December is that time of the year when South Africans enjoy spending time outdoors, going for walks or camping in nature, relaxing on the beaches and treating themselves to the ocean’s food basket.
It is also the time when bugs and creepy-crawlies which we don’t usually encounter during our normal daily routines, could cross our paths.
Be prepared and know what to do in case you are bitten by a snake or a spider, or stung by a scorpion or a bee.
Know which plants are poisonous and what to do when you are stung by a blue-bottle or jellyfish.
A useful guide when trying to determine whether a scorpion is venomous or not, is to have a look at it pincers and tail. The traditional rule of thumb is that a scorpion with a slender tail and large pincers is often not venomous, but when the tail is thicker and pincers are slender, it is likely to be the Parabuthus granulatus, which is found in the Western Cape.
Scorpions are usually found outside the home and mostly under stones or in sandy areas. They do not make nests or breed inside dwellings. Scorpions are usually active at night therefore it is advisable to wear shoes when outside – especially after sunset.
Although the majority of scorpions are relatively harmless, an intense pain could be caused by a sting. Most scorpion stings, therefore, result in only a mild local inflammatory reaction, with no systemic features.
A Parabuthus granulatus scorpion sting can cause a life-threatening poisoning which can be fatal, especially in children. If you are stung by a venomous scorpion the symptoms will present within 15 – 60 minutes. Pronounced restlessness is very typical in children.
- It is advisable to go to the emergency room especially when you experience pins and needles in your hands and feet.
- To help minimise the pain crushed ice can be applied to the sting site, as the available analgesics are not effective.
- Scorpion antivenom is available.
Snakes are just as afraid of you as you are of them, if not more so. They will try to stay away from you unless provoked.
The venom of snakes such as mambas and Cape cobras is neurotoxic (toxins that affect the nerve system) and life threatening. Symptoms, such as difficulty in breathing, develop within 30 minutes to four hours. If you are more than two hours away from medical assistance, respiratory support (such as mouth-to-mouth resuscitation) may be necessary.
A puff adder snake’s venom is cytotoxic (toxins that affect tissue) and also life threatening. Symptoms develop late, within 6 – 24 hours. Comforting and reassuring the patient is a very important part of the first aid treatment.
Keep the following tips in mind during the upcoming holidays:
- Before leaving on a hike, climbing, mountain biking or camping trip, find out where the nearest medical facility is and note the telephone number.
- When hiking, don’t go barefoot or wear sandals but wear sturdy hiking boots and long pants.
- Avoid places that are more likely to have snakes, such as large rocks, tall grass and any type of object that may create a home for snakes.
- Walking with sure steps can decrease your chances of getting bitten. Snakes respond to the vibrations they feel along the ground, and so will be able to feel you approaching and hide.
- Always look around, be aware of your surroundings and look down to where you are walking so that you don’t accidentally step on a snake.
- Remember snakes like to go underneath cars and many snakes can climb trees.
- When you are walking on a footpath or even the sidewalk, make sure you stay in the middle of the path.
In the case of a snake bite:
- Remember that antivenom should only be administered by trained medical staff.
- Get the patient to a medical facility as soon as possible.
- Phone ahead to notify them of the arrival of a snake bite victim.
- Try to get a good description of the snake.
- Note that in most cases, you have a couple of hours before serious life threatening symptoms manifest themselves.
- Immobilise the patient if possible.
- If alone, keep calm and do not walk too fast or run, as this speeds up the distribution of the venom.
- Do not suck the bite site and do not apply a tourniquet.
- Only in suspected neurotoxic bites (mamba, Cape cobra), it is recommended that you apply a wide crepe bandage firmly above the bite site (as tightly as for a sprained ankle) to slow the spread of venom to vital organs like the heart and lungs.
A bee sting can be a very unpleasant experience! Some people are highly allergic to bee venom and can present with life threatening symptoms after only one sting. Some might not even be aware that they are highly allergic, so it’s important to protect yourself against bee stings. The vast majority of stings cause only minor problems, but severe life threatening symptoms may occur rapidly.
How to avoid a bee sting:
- Don’t smell and look like a flower, in other words don’t wear perfumes and avoid wearing brightly coloured clothing, especially floral prints.
- Sugary foods and drinks will attract bees, so be careful what you eat outdoors.
- Throat stings may be very dangerous, so look inside the soda can before you take a sip. Alternatively keep your beverage in a bottle with a cap.
- Rinse your garbage containers and keep lids on.
- Don’t walk barefoot and do not wear loose-fitting clothes.
- If a bee is flying around your head, keep still and don’t swat at it.
Treatment if you get stung by a bee:
- Remove the stinger as soon as possible.
- Look for symptoms of allergic reactions such as diffuse swelling, itchiness, as well as difficulty in swallowing and breathing.
- If these symptoms are present, immediately go to a healthcare facility.
- You can take an antihistamine and if it was prescribed in the past, use epinephrine (Epipen).
- If allergic symptoms are absent, wash the area with soap and water and apply ice to the sting for 20 minutes.
