Three-month old Tshepo was fast asleep in his bed when, around 22:30, he started screaming. This was not his usual attention-seeking cries, this sounded quite agonizing. His mother rushed over to his bed and picked him up. He was squirming and crying out loudly. A few drops of blood soaked through his vest high up on his chest, and she immediate realized that there was a problem. While still puzzled and trying to work out what was going on, Gladys called her husband in a panic and as he arrived in the room, he noticed a large brown snake disappearing under the bed.
Both ran out of the room with little Tshepo and called the neighbours to help. While walking to the nearest road to await transportation to hospital, one of the neighbours killed the snake – it was an M’fezi (Mozambique Spitting Cobra).
It took close to an hour to get Tshepo to the local hospital, and by that time a dark patch had already formed just above the bite marks on his chest. As the local hospital had no antivenom, Tshepo was transported by ambulance to the regional hospital, but only got there about two hours later. He was treated with six vials of polyvalent antivenom, a product of the South African Vaccine Producer, that is used for the most serious snakebites in South Africa.
By the next morning some blisters had formed and over the next few days a necrotic wound had formed. Despite keeping the wound clean and replacing the dressing daily, Tshepo developed an aggressive bacterial infection known as Aeromonas. He died two days later.
The Mozambique Spitting Cobra (M’fezi), is a common snake throughout much of southern Africa, occurring from south of Durban throughout much of KwaZulu-Natal into Swaziland, eSwatini, Mozambique, Mpumalanga, Gauteng, Limpopo, Northwest Province and elsewhere further north. It averages around 1,2m in length but can reach 1,8m. Though primarily active at night, it may also hunt during the day. It feeds primarily on rodents, frogs, and other snakes, especially the Puff Adder. It is locally abundant, living under rocks and logs, in termite mounds and often found close to water. It may be attracted to homes where there are rodents and frogs or poorly maintained gardens with shelter in the form of building material or piles of rocks.
The venom of this snake is primarily cytotoxic, causing severe pain, swelling, and tissue damage. In small children and pets, it may also affect breathing. In addition to biting, it can also spit its venom as far as 3 m. As very little venom is spat each time, it can spit more than a dozen times. The spitting action is very effective, and the snake aims for the eyes.
On the skin the venom does no real harm and can be washed off, but in the eyes it causes instant pain. Victims need to rinse their eyes with lots of water and see a doctor, who will examine the eyes and prescribe an antibiotic ointment. Recovery usually takes two or three days and there are rarely serious complications.
If one looks at serious snakebites in South Africa, the Mozambique Spitting Cobra is on top of the list and is probably responsible for most serious snakebites. Many victims are bitten in the face, or on the chest or arms while asleep in their beds. This does not only happen in rural areas where people often sleep on the floor – it also happens in exclusive game lodges, where overseas visitors are paying thousands of rands a night for their room.
It was often thought that these “bed bites” were because of snakes seeking heat and accidentally being rolled on, but having studied hundreds of cases, it is evident that these snakes are accidentally ending up in houses while hunting. On them finding a sleeping mammal, they are biting in a feeding response – literally mistaking humans for meals!
Entrance is usually though an open door or entering under a door if there is a gap big enough for you to squeeze a finger through. Open windows are not much of a problem, unless there are plants growing up against them.
Preventing such bites is quite easy – seal off openings by having mosquito doors installed onto all exits, sealing off gaps under doors with rubber of sponge, and by sleeping under a mosquito net. Snakebites are very expensive to treat, and a bite from a Mozambique Spitting Cobra will cost far more than R100 000 to treat.
In the event of someone being bitten by a Mozambique Spitting Cobra, forget about first aid measures. There is nothing that helps. Get the person to the nearest hospital with a trauma unit. While only one out of ten snakebite victims that are hospitalised need antivenom, most Mozambique Spitting Cobra victims need antivenom – and urgently. The dosage should be in the region of 10-12 vials of polyvalent antivenom, and sooner rather than later. We now have good evidence that shows that if antivenom is not administered within about four hours following a Mozambique Spitting Cobra bite, it is ineffective and not worth giving. Doctors then must wait a few days to assess the extent of tissue damage before commencing with surgery.
Mozambique Spitting Cobra bites are common with around 40 – 60 babies and children getting bitten every year in South Africa. It is far better to take the necessary precautions to prevent a bite than treating it.
If anyone sees a snake in a house, it is better to call in a professional snake handler to clear the snake from the house. The African Snakebite Institute has developed a fantastic FREE app for your mobile phone that is wonderfully informative and has all the necessary details of professional snake handlers in your area. You can get the free app on the link http://bit.ly/snakebiteapp.
Johan Marais is one of Africa’s leading herpetologists and is CEO of the African Snakebite Institute. He is a best-selling author, a compulsive photographer, and a travel addict. Check out the website on www.africansnakebiteinstitute.com
All images copyright Johan Marais
