Spring is here, and animals that have hunkered down through the long, cold winter are finally coming out again, now that it’s warm. That’s certainly true for the venomous snakes that call North Carolina home.
The Tar Heel state has the dubious distinction of leading the nation in the number of copperhead bites per year, with Texas coming in a close second. A few months ago, Jessica Jones had her own close encounter with a copperhead in a friend’s yard.
My friend and former colleague, Rose Hoban, lives with her husband on a beautiful wooded lot in Chapel Hill. It’s the perfect habitat for all kinds of animals: Everything from deer to birds to snakes.
"So we’re walking in the woods, there’s a little wooded area right just behind our house. And we back up to a creek," explains Rose.
Back in September, Rose hadn’t been feeling well, so I volunteered to help her complete a few household tasks, including clearing out a sunny spot in her garden.
Rose: "We have a mulch pile, you can just see it it’s only about another 20 feet... You were carrying a bunch of stuff."
Jessica: "I had pulled up a plant that you didn’t like. You said hey do you think you can pull that plant out? And I said sure, where’s your compost pile? And I was directed over here, and I didn’t know where it was and I was looking on the horizon for it and just didn’t have my eyes on the path."
Rose: "And you had those flip flops on. Oh my gosh, I felt so bad!"
Yes, I was wearing flip flops. I know that wasn’t very smart. But what happened next didn’t occur to me as a possibility.
Jessica: "So Rose, I think this was the spot."
Rose: "Oh here? So he got you while you were moving."
Jessica: "I was walking down the path and then I felt something on my right ankle and I thought that was a huge wasp that just stung me. And then, I looked down and I saw this copperhead snake slithering on by."
Although I’d never seen a real copperhead before, I had seen photographs. Its earth-tone, argyle-like pattern was unmistakable. At first, the bite didn’t hurt that much.
But a couple of hours later, when I was sitting in UNC’s emergency room, my ankle had swelled up so much I could hardly walk. That’s where I first met Kevin Chronowski, a research assistant with the emergency department:
"I saw you even before you had seen any of our providers there that night. We talked out at triage in a room."
Chronowski offered me the opportunity to participate in a study UNC and Duke are conducting. They’re testing a very widely used antivenom called CroFab to see how it works on people with mild to moderate symptoms. Duke tends to give CroFab more frequently, while UNC gives it less often. I didn’t have enough time to enroll in the study. Doctors also didn’t think my case was severe enough to warrant the antivenom. All I needed was rest and to stay off my feet.
But Doctor Eugenia Quackenbush, who’s leading the study at UNC, says there are plenty of other patients to choose from.
"Typically patients will present at night," says Quackenbush. "The typical story is they’ve been walking the dog in sandals or walking across the grass in the dark. Another typical scenario is being bitten on the hand when reaching down. I recall a person who had dropped keys and reached down and was bitten on the hand."
Twenty sites across the state and even one in Texas are participating in the study. So far, 40 subjects have enrolled out of a sought after 182. CroFab is incredibly expensive to make; a 4 to 6 vial treatment can run around $18,000 or more. That high price tag could account for its discrepancy in use, say Chronowski and Quackenbush.
Quackenbush: "Definitely one has to take cost into consideration."
Chronowski: "And that’s why this study is important to make sure that clinicians can make an important decision not only about a patient’s well-being but also costs."
In the vast majority of cases, a copperhead bite isn’t fatal. But it is painful. And it can be dangerous. People bitten on their hands risk losing fingers because the swelling blocks blood flow. In a small subset of patients, the venom can cause blood cells to burst and blood vessels to become leaky. The results of the study should provide more information for physicians from Connecticut to Texas. That's the geographic range of the copperhead.
"Their camouflage is certainly a key to their success," says Professor J.D. Willson, a herpetologist at the University of Arkansas. "I think they’re one of the most beautiful snakes we have. Their camouflage is just beautiful, but also just perfectly blends in with leaf litter. So you can imagine that they could hide very well in a suburban area and never be found."
Wilson says copperheads have a fast life cycle. They bear a lot of young and they bear them live, by the way. He says they aren’t aggressive. Copperheads will only strike if they feel threatened.
Believe me, if I ever see one again, I will do my best to give it space.