Antivenom?

[Mort Hill]

I have found after many safaris that the concerns and worries about snakes will disappear after your feet hit the ground in Africa. It is like going through a sketchy part of town. When nothing happens, you tend to forget. That does not mean throw caution to the wind. I have been fortunate to see a great many snakes, as opposed to unfortunate and not see but feel. There is something eerily awe inspiring about coming face to face with that thing you so dreaded. Whether mamba, adder, boom slang or cobra, I just found myself observing the snake, and the replaying in my mind what had just happened. I just learned to listen for a frantic native tracker scream of “nyoka” and then heighten my awareness because they hate snakes worse than I do.

 

[John Camp]

• I am with Matt on this one. I know that we do not fear what we are accustomed to. I killed two copperheads in the yard last summer and I still walk through the yard and don't think anything of it. BUT, those snakes are super terrifying. Exotic dangerous stuff is always more frightening than domestic dangerous stuff. Nothing ever scared me as much as the coral snake I almost stepped on in the Veracruz jungle. It wouldn't keep me away, but man.

 

[rookhawk]

I realize the probability of getting bitten is small, but dang.....black mambas, geeen mambas, puff adders, cobras......

We've got plenty of rattlers here at home and I grew up around copperheads and water moccasins, but these African snakes seem to take things to a whole new level. Sounds like with some you have maybe a chance to get to a hospital; with others, not so much.

So does anyone carry antivenom? Is that typically something the ph or someone has along on their person? Would it be best to bring your own?

Are there antivenoms that are broadly effective against the most common bites? Are there reputable sources for getting the stuff so that you know it's not counterfeit or expired? What is the shelf life on a kit?

Or chance too small to worry about?

The antivenom may exist at a parks station, it may not. In Zim, getting it to you in time would be doubtful. Having a PH with the ability to communicate to get you the antivenom in time is doubly doubtful.

In RSA, you may have a shot.

Conditions for not dying from snakebite:

1. A plan established and discussed
2. Global Rescue or some other service to coordinate rapid response
3. A satellite phone to actually make the calls
4. A team that knows how to use your sat phone and who to call
5. The known numbers of the locations that have anti-venom ready
6. Cleared runways to get you the anti-venom and then to extract you...or helipad.

I've yet to see points 1-4 exist in Zim, but perhaps in RSA it is possible.

 

[Hank2211]

I have seen snakes on a number of trips to Africa, and killed a gaboon viper in Cameroon (on license) once. Most snakes you might encounter will get out of your way if they are aware of your approach. Some are nervous (black mamba for example) but most are not (puff adder for example). I was crawling on my belly trying to get closer for a shot when I came upon a puff adder . . . it moved away, and I expect most snakes would do the same, unless they are surprised or you annoy them.

The advice given here is sound (especially @rookhawk). Carrying or bringing anti-venom is simply not practical. You are very unlikely to die quickly with any sort of attention in the field. Med-evac like Global Rescue (the one I use) is practical, and with apologies to American Express, you shouldn't leave home without it.

The best course of action is to go to Africa and have a great time.

 

[Matt_WY]

Global Rescue is already in place, so good on that front. Due to the more experienced opinions here, I've decided on a more homeopathic approach. One for cytotoxins and one for neurotoxins. I should be good, as long as I still have some left if I get bit.

 

[Hank2211]

If all homeopathy was based on that principle, I think no one would argue about its effectiveness!

Far be it from me to argue with your choices of medicine, but I have found that The Macallan 18 tends to be the most effective for more serious woes.

 

[Dewald]

Yes! As of today I will refrain from negative comments towards Homeopathy... I will even profess to be a believer!

 

[Dirtdart]

Once while hunting on a farm in Namibia the PH stopped to let myself and another hunter take a photo under an ancient baobab tree. As we were striking a pose the other client pointed up in the tree and said, "What kind of snake is that?"
Immediately the PH says, "It's a f**king black mamba man get to the bakkie!" I am sure that the whole party broke their personal best and possibly some olympic records in the 50 meter dash that day. I can't think about it without laughing. Good times.

 

[AfricaHunting.com]

Here are some related articles:
- Snakebites - Who Gets Bitten & Who Dies?: https://www.africahunting.com/threads/snakebites-who-gets-bitten-who-dies.34771/
- How To Treat Snake Bites: https://www.africahunting.com/threads/how-to-treat-snake-bites.16857/
- Snake Bite: https://www.africahunting.com/threads/snake-bite.14712/
- Global Rescue Evacuates Man Bitten By African Cobra: https://www.africahunting.com/threads/global-rescue-evacuates-man-bitten-by-african-cobra.15356/

 

[TXhunter65]

On my first trip we saw a puff adder and black mamba while hunting we were in the truck both times, and I almost stepped on a puff adder laying on a rock step going into the lodge late one night, but it was 40 degrees so he wasn't wanting to move...thank goodness I didn't step on him though.

 

[Red Leg]

Global Rescue is already in place, so good on that front. Due to the more experienced opinions here, I've decided on a more homeopathic approach. One for cytotoxins and one for neurotoxins. I should be good, as long as I still have some left if I get bit.

View attachment 271893

Finally, a practical approach! (Though 18's are vastly more effective - and you'll die happier). The closest encounter I had was a warm fall day in Namibia. It was a gigantic black mamba and makes far better telling than representing any real threat. I suppose growing up in South Louisiana and living here in Texas make serpents simply part of the environment. That mamba and a gaboon viper were the most impressive poisonous snakes that I have seen. The Mozambique Delta has quite a few Boomslangs - we had a brown female hunting in the thatch above our heads one day at lunch. No one was excited - they are a rear-fanged snake and a victim has to really work at it to get bitten.

