IN THE midst of an increase in documented cobra sightings, commonly referred to as banakon by locals in Cebu, a public health expert assured that there exists a viable treatment for individuals in need.
Dr. Beethoven Bongon, toxicologist at the Vicente Sotto Memorial Medical Center (VSMMC), reassured the public that there is antivenom for those who will be cleared to receive the shot.
He said on January 8, 2024 that the antivenom accessible at VSMMC Poison Control Center is polyvalent, signifying its efficacy against not only one but three cobra species, including King Cobras, Philippine Cobra, and the Samar Cobra.
"We have the polyvalent [antivenom] and it is available here in Sotto (VSMMC)," he told SunStar Cebu.
He said this differs from the Purified Cobra Antivenin (Pcav), exclusively obtainable from the health research facility Research Institute of Tropical Medicine (RITM) in Muntinlupa City, Metro Manila, which is specifically effective against the Philippine Cobra species.
"The Pcav is only specific for Philippine Cobra, and that is what we call monovalent antivenom because its target is only against one species and it s effective," he said.
It was reported in December 2023 that Central Visayas, particularly Cebu, does not have Pcav, which is used as a treatment for Philippine Cobra bites.
Ruff Vincent Valdevieso, coordinator of the national immunization program at the Department of Health (DOH) 7, told SunStar Cebu last November that it is also not commercially available.
Least priority
Bongon said Cebu is not among the priority of RITM to provide supply of Pcav vials, stressing: "We are not on the priority list especially that their supply of that antivenom is also limited."
He clarified that Philippine Cobras, scientifically named as Naja philippinensis, is not common in Cebu, unlike King Cobra or Ophiophagus hannah.
He added that RITM has not received any reported Philippine Cobra bites, thus, they do no appropriate stocks of Pcav in Cebu.
He said Philippine Cobras are commonly found in Luzon, such as places in Pangasinan, Baguio, and Masbate, as well as in Mindanao like Zamboanga.
According to a report from RITM and DOH in September 2018, Pcav is regularly supplied to farmers in Bicol and Nueva Ecija, where the occurrence of documented snakebites is particularly high.
The report specifies that these regions are given priority for ampoule distribution because they are recognized as crucial rice-producing areas or the rice granaries of the country.
Meanwhile, he said that Samar Cobras or Naja samarensis is a venomous snake species found in the Philippines, particularly in the Samar and Leyte islands.
Unused
Bongon said that most snake bite incidents in Central Visayas, particularly in Cebu, involve non-venomous snakes, accounting for 90 percent of cases. As a result, administering polyvalent antivenom to patients is considered a rare occurrence.
The expert emphasized that not all snake bite victims require antivenom. Even in cases of venomous bites, it does not automatically mean that the patient is eligible for antivenom treatment.
Bongon added that when individuals are bitten by snakes, the recommended course of action is to bring the victim to local health centers or facilities.
Health experts at these locations will then coordinate with the Poison Control Center to assess the situation and determine whether antivenom is truly necessary.
"If antivenom is really needed, that is the time, the patient will be transported to Sotto (VSMMC)," Bongon said.
He added that in the past three years, they have not administered the antivenom drug to any patient, signifying that there are few cases of the snake bites that require this treatment.
He admitted that last December, their existing vials of the polyvalent antivenom went to unused and most are already near expiry, thus, they have decided to transport the vials to Davao Region, since they are needed more there.
"We were not really able to use it... but before it expired, since we did not anticipate any cases, it coincidentally happened that Davao requested some because they have many cases there, so we just shipped everything to Davao," he said.
The toxicologist clarified, though, that they were able to procure new stocks in case of emergencies of cobra bites.
He said the polyvalent antivenom at VSMMC holds solely the Compassionate Special Permit issued by the Food and Drug Administration, signifying its limited accessibility for commercial distribution. (KJF)