- You can take ibuprofen or paracetamol for pain relief and apply calamine lotion or hydrocortisone cream to the sting site.
The neurotoxic group includes the Latrodectus or button spiders and the cytotoxic spiders are represented by the sac and violin spider.
The bite of the daddy-long-legs, rain and baboon spiders can be very painful and there is a possibility of infection, but these spiders are not poisonous to humans.
The Latrodectus species are subdivided into the black widow (button) spider group and the less venomous brown widow (button) spider group. Black button spider venom is approximately five times more potent than the venom of the brown button spider.
The black button spiders are dark brown to pitch-black, with no ventral markings on the abdomen, and the egg sacs are usually round with a smooth appearance. They are usually found in the veld.
The brown button spider’s colour varies from cream to grey brown and pitch black. On the abdomen is a prominent red or orange hourglass and the egg sacs are characterised by their spiky appearance. They are found around the house, beneath windowsills, garden furniture and post boxes.
Symptoms and signs of black button spider bites:
- Bites of a black button spider are usually very painful.
- The pain spreads to the lymph nodes within 15 minutes.
- The patient develops muscle pain and cramps within 60 minutes.
- The patient has difficulty in walking and weakness in the legs.
- Excessive sweating and anxiety is typical.
- Small children, the elderly and people with cardiovascular and respiratory illnesses are particularly at risk.
- People who were bitten by these spiders will need antivenom and will most likely be hospitalised.
- The bite of a brown button spider causes a milder form of envenomation than that of a black button spider, and hospitalisation and antivenom is often not necessary.
Sac spiders are recognised by the pale colour (straw to yellow-green) with black mouthparts. They hide in the folds of curtains or under clothes.
The violin spider is browner to red brown in colour, with a typical dark violin shaped mark on the dorsal surface of the cephalothorax, and the abdomen is round in shape. They are nocturnal and mostly live in caves and grasslands.
Violin spiders are often confused with daddy-long-legs and the spitting spider.
- Bites usually occur at night and are rather painless.
- A red, itchy mark develops which can then lead to infection.
- A patient will need antibiotics and will regular follow up visits at the same doctor.
- This type of wound often takes a long time to heal.
This time of the year many South Africans enjoy eating seafood. Scombroid poisoning (also referred to as histamine food poisoning) comes from the consumption of ‘spoiled’ fish, which has undergone changes as a result of improper storage conditions.
- Scombroid poisoning resembles a histamine-like or acute allergic reaction with a rapid onset.
- Most patients experience a hot, blotchy flushing of the skin, especially of the face, neck and upper chest.
- Gastro-intestinal symptoms and signs, such as diarrhoea, are also prominent. Most cases are mild and self-limiting, even without treatment.
- Scombroid poisoning may occur after ingesting raw, cooked, smoked or canned fish.
- Patients with scombroid poisoning are often misdiagnosed as having a food allergy and inappropriately instructed to refrain from eating seafood.
Blue-bottles, jellyfish and sea-anemones
These creatures have specialised stinging cells which may fire during contact. A sting results in a painful and itchy skin eruption.
- Stings must be irrigated with sea water and NOT fresh water, which will cause stinging cells to discharge.
- The use of vinegar may help to deactivate the toxin.
- Physical removal of the cells may be achieved by scraping of the exposed area with the edge of a sharp knife or even a plastic card.
- The next step is to immerse the affected area in very hot water for pain relief.
- A topical anaesthetic and or cortisone cream and calamine lotion can be used.
Poisonous plants grow in every garden in South Africa. They form an important part of our indigenous flora, and therefore it is not practical to eradicate them all. It is more important to get to know more about them.
Systemic plant poisoning is rare due to the fact that small amounts are usually ingested. Large amounts of these plants need to be consumed before any symptoms will develop.
Common plants found in and around the house, and that children often put in their mouths, include the following:
- The dumbcane (Dieffenbachia species), elephant’s ear, arum lily and delicious monster. They all contain calcium oxalate crystals. Chewing on parts of these plants may produce an immediate intense pain of the mouth, tongue and lips. Management includes clearing the mouth of plant parts and administration of cool liquids or crushed ice to sooth the burning sensation.
- Ingestion of the ripe syringa tree berries is common in children, but rarely causes any form of poisoning because the ripe berry has a very hard kernel which contains the poisonous substance. To break the kernel you will need to use a hammer. It usually passes through the gastro-intestinal tract intact. Nausea and diarrhoea could possibly develop.
- The oleander plant (Nerium oleander) is known to be poisonous, but large amounts (at least 15 leaves) have to be ingested before systemic poisoning will occur.
- Plant dermatitis is mainly caused by the Euphorbia plant species. It contains a milky sap that is responsible for the skin reaction. Eye contact can cause blindness therefore the eyes should be washed with copious amounts of water.
- The stinging nettle will cause red, itchy hives. It is not dangerous and these reactions usually resolve within a few days.
- he most serious toxic effects encountered with plants are the intentional ingestions by teenagers of the thorn apple seeds and the moonflowers. They usually ingest this for the hallucinogenic effects.