SA Vaccine Producers face delays in snakebite antivenom production

As South Africans endure a hot summer, a time in which snakes come out of hibernation, the production of snakebite antivenom at the South African Vaccine Producers (SAVP) is being delayed by upgrades to the facility. 

“The initiative intends to address previous concerns related to machine breakdowns, which are mostly caused by ageing equipment and inadequate infrastructure,” the National Health Laboratory Service said in a statement. The SAVP is part of the National Health Laboratory Service.

The African Snakebite Institution estimates that more than 4 000 people are bitten by snakes annually although only a quarter of them are admitted to hospital. Only 10% of those require antivenom treatment.

The institute said there was more than enough snake venom available for immunisation.

This was backed up by Jason Seale, the director of the Hartbeespoort Dam Snake and Animal Park, who said the depletion of antivenom reserves at the National Health Laboratory Service will not affect the country’s reserves.

“In South Africa, snakebites are not that regular but when they do occur they need to be treated with the correct antivenom for the best results but there are two antivenom’s which is enough for the demand,” he said.

The regions with the highest incidence of snakebites are KwaZulu-Natal and Mpumulanga, where 24 to 34 people per 100 000 are bitten annually. North West also has a high incidence of bites.

The most common snake antivenom in South Africa is the SAIMR polyvalent produced by the South African Vaccine Producers. The other antivenom — used at the Hartbeespoort Dam Snake and Animal Park — is the World Health Organisation-approved Panaf Premium, which can be used on both animals and humans. 

Seale said Panaf Premium has been proven highly effective because it can be used to treat venom from 24 different species while the SAIMR polyvalent can only be used against the venom of 10 snake species. 

“We have been using it since last year and it has proven very effective so we have started supplying it to the government agencies and hospitals,” he said. 

Panaf is a lyophilised product, a powder consistency, that does not require cold storage and has a four-year shelf life. The price per vial is just over R2 000 but the downside is that a patient requires double the number of vials compared with the SAVP polyvalent antivenom. 

According to the African Snakebite Institute, one of the biggest problems with the SAVP polyvalent antivenom is that about four out of 10 patients have anaphylaxis as a result of an allergic reaction to the horse plasma which requires urgent medical intervention. 

For this reason, the antivenom is only administered in a hospital environment by trained medical professionals. 

“To date, none of the patients treated with Panaf Premium in South Africa have had anaphylaxis. Roughly nine out of 10 snakebite victims that are hospitalised do not receive antivenom, purely because the level of envenomation does not justify its administration,” the institute said.

The National Health Laboratory Service declined to comment when asked when production of the antivenom vaccine will resume.