
Vipers, mambas and taipans: the escalating health crisis over snakebites - tetraodonpuffer
http://www.nature.com/news/vipers-mambas-and-taipans-the-escalating-health-crisis-over-snakebites-1.20495
======
harshreality
It should surprise no one that in much of Africa there are economic and
sociopolitical challenges involved in supplying antivenin. It's an economic
challenge even in first world countries, and antivenin is expensive as a
result.

There's no mention of what the snakes are doing in the first place when humans
run across them and get bitten, or how much good those snakes are doing by
saving people in those countries from a host of rodent-transmitted diseases.

The article seems to focus on two things:

1\. Focus less on advanced gene-splicing antivenin R&D, and more on
traditional antivenin production, because Africa has unmet demand. This is
merely a coy way of saying [more] developed countries should supply and
subsidize antivenin for less developed countries that can't pay.

Rather than blame developed countries for focusing on R&D that doesn't solve
Africa's immediate problem, some understanding would be in order. Genetic
engineering approaches, once R&D is done, probably scale better than the
traditional way of producing antivenin. Furthermore, anaphylaxis is a common
problem with many kinds of antivenin and other vaccines. Genetic engineering
approaches, which don't rely on purification of antibodies from animal blood,
lead to fewer, and perhaps not any, extraneous proteins in the antivenin. That
means less risk of an allergic reaction.

I don't know if that's the entire reason, but pharma companies don't
intentionally throw away money on R&D. If they're funding something, there's a
good reason.

2\. Improve the economics, politics, and scientific awareness of developing
regions of Africa (that is to say, most of it). I'm sure nobody has thought of
that before.

 _" Africa has an antivenin supply problem, and all we have to do to fix it is
modernize, educate, and politically stabilize those countries."_ Oh, that's
all? Why didn't someone say something before? Such an easy and obvious
solution to all those untreated snakebites.

~~~
vacri
> _It 's an economic challenge even in first world countries, and antivenin is
> expensive as a result._

Here in Australia, the funnelweb spider (around Sydney) is our only
particularly lethal arachnid. Recently they've been struggling to find enough
spiders to milk for the antivenom, and so have started to ask the general
public to lend a hand in catching the damn things.

[http://www.smh.com.au/environment/nsw-reminded-to-help-
catch...](http://www.smh.com.au/environment/nsw-reminded-to-help-catch-funnel-
web-spiders-to-help-with-antivenom-stocks-20151010-gk5wbj.html)

Interestingly, the 'spider safety kit' in that article is "a glass jar and a
plastic ruler" :)

~~~
tunap
The problem, as I experienced with _two_ black widow bites a few weeks ago is
I did not realize I had been bitten until the symptoms were in full effect. By
the time I realized it _was not_ a flu virus it was already too late. I didn't
even realize it was a spider bite until the weeping crater appeared at the
presumed mosquito bite sites.

~~~
bluejekyll
> already too late

Ignorance here; too late for what? Treatment? Meaning the wound was already
bad enough that you just had to let it heal on its own?

Just curious about what that meant.

~~~
nickthemagicman
Black Widows are primarily neurotoxic. They don't cause a lot of hemolytic
tissue damage at first and so the bite itself might not be noticable and the
bite wound might just look like mosquito bites. And the onset of the venom
takes hours. So you might not know you've been bitten until hours later when
you go from flulike symptoms to freaking full on insane pain all over. And
then all of your organs fail. So a major complication of venomous bites is
that your window to get to a medical facility can be notably decreased.

------
hackaflocka
According to Nassim Taleb, when all the lions were killed in the Middle East,
the goats multiplied, and they apparently love tree roots, which led to the
Middle East turning into desert (not sure if it's true, but he says it is and
I'm inclined to believe it).

Does anyone know what could be some unintended negative consequences of
exterminating all snakes?

It always amazes me that in North America, they exterminated Wolves from most
of place, and so were able to create a safe working environment for farming.
Although the deer population is a little out of control, it's not a as bad as
goats turning the land into desert.

~~~
sravfeyn
Snakes kill rodents that transmit various diseases (mentioned in the article)

~~~
zeveb
Could domestic animals (e.g. cats & dogs) keep the rodent populations in
check? Would _they_ get out of hand?

~~~
tunap
Perhaps if it was managed properly, ie: spay/neuter before release & replenish
the 'supply', as needed. For example, without natural predators the Hawaiian
islands are now swarming with feral cats, albeit theirs started as a human
problem(abandonment):

[https://encrypted.google.com/search?q=hawaii+cat+problem&gbv...](https://encrypted.google.com/search?q=hawaii+cat+problem&gbv=1&prmd=ivns&tbas=0&source=lnt&sa=X&ved=0ahUKEwjYgcaDhe3OAhVM2WMKHdVPBysQpwUIDQ)

------
hellrich
So why is no African government / company stepping in to produce antivenoms,
if the technology is supposed to be 80 years old and rather basic?

~~~
mhuffman
Well, this is going to be an unpopular opinion I'm sure, but a lot of Sub-
Saharan African countries seem to be shuffling Health and Human Services off
to Western countries to handle, while they use economic aid for more "corrupt"
purposes.

