In the past five years [2010-2014] a total of 1,190 persons were victims of snakebites of which 95 proved fatal. This is according to statistics released yesterday by the Public Health Ministry. Based on the statistics provided by the Ministry men were more prone to the lethal bites.
Given this development, the Ministry has been on a focused mission to thwart the impact. This has translated to the Ministry’s recent acquisition of anti-venom treatment from Costa Rica. The anti-venom is currently available at the Georgetown Public Hospital Corporation [GPHC], said Chief Medical Officer, Dr. Shamdeo Persaud.
He disclosed that the Public Health Ministry has put the final touches on its protocol for treating snakebites while simultaneously anti-venom treatment is being made available at certified public health sites.
Dr. Persaud said available statistics and anecdotal evidence suggest that the public health sector must take a more aggressive stance to help curb incidences of life-threatening bites from venomous vipers rampant especially in the country’s heavily-forested interior communities.
“The Ministry procured separate preparations of anti-venom [PoliVal–ICP anti-venom]. They are available at Ministry of Public Health sites that have the necessary capacity to administer this treatment.
This poly-valiant anti-venom is indicated for use in the common viper [Labaria and Bushmaster] envenomation,” Persaud revealed.
GPHC currently has the capacity to implement the new protocol. The institution also has the ability to manage possible complications from the use of anti-venom including: allergic/anaphylactic reaction, which could be life-threatening.
The most common anaphylactic reactions are to foods, insect stings, medications and latex. If one is allergic to a substance, one’s immune system overreacts to the allergen by releasing chemicals that cause allergy symptoms.
Dr. Persaud said the GPHC Accident and Emergency [A&E] Unit is spearheading a training scheme for all relevant staff at Regional and District Hospitals nationwide to help prevent over-burdening the GPHC system.
The Ministry is also exploring best practices to monitor the physiological effects of envenomation [the process by which venom is injected into a victim through bite or sting] and its complications.
The current management protocols include supporting pain control, tetanus protection, blood transfusion, infection control and wound care for victims.
The Ministry is also in the process of rolling out the newly-crafted protocols nationwide and making available the necessary paraphernalia for proper management of snakebites.
As part of the snakebite sensitisation plan, communities will be educated about proper measures to implement and minimise contact with snakes and avoid their deadly bites. They are also being provided with guidance on safety measures to follow if bitten and participate in capacity-building training for all medical and health professionals on the management of snake bites at public health facilities.
One innovative move, Dr. Persaud said, will be establishing a national network of snakebite survivors to help raise awareness and promote safe practices among residents vulnerable to the reptiles of death.
The Ministry is also seeking the cooperation of all residents of high-risk areas including farms, forested areas, woodlands, grasslands and newly developed housing areas to: ensure that possible breathing sites for snakes be reduced by eliminating dumping and heaping of organic and vegetation waste such as branches, weeds, cuttings and coconut shells; remove overgrown vegetation that may serve as avenues to residents’ yards and public waterways by dangerous species of snakes; desist from discarding/dumping unused foods and food materials indiscriminately. This may attract rats and also snakes [searching for food] to the domestic surroundings.
Using personal protective equipment [PPEs] and observe caution signs when exploring, clearing or venturing into high-risk areas are other avoidance measures.
Bleeding, neurological complications and extensive tissue necrosis [e.g. gangrene] usually accompany bites from venomous snakes. And because anguine chomps frequently take place in the country’s heavily-forested interior areas, victims routinely have to be air-dashed to the capital for life-saving treatment.
This is always an expensive enterprise. However, coastal victims of bites from venomous serpents are a bit more fortunate in that they can readily get treatment at local health facilities for envenomation, which involves preventing further release of toxins in the victim’s body.
According to Dr. Zulfikar Bux, Head of the GPHC’s Accident and Emergency Unit, doctors must exercise more caution when administering anti-venom to snake-bite patients and must also familiarise themselves about likely side effects.
“The anti-venom is not like regular medication. You have to know about the dosage and how to administer it to the patient because not every single snake bite [is poisonous]. It’s the complicated bites…that are more serious [so] you have to anticipate complication because they are some amount of risks of hypersensitivity and severe allergic reaction to the anti-venom,” Dr. Bux explained.
Dr. Bux, who is also an emergency specialist, was instrumental in helping develop the protocol which guides administering of anti-venom in Guyana. He said the protocol meets the medical requirement and was accepted and approved by the Medical Advisory Committee of the GPHC.
Following the acceptance of the protocol, 20 doctors from the District Hospitals in Pomeroon Supenaam [Region Two]; Essequibo Islands/West Demerara (Region Three]; and Mahaica/Berbice [Region Five] were trained in implementing the new guidelines to treat snake bites.
“The training was well received by the doctors. We did a pre-test assessment which showed that physicians have limited knowledge in administering the anti-venom. Post-test results following the training showed that their knowledge base increased quite drastically,” Dr. Bux related.
He added, “Our next step will be to take the team to the hinterland to conduct the training. Once they have been certified as successful, we will distribute the protocol to those hospitals and implement the anti-venom participating medical institutions.”
Guyana is home to a wide variety of species of snakes, and of these, four are known to be deadly: the Labaria [Bothrops atrox]; the Carpet Labaria [Bothrops taeniata] and its close relative, the Bushmaster [Lachesis muta].
The latter is found in most parts of the country but is especially prevalent in the moist coastal plains, rainforest and arid grasslands.
The other deadly species include the Rupununi Rattler [Crotalus durissus] found mainly in the savannah grasslands and the Coral snake [Elapids] found in a variety of environments and move seasonally to diverse areas in search of food.
Guyana’s economy still depends heavily on agriculture and the heavy dependence farming, logging and mining exposes locals to the risk of contact with venomous snakes and their deadly and their lethal bites.
Meanwhile, the Ministry will continue year-round collaboration with all stakeholders to help reduce the incidences of snake bites should they occur. This Ministry officials are convinced will position the public health sector to guarantee timely intervention and adept management of victims to save their lives.
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