Silverglen and Shallcross in Chatsworth, Queensburgh, Reservoir

Hills, Shongweni, Inanda and Verulam.

The National Snakebite Advisory Group (NSAG) has called for urgent intervention to alleviate the crisis in management and care of snakebite victims.

“An open letter has been signed by 27 experts in the field of snakebite treatment, including highly experienced medical and trauma practitioners as well as antivenom and snake-handling experts," said Timothy Hardcastle of the NSAG and the Trauma Society of South Africa.

“The letter calls for the prevention of a situation where life-saving care can no longer be provided to patients in need of health-care assistance for snakebites.

“Antivenom has excellent outcomes when used timeously and correctly."

The NSAG offers a free national advisory support service to medical personnel, clinicians and centres in the public and private sectors.

Since 2017, the group and its affiliated members have actively educated the public and health-care professionals to facilitate the appropriate management of snakebites in southern Africa.

“At present our greatest concern and challenge is the unreliable production of the South African Vaccine Producers’ products due to management, staffing constraints, animal welfare, unreliable generator capacity, machine breakdowns and refrigeration issues.”