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New antivenom for all local snakes

03 Feb 2021

  • SL has one of the world’s highest snakebite rates

  A collective of Sri Lankan scientists have developed an antivenom to be used to treat snakebites from snake species found in Sri Lanka, ranging from those which are mildly venomous to highly toxic, The Morning learnt. Speaking to The Morning yesterday (3), University of Peradeniya Faculty of Veterinary Medicine and Animal Science Department of Veterinary Pathobiology Senior Professor R.P.V.J. Rajapakse said that the particular antivenom study had started years ago. The initiative had come from Sri Lanka Medical Association Expert Committee on Snakebites Co-Chair Prof. S.A.M. Kularatne, who wanted to neutralise snake venom, thereby halting further damage. “Prof. Kularatne saw snakebite victims presented to the Anuradhapura Teaching Hospital while he was working there. Indian antivenom was the only solution available at that time,” stated Prof. Rajapakse. According to Prof. Rajapakse, there are antivenoms that treat bites from a specific type of snake (monospecific antivenoms), and also those that treat bites from a number of snakes found in a particular geographic region (polyspecific antivenoms). “Sri Lanka has one of the highest snakebite rates in the world according to the Ceylon Medical Journal (CMJ). Although there are 92 species of snakes in this country, much of the morbidity and about 95% of the mortality associated with snakebites is due to the highly venomous cobra, Russell’s viper, and Ceylon krait,” said Prof. Rajapakse. Currently, all antivenom used in Sri Lanka is supplied from India, which he noted was costly and occasionally ineffective for snakes in Sri Lanka. Therefore, the development of a new polyspecific antivenom would help reduce deaths caused due to snakebites from snakes indigenous to Sri Lanka. “Antivenom was created by immunising horses with the venom of a particular snake in Sri Lanka. Their blood serum is then processed, as it will contain antibodies capable of neutralising the effects of the venom. This was done in an Indian laboratory, since we do not have the facility,” Prof. Rajapakse said. According to Prof. Rajapakse, this antivenom is presently being reviewed by the Ministry of Health. However, although Sri Lanka has the necessary expertise, the manufacturing process would happen in India due to the high cost involved. “This would be a collaborative effort between India and Sri Lanka, where we give the expertise and the manufacturing is done by India. We do not have the facilities needed since the cost for a factory would be billions of rupees and needs to be approved by the World Health Organisation,” he said. Speaking to The Morning, Prof. Kularatne said that the Russell's viper (Daboia russelii), the Sri Lankan cobra (Naja naja), the Common krait (Bungarus caeruleus), the Ceylon krait (Bungarus ceylonicus), and the hump-nosed viper (Hypnale hypnale) are the highly poisonous snakes found in Sri Lanka. “Hump-nosed vipers are so common in Sri Lanka, but the antivenom from India does not respond to this venom. However, the new antivenom would respond to this issue,” said Prof. Kularatne. “The antivenom is normally given intravenously (through a needle in the arm) so that it can take effect as quickly as possible,” added Prof. Kularatne. As the CMJ points out, in the year 2000, over 37,000 patients were treated for snakebites in Sri Lankan government hospitals and that the national figure for snakebites is likely to be much higher, as many of the victims do not have the opportunity to seek hospital treatment or do not seek hospital treatment.  However, as per Prof. Kularatne’s estimate, in recent times, around 100 deaths are reported per year, while there are about 40,000-80,000 snakebite cases reported per annum. Therefore, the annual requirement of antivenom in Sri Lanka is around 80,000 doses, noted Prof. Rajapakse.

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