Fatal snakebites remain low thanks to well-developed clinical services, awareness programmes and safety campaigns, says expert
WHILE snakebites and encounters are common in Malaysia, fatal incidents are rare.
On average, at least three people are bitten by snakes every day, based on data from non-profit body Remote Envenomation Consultancy Services (RECS).
Figures show that Sarawak recorded 1,151 cases, Pahang with 899 cases and Perak having 811 cases from 2017 to 2021.
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In 2023, the Civil Defence Force (APM) was reported saying it caught 104,859 snakes in residential areas, according to Bernama.
Universiti Kebangsaan Malaysia (UKM) clinical toxinologist Assoc Prof Dr Ahmad Khaldun Ismail said between 2018 and 2023, two to three new snakebite cases were referred daily to RECS.
Assoc Prof Ahmad Khaldun: Right treatment and early arrival at the hospital are essential for those bitten by venomous snakes.
Assoc Prof Ahmad Khaldun, who founded RECS in 2010, said the body specialised in clinical toxinology.
He also said from 2023 to 2024, RECS recorded three venomous snakebite fatalities.
“We estimate the number of cases referred to RECS is just one-third of the total number of cases presented to all hospitals in Malaysia – therefore, the incidents of fatalities could be more,” he said.
He added that RECS was affiliated with the Malaysian Society on Toxinology (MST) and clinical toxinology special interest group under the College of Emergency Physicians Malaysia.
Assoc Prof Ahmad Khaldun shared the statistics during a First Aid Course for Snakebites (FACS) organised by a developer for its staff in Ara Damansara, Selangor.
Snake expert Muhammad Khaidhir Arif Chek Mat with a gold-ringed cat snake. — Photos: YAP CHEE HONG and AZLINA ABDULLAH/The Star
“Venomous snakebite fatalities are relatively low in Malaysia, compared to neighbouring countries – such as Indonesia and Vietnam,” he told StarMetro.
He attributed Malaysia’s low fatal snakebite rate to its well-developed clinical services, continuous awareness programmes and safety campaigns.
The right treatment and early arrival at the hospital were essential when bitten by venomous snakes, he added.
Deadly neurotoxins
Assoc Prof Ahmad Khaldun said most deaths were caused by neurotoxins from venomous snakes spreading quickly before early treatment or from complications due to the bite such as septicaemia and multiorgan failure.
Indigenous venomous snakes mentioned in the Guideline: Management of Snakebite (2017) by the Health Ministry include – cobras, king cobras, kraits, coral snakes, pit vipers, keelbacks and sea snakes.
Varying species of venomous snakes release dissimilar types of venom that may spread in the human body at different speeds.
Participants taking pictures of snakes on display during the FACS programme.
This will influence how fast the local and systemic symptoms of snakebite (also known as envenoming) appear to the victim, he said.
“Deadly venomous snakes such as the cobra and king cobra spread their toxins fast in humans, leading to difficulty in breathing and death within minutes after getting bitten.
“The venom produced by snakes is not meant to kill humans but for predation such as birds, rodents, rabbits and more,” he said.
Vigilance and education
Assoc Prof Ahmad Khaldun said the public should always be cautious and learn how to deal with snakes should they encounter them.
The lack of knowledge or basic scientific understanding about snakebites could lead to deaths, he added.
“Many people are misled by myths and untrue information.
Baby pythons found in a drain in Section 20, Shah Alam. — Filepic
“In the past, there were not many experts specialising in clinical toxinology.
“This is where the public relied on documentaries or listened to old wives’ tales.
“Over the last 15 years, RECS has been trying to increase public awareness about snake species and appropriate management in Malaysia,” he said.
Snake territory
Assoc Prof Ahmad Khaldun said humans were encroaching on the habitat of snakes, not the other way round.
“Snakes have always been there, long before humans.”
He referred to the recent case where 29 reticulated pythons were found in a drain near a restaurant in Shah Alam, Selangor.
“This is not just one case. Many cases like this have happened before – where snakes find areas which are safe for breeding,” he said.
“Reptiles do not regulate their body temperature like humans. When the temperature is too hot for them, they look for a cooler space.
“Usually the call for snake rescuers spike during hot weather as snakes find refuge in residential areas.”
Hidden menace in mess
Snakes are also attracted to areas, including homes with improper domestic waste management.
“If we do not dispose of food properly, we are attracting rats and these draw in more snakes as well,” said Assoc Prof Ahmad Khaldun.
“Pythons are common while cobras are also quite cosmopolitan. They are adaptive to human habitats; they look for rodents and shelter. However, accidental bites from king cobras are low.
“Humans are not a natural food source for snakes. But, human habitat provides food source for snakes,” he said.
He added that unkempt things around the house provided the perfect hiding places for snakes.
He said the public should understand that snake encounters were due to their natural behaviour in response to environmental conditions.
Accidental snakebites
People often do not even realise there is a snake in their midst until it is too late.
“Among the common cases consulted by RECS involved victims who did not notice that they had stepped on a snake while getting into or out of the car – or when washing dishes in the kitchen.
“Some people can get snakebites from sleeping on the floor or walking without proper shoes,” said Assoc Prof Ahmad Khaldun.
Other cases involve the mishandling of snakes.
“For instance, some people may attempt to play with snakes while being unaware of the potential dangers that could happen to them and this could trigger the snakes’ defensive behaviour,” he said.
