SNAKES (not) ALIVE !!!!

This past Saturday, we were sitting on the porch outside our room enjoying a peaceful day. One of the docs, pediatrician Russ Ebersole, whose home is a stone's throw away, came over and asked if wanted to see a snake. After verifying that he meant a DEAD snake, we walked over to see a 2 foot long Gabon viper that had been killed by a villager not far from the entrance to the hospital compound. Since snakes can twitch for awhile after being killed, we kept our distance !! Note the long fangs in one of the pictures. 

Togo is home to many varieties of poisonous snakes including puff adders, cobras, Gabon vipers, and green mambas. Before going any further, it is important to say that NO missionary has ever been bitten here and that we try to walk on cleared pathways, always using flashlights at night! The docs here report that they see around a dozen bite victims a year and that deaths are infrequent, thanks to FAV Afrique, an antivenom that is good against multiple species of snakes.

There are 3 types of presentations that can be seen with snakebite. First is that of a swollen arm or leg with tissue destructiuon that can lead to loss of fluid volume, shock and cardiac arrthymias. Second is tissue destruction PLUS a blood clotting problem (DIC) that can lead to fatal bleeding. Third is a bite with a neurotoxic venom that can cause varying degrees of paralysis which can prove fatal.

 

Interestingly, only about half of snakebites inject venom; the rest are so-called "dry bites". If it is unclear that venom has been injected, the patient is initially monitored closely before the decision is made to give antivenom. That is because the antivenom is a horse serum that has the potential to cause severe allergic reactions.