SNAKEBITE IN PAPUA NEW GUINEA: A BRIEF OVERVIEW

David Williams BSc


Snakes are widely feared in Papua New Guinea, and with very good reason. Venomous snakebite is a serious public health problem, with localized incidence among the highest of any tropical region in the world.

In Central Province, the incidence averages 215.5 victims per 100,000 people, but in some sub-provinces, such as Kairuku (which includes Yule Island and the villages of Bereina and Veifaa) the localized incidence exceeds 1,300 victims per 100,000 among the highest incidence of snakebite in the world. Each year in Central Province an average of 7.9 victims per 100,000 die as a result of snakebites, and this figure may in fact be far higher many victims die before they can reach Aid Posts and Rural Health Centres, and these deaths rarely register in official statistics. In studies conducted during the early 1990s in Central Province, it was found that children accounted for 16% of envenomed patients, with 8.5% being below 10 years of age, while the overall mean age of patients was 25.0 years. At this stage there is very little detailed information available about the incidence, or mortality arising from snakebites in other provinces of southern Papua New Guinea.

Perhaps the most astonishing revelation in Central Province has been that despite the view of the general community that Papuan blacksnakes (Pseudechis papuanus) are the most dangerous species; the opposite is in fact true. A staggering 82.3% of patients admitted to Port Moresby General Hospital with symptoms of snakebite, have been found to have been bitten by a much more dangerous snake, the Papuan taipan (Oxyuranus scutellatus canni) a large (to 4 metres), fast-moving snake with the third most toxic venom of any snake in the world! Papuan taipans are also common across Milne Bay, Gulf and Western Provinces, and in southern Irian Jaya, and there is evidence that in remote communities, the mortality rate after bites by this species is 100%.

There are also five other species that are considered medically important, and these are distributed throughout Papua New Guinea and Irian Jaya, including: death adders (Acanthophis spp.), the Papuan blacksnake (Pseudechis papuanus), the Papuan brown snake (Pseudonaja textilis), New Guinean small eyed snake (Micropechis ikaheka) and the Papuan mulga snake (Pseudechis australis). At the present time however little is known about either the incidence or mortality associated with snakebites in most other regions of Papua New Guinea. An ongoing study of snakebite in Western, Gulf and Central Provinces by this author is helping to build a clearer picture of the extent of the problem in southern Papua New Guinea, but there is a need to broaden this focus to take in all parts of the country.

Currently the only medical treatment available for snakebite victims includes the use of extremely expensive (K$3,300.00 per dose) antivenom purchased from Australia, combined with the use of mechanical ventilation and other drugs. Several scientific studies have identified serious problems with the ability of this antivenom to reverse the most serious, life-threatening effects of some snake venoms, particularly Papuan taipan venom. At the same time, the high cost often leads to shortages, and for many victims, there simply is no antivenom available when required. The aim  of my current research effort is to catalyse the development of new low-cost, safe and efficacious antivenoms for local production and distribution through Papua New Guinea and Irian Jaya.

REFERENCES

1.       WILLIAMS DJ, KEVAU IH, HIAWALYER GW, et al. (2003) The epidemiology of snakebite in the Mekeo Region of Central Province, Papua New Guinea. 14th World Congress on Animal, Plant and Microbial Toxins, Adelaide Australia 2003.

2.       WILLIAMS D, BAL B (2003) Papuan taipan (Oxyuranus scutellatus canni) envenomation in rural Papua New Guinea. Annals of the Australasian College of Tropical Medicine. 4(1):6-9.

3.       WILLIAMS DJ, KEVAU IH, HIAWALYER GW, et al. (2002) Analysis of Intensive Care Unit admissions for treatment of serious snakebite at Port Moresby General Hospital. 6th Asia Pacific IST Congress, Cairns Australia 2002.

4.       OSHEA MT (1996) A guide to the snakes of Papua New Guinea. Independent Publishing Port Moresby (PNG).

5.       LALLOO DG, TREVETT AJ, SAWERI A, et al.  (1995) The epidemiology of snakebite in Central Province and National Capital District, Papua New Guinea. Trans Roy Soc Trop Med Hyg. 89:178-82.

6.       TREVETT AJ, LALLOO DG, NWOKOLO NC, et al. (1995) The efficacy of antivenom in the treatment of bites by the Papuan taipan (Oxyuranus scutellatus canni) Trans Roy Soc Trop Med Hyg.89:322-25.

7.       TREVETT AJ, LALLOO DG, NWOKOLO NC, et al. (1994) Analysis of referral letters to assess the management of poisonous snake bite in rural Papua New Guinea. Trans Roy Soc Trop Med Hyg. 88:572-74.

8.       CURRIE BJ, SUTHERLAND SK, HUDSON BJ, SMITH AM (1991) An epidemiological study of snake bite envenomation in Papua New Guinea. MJA.154(4): 266-8.


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