By Eduardo M. Gonzales, MD
We regularly go home to the province where we have a farm and I’m particularly wary of snakes. How many Filipinos get bitten by poisonous snakes annually, and what should we do in case we get bitten by one?
The true incidence of venomous snakebites is difficult to assess and often is underreported, but the best estimates are that there are approximately 5.4 million victims per year worldwide, of whom 80,000 to 130,000 die and another 400,000 get disabled.
In the Philippines, deaths by snakebites per year have been estimated to be around 250.
Most of the species of snakes in the Philippines are harmless but the country is also home to some of the deadliest snakes in the world that is why poisonous snake bites still represent an important, albeit largely unpublicized, health hazard in the country, especially in the rural areas.
Venomous snakes in the Philippines
Poisonous snakes in the Philippines fall into four categories. various cobra species that are easily identified by their intimidating hoods inhabit the Philippines, including the king cobra, the world’s largest venomous snake, and three species of spitting cobras that have the ability to spit a blinding stream of venom at a target as far as 10 feet away. There are also pit vipers, brightly colored snakes that dwell in trees. There are coral snakes, of which several species are found in the Philippines and which are identifiable by their multicolor bands or stripes. And then there are sea snakes or kraits consisting of several species that dwell among mangroves, rivers, lakes, and streams though a few can be found in the open ocean.
Signs and symptoms of poisonous snake bite
A wide spectrum of clinical manifestations may result from a poisonous snake bite, including bite marks on the skin, which range from obvious puncture wounds to almost invisible small scratches. The person may also feel severe pain around the bitten area, tingling, stinging, burning, or abnormal feelings in the skin, swelling, bruising or bleeding from the site of bite or gums, swollen and tender glands in the armpit or groin of the limb that has been bitten, fever, headache, sweating, nausea, vomiting, thirst, stomach pain, anxiety, dizziness, drowsiness, confusion, blurred vision, breathing difficulties, swallowing problems, irregular heartbeat, muscle weakness, collapse or fainting, paralysis, and coma.
Do’s and don’ts in snake bite
A snake bite is a medical emergency that needs hospital management. In other words, the victim has to be brought to the hospital as soon as possible so that antivenom and emergency medical care can be administered. Antivenoms are the only antidotes for snake venom but even if not available, hospital emergency and supportive care gives the victim a fighting chance. In the Philippines, the only antivenom that is usually available in many government hospitals is Purified Cobra Antivenin (PCAV), which is produced by the Research Institute for Tropical Medicine (RITM). As its name implies, PCAV is effective only against cobra bites.
As first aid measures, the following are the do’s and don’ts in case of a snake bite:
• Clean the wound with soap and water.
• Apply pressure bandage to bitten limb.
• Make the victim as still and calm as possible. Carry him or her when transporting.
• Keep the bitten area lower than the heart.
• Immediately bring victim to the hospital.
• Do not try to catch or kill the snake, but try to remember its shape and color.
• Do not cut or slice the bite wound.
• Do not try to suck out venom.
• Do not apply tourniquet.
• Do not apply ice or immerse the wound in water.
• Do not give alcohol as a painkiller.
• Do not give caffeinated beverages.
• Do not elevate wound above heart or chest wall.
• Do not give aspirin and pain relievers.
• Do not apply traditional remedies.
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