AMID a rise in documented cobra sightings, locally known as banakon, in Cebu, a public health expert has assured the public that a viable antivenom is available for those requiring treatment.
In an interview early this month, Dr. Beethoven Bongon, a toxicologist at the Vicente Sotto Memorial Medical Center (VSMMC), said polyvalent snake antivenom is available at VSMMC Poison Control Center in Cebu City. It can be obtained by patients who have been cleared to receive the shot.
Bongon said this polyvalent antivenom is effective not only in one, but three cobra species, including the king cobra, the Philippine cobra, and the Samar cobra.
He said the polyvalent antivenom 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 its effectivity,” he said.
According to reports earlier this month, a king cobra was captured in Sitio Libho, Barangay Salag, Tabogon. There were also documented sightings reported in Barangay Busay in Cebu City. Additionally, various sightings were reported late last year, including those in Barangay Lamacan in Sibonga town and Barangay Magsico in San Fernando.
In December last year, it was reported that Central Visayas, particularly Cebu, lacks PCAV.
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 clarified that Cebu is not a priority for RITM to supply PCAV vials, saying “We are not on the priority list, especially that their supply of that antivenom is also limited.”
He further explained that the Philippine cobra, scientifically named Naja philippinensis, is not prevalent in Cebu, unlike the king cobra or Ophiophagus hannah.
He added that RITM has not received any reported Philippine cobra bites, thus, they do not have appropriate stocks of PCAV in Cebu.
Bongon said Philippine cobras are commonly found in Luzon, such as places in Pangasinan, Baguio and Masbate, and also places 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, Bongon said Samar cobras or Naja samarensis is a venomous snake species found in the Philippines, particularly in the Samar and Leyte islands.
Unused
Bongon said most snakebite incidents in Central Visayas, particularly in Cebu, are 90 percent not from venomous snakes; thus, it is only a rare case that they administer the polyvalent antivenom to patients.
He added that in the last three years, they have not had to use the antivenom treatment on any patient, signifying that fewer cases of snake bites require this treatment.
“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.
He admitted that last December, their existing vials of the polyvalent antivenom went unused, and most are already near expiry; thus, they have decided to transport the vials to the Davao Region since they need them more there.
The toxicologist, however, clarified that they were able to procure new stocks in case of emergencies of cobra bites.
The toxicologist said the polyvalent antivenom at VSMMC holds solely the Compassionate Special Permit (CSP) issued by the Food and Drug Administration (FDA), signifying its limited accessibility for commercial distribution.
According to the FDA, the CSP is an authorization “signed by the FDA director general granting a qualified institution such as the DOH, a specialized institution, and a DOH-licensed hospital, or a qualified licensed physician the privilege to avail an unregistered or unauthorized drug product, vaccine, or medical device through an FDA-licensed establishment for its restricted use.”