Nothing strikes fear into even the bravest heart more than
the thought of a venomous serpent sinking its fangs into your
flesh! I recently had the pleasure of lunching on Sanur beach
with some dear friends when the phone rang. “Sorry to
disturb you, we have a slight problem here. My friends gardener
has been bitten by a snake, and is now unconscious in Sanglah
hospital”.
Further questioning revealed that this unfortunate gentleman
was in the intensive care unit on a respirator (breathing
machine). As luck would have it, my lunch companions were
also doctors and all agreed that the best was already being
done for this man. In most cases, snake venom acts as a neurotoxin
(nerve poison) that paralysis’s it’s victim. The
toxin will eventually wear off, but the victim needs to be
kept alive on a breathing machine until such time that it
does.
Re-assured, the woman ended our telephone conversation. I
have since heard that the man concerned has made a full recovery.
What kind of snake actually bit this man?…who knows.
There are several candidates for the guilty party. Over half
a dozen venomous snakes are native to the island of Bali.
In this case the Cobra or the Malayan Krait were the most
likely offenders. Oh, and for those of you that might be wondering
where this event took place, it was in a garden in Kerobokan.
It is fair to say though, that this could have happened anywhere
on the Island where there is vegetation, water, rats &
frogs. Fortunately most snakes are shy, and will not initiate
attacks on humans. Most bites occur when a snake is accidentally
disturbed, or when an attempt is made to catch, kill or taunt
the creature.
I am always bemused by the range of answers extracted when
indigenous islanders are asked about the local variety of
snakes and how dangerous they might be. I have heard everything
from “No snakes in Bali, and even if you see one it
is not dangerous” (good sales tactic for tourism), or
“Many snake in Bali, all poisonous”. The latter
is closer to the truth, although despite the fact that some
of the snakes found here have highly venomous (lethal) toxin,
there are remarkably few deaths as a result of being bitten.
Lets look at what kind of venomous snake you might come across
around the island, what they look like, how to avoid them
and what to do if you are bitten.
King cobra (Ophiophagus hannah) - Locally known as “lipi
uwoh”, or “ular rajah”. This is the largest
member of the Cobra family growing to some 6 meters in length.
The Cobra is a ground dweller, feeding on small reptiles.
The dull brown color easily camouflages this snake, which
displays a characteristic hood when it is threatened. Interestingly
enough this snake is said to have one of the highest IQ’s
of all snakes (wonder how they figured that out!?). The cobra
is not an aggressive snake (except when brooding) and will
avoid confrontation, however it will fearlessly stand its
ground and strike if provoked.
King cobra bites are not common, but when they do occur they
are often severe. Due to the size of this snake (big mouth
as well!), envenomation is common. (Note: venom is not released
EVERY time any snake bites). Approximately 80% of cobra bites
envenomate (release venom). 60% of these cases will be fatal
if untreated. Bites cause pain and swelling locally. Other
symptoms such as dizziness, drooping of the eyelids and shortness
of breath & general paralysis occur as soon as 10 –
15 minutes following the bite. This snake’s venom acts
as a “neurotoxin” (attacks the nerves).
Javan spitting cobra (Naja sputatrix) – Locally known
as “lipi uwoh” or “ular sendok”. This
cobra is slightly smaller than it’s “king”
cousin, and grows up to 1.8 meters in length. A dull brownish
black in color it is frequently found in dry rice fields where
rodents are plentiful. As for the king cobra, bites from the
spitting cobra have a high rate of envenomation, and the poison
is often fatal if not treated. This creature has a couple
of added extras, like the ability to spit its venom accurately
into the eyes of any offender causing extreme pain and temporary
blindness. Bites from this snake often cause the flesh to
rot (necrotoxin) at the site of the bite. This snake’s
poison is also a neurotoxin causing headache, nausea, abdominal
pain, and paralysis from one to 12 hours after being bitten.
Malayan krait (Bungaris candida) – Locally known as
“lipi pepaku” or “ular katang tebu”.
This black and white stripped ground snake is one of the most
venomous snakes on the island. Fortunately it is quite shy
and will hide its head in it’s own coils if approached.