If you want something practical to worry about in Africa it is insects and bacteria. I'll take an encounter with a six-foot Egyptian Cobra over finding a tick embedded in me. Forget to take you anti-malarial, and ole Anopheles will put you in the hospital or kill you. The little pepper ticks of some areas of South Africa will give you a fever that will make you think you are dying, and everyone hates Tsetse flies. I don't know anyone who has contracted Trypanosomiasis, but ........ Oh yes, and did the cook really wash his hands before he worked on those sandwiches or the mixed salad? And as much as I love hunting the Zambezi Delta, I just know that a trematode flatworm may be gunning for me one day in one of those stinking sloughs.

On second thought, maybe worrying about snakes is the better course of action.

 

[sgt_zim]

100 USD per vial...that's way cheaper than CroFab (the blend used in the US for rattlers and cotton mouths). That stuff runs about 5k-6k/vial, and multiple vials are frequently necessary.

When I was an ED nurse, always fried my bacon when docs would write orders for CroFab for copperhead envenomations. It's made from the venom of 3 Crotalidae (rattlers) and cotton mouth. It has nothing to do with copperhead venom.

 

[Red Leg]

100 USD per vial...that's way cheaper than CroFab (the blend used in the US for rattlers and cotton mouths). That stuff runs about 5k-6k/vial, and multiple vials are frequently necessary.

When I was an ED nurse, always fried my bacon when docs would write orders for CroFab for copperhead envenomations. It's made from the venom of 3 Crotalidae (rattlers) and cotton mouth. It has nothing to do with copperhead venom.

I am not a doctor, but Rattlesnakes, Cottonmouths, and Copperheads are all sub-family Crotalinae and the anti-venoms, specifically for instance CroFab, typically made from the more toxic rattlesnake and cottonmouth, are intended for all three. I am pretty sure there is no specific copperhead anti-venom.

Though frankly, I'd rather ride out a copperhead bite without anti-venom. They won't kill a healthy adult, but the anti-venom can cause serious issues.

 

[sgt_zim]

Not trying to pick a fight, so apologies if this comes off as combative. And I totally agree, I'd never consent to CroFab if a copperhead bit me. I would insist, however, on a compressed schedule of small doses of morphine (or at least demerol). Low mortality rate notwithstanding, it has to hurt like a mofo.

sub-families look taxonomically close, but they're a different genus - Agkistrodon. The similar taxonomy is why it is often given for coppherhead envenomations, but the protein structures in copperhead venom aren't particularly close to the protein structures of rattler or cotton mouth venom. They're certainly more closely related than venom from elapids (coral snakes, cobras, etc), but still not particularly close. If you've ever taken organic chemistry and understand stereochemistry, you'll understand instantly why it is unlikely to be useful.

AFAIK, it has *never* been demonstrated as efficacious for copperheads. At 5-6K per dose, that's an expensive *maybe* which may end up requiring a few doses of epi and/or IV Benadryl. I had a patient go south, at a rate which you'd have to have seen to believe, from an allergy to Levaquin (which he didn't know he was allergic to). I was able to get him Benadryl 50 mg IV within about 90 seconds - and holy $h!+ he was getting bluer by the second. 60 seconds later, he was back to being pink and breathing normally. Anaphylaxis is no joke. Definitely count me out on CroFab for a copperhead envenomation. Every medication requires a CBA. And from where I sit, the balance sheet on this med is very heavy on the C and very light on the B for copperheads. If, OTOH, I were bitten by a sidewinder, diamondback, or canebrake, it'd be worth the risk to me.

FWIW, I always thought canebrake rattlers had a really cool specific epithet: Crotalus horridus.

 

[Red Leg]

Fair enough. So let's agree that anti-venom for a copperhead is probably a bad idea for more than one reason.

 

[sgt_zim]

Fair enough. So let's agree that anti-venom for a copperhead is probably a bad idea for more than one reason.

Totally.

 

[Brent in Az]

Do you guy's remember the reality T.V show called "Venom ER", I think it was called.? They treated Rattlesnake bite victims.

After seeing the aftermath of a bite, I know I don't want to get bit. A rattlesnake came within a 1/2" of sinking it's fangs in my hand. Fortunately for me, it missed.

 

[sgt_zim]

Do you guy's remember the reality T.V show called "Venom ER", I think it was called.? They treated Rattlesnake bite victims.

After seeing the aftermath of a bite, I know I don't want to get bit. A rattlesnake came within a 1/2" of sinking it's fangs in my hand. Fortunately for me, it missed.

That's where I got interested in understanding envenomation treatment. I think out there, that doc was dealing mostly with mojave and sidewinder bites - a long-haired, skinny dude with a short beard. He definitely seemed to know his business.

 

[JimP]

Yep, that doc treated a brother in law of a friend of mine.

When all was done he had received something like 120 vials of antivenom, if I remember right he hospital stay was well over $200K by the time that he was done and ready to go home. All for picking up a golf ball in some brush down in So. Cal.

 

[WAB]

Fair enough. So let's agree that anti-venom for a copperhead is probably a bad idea for more than one reason.

It really depends. I get hit by a copperhead on my left index finger a few years ago, hurt like a &$&@! The doc waited a couple hours before administering the anti-venom, but by that point the swelling was so bad they were afraid my hand was in danger. 3 days and 4 courses of antivenin later I was released from the hospital. Bastard was still under the step where he got me. Shot him right between the eyes.