SAN JOSÉ, Costa Rica — Costa Rican shantytowns have a new tropical disease. They call it Terciopelo, which is Spanish for “velvet.”
The English speaking world calls it the Bothrops asper, or the “ultimate” pit viper species that is considered one of the most dangerous snakes in the world. Costa Ricans call it the Velvet Killer. According to a new study printed in Science Advances, Bothrops asper have been wreaking havoc on poverty-stricken communities in Costa Rica, creating a public health crisis akin to that of an infectious disease.
Researchers Luis Fernando Chaves, Ting-Wu Chuang, Mahmood Sasa and José María Gutierrez believe that snakebites can be seen as a neglected tropical disease. It is estimated that there are 2.5 million people who are affected by Terciopelo each year. Of those, 400,000 will develop permanent disabilities as a result of tissue necrosis that can impair physical activity for life. The unluckier 85,000 will die.
That is more than 40,000 more fatalities than Yellow Fever, which kills about 30,000 annually, according to WHO.
Particularly in Costa Rica, high levels of inequality in housing and income across the nation illustrate a pattern of snake attacks that can be grouped by housing quality and income. In the study published in September of 2015, the research team of Chaves, Chuang, Sasa and Gutierrez wrote:
“Our results highlight the fact the snakebites occur more frequently in poor settings, following a common pattern for other tropical diseases in the region. Overall, a high poverty gap index was predictive of snakebites, and a similar pattern was observed for the percentage of destitute housing, especially in rural areas.”
What is it about Costa Rican destitute housing that makes it a hot bed for Terciopelo? The poorest percentage of Costa Ricans tend to live in shantytowns or ad-hoc shelters made from aircraft-carrier metal, cardboard or any other available material. The conditions, especially in more urban shantytowns, are cramped, dark and in the rainy season, damp; all of these are perfect conditions for a venomous snake that has wandered from its rainforest home. The study showed that provinces with 34 percent “destitute housing” had the highest risk of snake attacks as well as the highest rate of bite incidence.
Just like any other public health crisis, Terciopelo snake bite frenzy faces its own set of challenges that arise from the rural-urban divide. The snake has been present in Costa Rican society since the days of Mayan civilization, where their habitats were used as strategic barriers to protect cities. This history has given way to a number of home remedies that, while ancient, do not have the same power as traditional antibiotics in fighting the tissue necrosis that follows a bite.
WHO has reported that even in the more rural shantytowns, it is the presence of subsistence agriculture that provides snakes with ample holes and other places to hide and saddles victims with the added burden of being far from medical treatment. Once the snake strikes, there is very little time to begin an antivenom therapy.
“Many victims fail to reach a hospital in time or seek medical care after a considerable delay because they first seek treatment from traditional healers. Some even die before reaching a hospital,” writes WHO.
– Emma Betuel
Sources: WHO, MSU, Today Costa Rica, Science Advances 1, Science Advances 2, Science Advances 3
Photo: Flickr