DOH trainings in handling patients bitten by venomous animals sought

Cebu City Health Department also explains why the department does not have antivenom vaccines

Logo of Cebu City Health Department/Facebook

CEBU CITY, Philippines — The Cebu City Health Department does not provide antivenom vaccines in its Animal Bite Treatment Center (ABTC). This is according to an official of the department.

Dr. Daisy Villa, head of the city health department, said this in her letter to the City Council dated January 30, 2024 and was among the agenda in the council’s regular session on Wednesday, February 7.

Villa penned this letter to give an update to the resolution that was moved by Councilor Rey Gealon and seconded by Councilor Mary Ann De Los Santos.

The resolution requested the city health department to ‘acquire antivenom to treat snake bites in light of the recent sightings of snakes within Cebu City.’

READ: TIMELINE: The unprecedented sightings of king cobras in Cebu

DOH trainings needed

Villa said that their animal bite vaccines were limited to cat and dog bites, and anti-tetanus vaccines only.

She said that for now, ‘the ABTC team were not yet properly trained in handling patients with snake bites.’

“Hence, the usual protocol in case a patient bitten by venomous insect or animal is referred in ABTC or in the Out Patient Department of this office, there are immediately forwarded to the nearest hospital particularly the Vicente Sotto Memorial Medical Center (VSMMC) since they are the government hospital allowed to purchase the antivenom through compassionate social ground (CSP) which requires specific documents as of the moment,” Villa further said.

She added that besides the regulated selling and purchase of the antivenom vaccines, the city health department had not included purchasing the antivenom in its budget for the fiscal year 2024.

Moreover, she said that as much as their office would like to provide immediate medication to the patients but they were ‘constrained’ due to the absence of trained personnel and antivenom vaccine.

She said that they were anticipating that the Department of Health (DOH) would see the urgency of the matter.

She also hoped that in the near future, the DOH would offer or conduct training for the personnel on the infiltration, categorization, and handling of patients bitten by venomous insects or animals for hospitals and public health centers.

READ: Why are there several sightings of king cobras in Cebu?

Who can administer antivenom?

In a previous interview of CDN Digital with Dr. Beethoven Bongon, toxicologist in VSMMC, said that there were guidelines on when and how to give the antivenom.

“Limited gyud atong supply sa antivenom. That is why meticulous kaayo mi. E-examine gyud namo ang patient if indeed kinahanglan ba gyud niya ang antivenom treatment,” Bongon said.

(The antivenom is really limited. That is why we are meticulous. We really will examine the patient if indeed he or she will need the antivenom treatment.)

He also said that antivenom was a “double-edged sword,” which meant “it can treat you and it can also kill you” (if it is not properly administered).

READ: What venomous snake has high-risk exposure in Cebu?

Purified Cobra Antivenom

Bongon clarified that the antivenom in VSMMC was not the PCAV or the Purified Cobra Antivenom which would be provided by the RITM.

He said that PCAV was a monovalent antivenom. This means that it is only effective for a specific species and that is the Naja philippinensis (Philippine Cobra).

The antivenom the VSMMC has is the CSP or the Compassionate Special Permit issued by the Food and Drug Administration (FDA).

Bongon said that this would mean that it had “no full” FDA approval, hence, the reason why it was not commercially available.

“That is why CSP siya. Dili namo siya pwedeng mapagawas. Diri ra gyud na sa Sotto (VSMMC) gamiton. Same sa mga institutions that have the same antivenom. CSP ra pud na ang ilaha,” he said.

(That is why it is CSP. We cannot release it. It will only be used at Sotto (VSMMC). It’s the same in institutions that have the same antivenom. What they also have are CSP.

Read here for Bongon’s explanation: Cobra bites: Where to get antivenom treatment when bitten by a venomous snake in Cebu