Be­ware the black mamba

If sur­prised or cor­nered the black mamba will bite read­ily and may even bite more than once

Weekend Witness - - News -

THIS week, af­ter well-known Labour Court Judge An­ton Steenkamp died as a re­sult of a black mamba bite while trav­el­ling in Zam­bia with his wife Cather­ine, the African Snakebite In­sti­tute is­sued a state­ment de­bunk­ing myths and set­ting the record straight about the black mamba.

While de­tails of the in­ci­dent in­volv­ing Steenkamp are still un­clear, it ap­pears that the snake bit him on the lower leg and that they were sev­eral hours away from the near­est ma­jor town.

He died be­fore an­tivenom could be ad­min­is­tered.

The black mamba is by far the largest ven­omous snake in Africa, reach­ing close on four me­tres, and is rated as one of the dead­li­est snakes in the world.

It oc­curs from south­ern KZN through most of the province into ad­ja­cent Mozam­bique, Swazi­land, Mpumalanga, north­ern Gaut­eng, Lim­popo, North­west, the North­ern Cape and fur­ther north­wards through­out much of Africa, reach­ing Sene­gal in the west.

De­spite its rep­u­ta­tion, it is by no means an ag­gres­sive snake and will avoid hu­man be­ings if given the choice.

It never chases peo­ple — a rather pop­u­lar myth.

But if sur­prised or cor­nered it will bite read­ily and may even bite more than once.

This snake bites few peo­ple in South Africa, but of the dozen-odd snakebite fa­tal­i­ties recorded an­nu­ally, the Black Mamba ac­counts for about half of them, the other cul­prit be­ing the Cape Co­bra.

The venom of this snake is po­tently neu­ro­toxic and within min­utes of a se­ri­ous bite, vic­tims ex­pe­ri­ence pins and nee­dles in their lips, and of­ten speak of a metal­lic taste in the mouth fol­lowed by nau­sea, vom­it­ing, a paral­ysed tongue re­sult­ing in slurred speech, and ex­ces­sive sali­va­tion.

As the vic­tim weak­ens the eyes be­come droopy, the pupils di­late and the vic­tim may sweat ex­ces­sively. Breath­ing be­comes pro­gres­sively laboured and if un­treated, re­sults in death due to a lack of oxy­gen.

In any mamba bite it is of ut­most im­por­tance to get the vic­tim to the near­est trauma unit, or if you are far away from a hos­pi­tal, to meet an am­bu­lance half­way.

Paramedics can as­sist with ar­ti­fi­cial res­pi­ra­tion or even ven­ti­la­tion of the pa­tient, if they have the cor­rect equip­ment.

Once hos­pi­talised, the pa­tient will in all prob­a­bil­ity be ven­ti­lated while an­tivenom is ad­min­is­tered or ob­tained.

From a first aid point of view, pres­sure im­mo­bil­i­sa­tion (wrap­ping the af­fected limb tightly with a pres­sure ban­dage, not a tourni­quet) could de­lay the on­set of symp­toms, but a cer­tain amount of skill and train­ing are re­quired to prop­erly ap­ply pres­sure im­mo­bil­i­sa­tion.

If the pa­tient stops breath­ing, mouthto-mouth re­sus­ci­ta­tion could be ben­e­fi­cial but for a rel­a­tively short pe­riod only. A Bag Valve Mask Re­serve (BVM), in the right hands, could be life-sav­ing and if used cor­rectly, a pa­tient could be ven­ti­lated in this man­ner for more than an hour or two.

Only trained in­di­vid­u­als can use Bag Valve Mask Re­serves ef­fec­tively.

Ac­cord­ing to Jo­han Marais, CEO of the African Snakebite In­sti­tute, the treat­ment for se­ri­ous black mamba bites is an­tivenom. The poly­va­lent an­tivenom, man­u­fac­tured by the South African Vac­cine Pro­duc­ers in Johannesbu­rg, is ef­fec­tive for bites from South Africa’s mam­bas, co­bras, Rinkhals, Puff Adder and Ga­boon Adder.

In se­ri­ous Black Mamba bites, pa­tients re­ceive any­thing from 12 to 20 vials of an­tivenom.

In the past few months, South Africa has seen a few Black Mamba bites, and most of th­ese pa­tients were treated with an­tivenom and re­cov­ered fully. The dos and don’ts of first aid for snakebite are avail­able on the free African Snakebite In­sti­tute app — ASI Snakes. Oth­er­wise, the app can be down­loaded from www.africansna­kebite­in­sti­ The Black Mamba — de­spite its rep­u­ta­tion, it is by no means an ag­gres­sive snake and will avoid hu­man be­ings if it is given the choice. PHOTO: FILE

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