Attacks usually occur if this snake is persistently provoked.
Growing to about 1.5 meters in length this snake has a high
envenomation rate, with an even higher fatality rate (60 –
70 %) for untreated bites. Once again this snakes poison is
a neurotoxin. Paralysis can occur in less than an hour, or
there may be a delay of several hours. Surprisingly, the bite
is self causes little or no local pain or swelling.
Green pit viper (Trimeresurus albolabris) – Locally
known as “lipi gadang” or “ular hijau”.
This bright green viper with a distinct brown red flash on
it’s tail, prefers trees and bushes and not holes in
the ground as its name suggests. The term “pit”
refers to heat sensitive pit organs on either side of the
snakes broad triangular head that are used to detect the body
heat of potential prey in the dark of the night. This snake
has a thick body, and reaches an average of not more than
one meter in length.
This snake is quick to bite if approached, preferring to
strike rather than retreat. For this reason the viper is responsible
for most venomous bites around these parts. Variable effects
may occur after envenomation, which may include headache,
nausea, vomiting, abdominal pain, diarrhea, dizziness, collapse
or convulsions. This snakes poison is a hemorrhagic / procoagulant
toxin which may cause bleeding or blood clotting in it’s
victim. There is a 1 – 10% fatality rate in untreated
bites.
Oriental whip snake (Ahaetulla prasina) –Locally known
as “lipi arjuna” or “ular hijau” (It
is also green in color!). This long, thin “whip”
like snake ranges from bright green to light brown in color,
and has distinctive yellow markings circumscribing its small
black eyes. The arrow shaped head is relatively large for
its very fine body. Growing up to 2 meters in length it prefers
to live in shrubs and trees where it winds itself in fine
coils around the branches. This snake is a shy creature and
bites or envenomation rarely occur. In the case that some
one is bitten the venom can cause a local reaction with mild
swelling and pain only.
Sea Snakes (Banded sea snake – Hydrophis cyanocinctus;
Common sea snake – Enhydrina schistosa ) - Locally known
as “ular laut”. Sea snakes are plentiful around
the coast of Bali and her neighboring Islands. Up to 1.5 meters,
and as the name suggests, the banded sea snake has bi-colored
bands the length of it’s body. These sea snakes tend
to be more active at night, and can even be seen basking on
the sand along the beaches after dark.
While this snake is considered venomous, bites are rarely
reported due to several reasons. This character has a comparatively
small mouth, and its envenoming fangs are set towards the
back of the jaw. Bites that have been reported have occurred
on earlobes and the web of skin at the base of the fingers.
While this is a curious creature it is not aggressive unless
provoked, when it will not hesitate to attempt a bite.
This snake’s venom is a neurotoxin, and may contain
“myotoxins” (attacks the muscle). While envenomation
may be rare, all bites from sea snakes should be treated as
potentially dangerous.
Common trouser snake (Erectus board shortus) – locally
known as “cowok”. This creature can be found in
almost every habitat on the island and is not difficult to
locate as it comes attached to the male species of the homo-sapien.
Flaccid at rest it quickly becomes erect if provoked. This
snakes poison works by “insemination” rather than
“envenomation”. This species actively seeks out
prey and is not usually shy on initial encounters but tends
to retreat once it has inseminated it’s victim.
Not all victims will experience adverse reactions following
an encounter with “erectus board shortus”. Signs
however are insidious and can take weeks or months to appear.
Initial symptoms would include nausea, vomiting and swelling,
bloated abdomen (female victims only). While these encounters
are rarely fatal, victims inseminated by infected creatures
(HIV, Hepatitis C) may contract the disease. The fatality
rate in these cases is high!!!
…… ..In the next edition we will look at how
to treat snakebites in a first aid situation, as well has
how to avoid being bitten. Thanks goes to the staff of Rimba
reptile park, Camilla at Global Aquatic Divers, Dr Julien
White (professor of toxicology W.C.H. Adelaide, S.A.), and
Margot for all their assistance in compiling this information.
Until next edition stay healthy, stay happy, and watch where
you step!
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
