After NorCal rattlesnake bite, man needs 54 doses of antivenom to survive

An Idaho man visiting his parents in Oroville thought he had stepped on a sharp sticker plant or thistle when he looked down to see a rattlesnake at his feet instead. 

Read more NorCal school desperately trying to keep nickname after state racial mascots ban

“I got bit twice, and one of the bites, where it was was kind of a shallow, but the other one got my vein,” Chris Howarth told SFGATE. “… I went inside. My wife thought I was joking.”

But when Chris showed his wife his leg, she and their young children started “freaking out.”

Chris had just stepped into his parents’ backyard to check the waterline when he was bitten on May 26. The bites happened as California saw a spring increase in rattlesnake activity following a March heat wave this year, with three people dying due to rattlesnake bites and at least 249 bites reported as of early July.

Chris’ wife Jenny Howarth immediately drove him to the Oroville Hospital about 15 minutes away. By the time they arrived, he was already showing signs of a reaction to the venom, including a numb tongue, swollen lymph nodes and difficulty breathing. While he was able to receive the antivenom in about an hour, the ordeal didn’t end there. 

One of the puncture wounds was deeper, meaning venom from the snake went “directly into his bloodstream,” Jenny said. 

For days at Oroville Hospital, Chris said he felt like he was on a roller coaster as antivenom would help clear his symptoms only for them to return hours later.

On the third day, despite the doses of antivenom, Chris developed a dangerous blood clotting condition, disseminated intravascular coagulation, leaving him at risk of bleeding out. He was getting platelets and antivenom to help control the condition, but on day six, the hospital ran out. 

“I started feeling really sick,” Chris said. “… My leg was really, really swollen, and as it was kind of a scary situation, I wasn’t sure if I was going to pull through. At one point, I wrote some letters to my kids to make sure they had one last letter from Dad.”

Oroville Hospital did not respond to SFGATE requests for comment about how it handles low supplies.

After the hospital ran out of medication, it transferred Chris to Stanford Hospital for further treatment the same day. At Stanford Hospital, physicians tried a different antivenom that seemed to finally help his symptoms diminish. In total, Chris had 36 doses of antivenom in Oroville and 18 at Stanford, spending 12 days hospitalized, mainly in the intensive care unit. 

Rais Vohra, medical director for the California Poison Control System’s Fresno-Madera division, said many people won’t need more than a few doses of antivenom after a rattlesnake bite.

“There’s some people that need just a couple of vials, and then on the other end of the bell curve, there’s some people that, depending on what their clinical course looks like, will need more than average,” he told SFGATE.

Read more NOAA releases new sky-high odds of historic El Niño in California

Vohra said needing 54 vials of antivenom is relatively rare. But sometimes the antivenom doesn’t fully neutralize the venom even after many doses. 

“It just sounds like a really unfortunate case,” he said of Chris’ injury.

During a busy season for rattlesnake bites, Vohra says there’s a protocol for hospitals if they start to run out or run low on antivenom, including transferring the patient to another location. Additionally, Vohra said hospitals can call their supplier for more antivenom, which usually arrives in a few hours or a day. 

In an emergency, they can call poison control to help them source more. 

“We do this with antidotes all the time, because, you know, not every hospital keeps every antidote,” Vohra said. If a hospital calls poison control and doesn’t have a key medication, poison control can direct them to another location that has the medication they can borrow until they get resupplied. “That’s not unheard of for any number of different medications, including antivenom.”

The couple said Chris had excellent care at both hospitals but they want to raise awareness about rattlesnake dangers year round in California, especially as the area had been cooler and wet before Chris was bitten.

“You’re not usually looking for rattlesnakes, when it’s cool and rainy like that,” Jenny said. “You think of it being more out when it’s like hot and dry.”

One complication of wet weather is that the telltale sound of the snake’s rattle can be silenced, which the couple realized after Chris’ father went to kill the snake and found it shaking its rattle without any sound. 

“It’s like the rattle gets wet or muddy, then it sounds like doesn’t really make any rattle noise, or it’s really muffled,” Jenny said.

The Howarth family returned to their home in Meridian, Idaho, in June, but Chris is still unable to work as a letter carrier and has lingering symptoms six weeks after the injury. A friend launched a GoFundMe for the family to help with expenses. 

“We just want people to know how serious it can be,” Jenny said. “I’m a nurse and I had no idea.”