On the one hand it is always good to help people in need (especially
children), but on the other hand, since it is just "given help" and not
infrastructure development -- it tends to just kick the can down the road a
little further.

Worse, sometimes aid even helps to stimulate corruption and economic imbalance
that keeps many of those countries trapped in a borderline desperate cycle.

Here is an older, but still relevant, Wall Street Journal article that
discusses the predicament from an economic standpoint[1].

[1]
[http://www.wsj.com/articles/SB123758895999200083](http://www.wsj.com/articles/SB123758895999200083)

~~~
mafribe
Development aid also undermines democracy in developing countries because the
elites focus on pleasing foreign donor organisations, rather than being
accountable to their own population.

There is also a tendency of aid to destroy local economic structure, as the
local producers can often not compete on price with free aid.

If you look at countries that managed to develop (e.g. South Korea or China in
recent years), then they all did it without substantial involvement of foreign
aid.

It is interesting to reflect on why development aid is so popular in the
developed countries despite its obvious failures. Here are some reasons.

\- Development organisations serve as levers of soft power. (If you give us
XYZ, we'll fund your railway/sewage treatment plant/school).

\- On-the-ground workers of development organisations are convenient sources
of information and can often be used to supply false IDs for spies, military
operatives and the like.

\- Multi-national companies regularly support development aid, because it's
good and cheap PR.

\- Aid organisations are lucrative sources of income for their senior staff in
the developed world, and they well-oiled PR machines to keep the funds
flowing, and mute criticisms.

~~~
zeveb
> Development aid also undermines democracy in developing countries because
> the elites focus on pleasing foreign donor organisations, rather than being
> accountable to their own population.

Of course, it can be _good_ to undermine democracy, when the majority of the
population support e.g. female genital mutilation or burning witches.

------
danielbarla
Something doesn't seem right with the statistics used here. 5 million bites
sounds very high. The likely difference is the disclaimer from the article
"these numbers reflect estimated, rather than reported, cases". My guess is
that non-reporting is _very_ prevalent, but it's disproportionately likely for
non-serious bites. Deaths and very serious bites probably do get reported much
more frequently.

As a counterpoint, take this article investigating South Africa's KZN province
[1]. This province has most of SA's most venomous snakes, and also some of the
highest incidences of snake bites in SA. The article estimates this at 24 to
34 bites per 100,000 people per year. The mortality rate is between 1 to 2% of
these reported cases, bringing the total to 49 to 69 people per year, in a
province of just over 10 million. It's easy to see why snake bites are not a
particular focus; there are 9 different species venomous snakes in a
geographically large province. Contrasted with HIV / AIDS which kills many
tens of thousands a year in the same province, the difference is stark.

I'm honestly not sure why there's such a difference between the numbers in
these articles, but it's day and night.

[1]
[http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S...](http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009001100024)

~~~
harshreality
Why are you focusing only on SA? SA is not representative of Africa as a
whole, much less Asia.

[https://en.wikipedia.org/wiki/Epidemiology_of_snakebites](https://en.wikipedia.org/wiki/Epidemiology_of_snakebites)
paragraphs 2 and 3.

[https://en.wikipedia.org/wiki/Epidemiology_of_snakebites#/me...](https://en.wikipedia.org/wiki/Epidemiology_of_snakebites#/media/File:Number_of_snake_envenomings.svg)

~~~
danielbarla
SA is simply where I live / have some heresay experience with. While snake
bites are not unheard of, they are not exactly common either, so I'm skeptical
on the topic.

Nevertheless, I still think the poster on the original article is misleading.
It headlines with "~5 million snake bites", while your citation puts it at
anything between 1.2 to 5.4. Actual envenomings are between 420K to 1.8
million. That's a huge variance in itself, and the uncertainty is not
reflected in the article much.

My point is also that if they're inflating the estimated deaths by as much as
the reported bites to estimated bites, it's likely incredibly incorrect.
Deaths generally get investigated and reported, while lesser bites would not
necessarily.

------
RobertoG
I can't avoid to think that, at least in the case they use to illustrate the
problem at the start of the article, the problem would be solved with boots,
not with expensive antivenin.

~~~
manarth
That's partly economic: to be effective, you'd need to provide all of the at-
risk population with boots, whilst with antivenin, the cost is treatment for
those affected.

It wouldn't surprise me if the cost of prevention was higher than the cost of
treatment.

Secondly, there's also a cultural/environmental question: if the population
generally wear sandals or go barefoot, could they be easily persuaded to don
protective boots - especially if their feet are then continually hot and wet?
A Discomfort aside, could the boots increase the risk of other issues, such as
trenchfoot?

------
GrumpyNl
I don't believe the header so i don't believe the article. The header claim,
tens of thousands, "tens of thousands" \- 20,000 to 99,999 kills a year. I
call bs.

~~~
205guy
Yeah Science:
[http://journals.plos.org/plosntds/article?id=10.1371/journal...](http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0001018)

It was linked from the footnotes. Your uninformed beliefs or opinions are
irrelevant and your "bs" bravado is juvenile.

