58,000 snakebite deaths in India go unreported each year

In India, snakebites are a pressing public health issue, causing 58,000 annual deaths, the highest global rate. Many incidents go unreported, complicating treatment efforts. Experts argue that addressing the lack of data and improving reporting mechanisms are crucial steps toward reducing snakebite-related fatalities and disabilities.

The Indian Council of Medical Research (ICMR) is gathering hospital and community-based snakebite data to uncover the true scale of the problem. Professor Jaideep Menon of Amrita Vishwa Vidyapeetham, Kerala, leading this project, notes snakebites were reclassified as a neglected tropical disease by the World Health Organization (WHO) in 2017 due to insufficient data, highlighting India's challenges in addressing the issue.

"India has the highest proportion of deaths and disabilities from snakebites, and understanding the problem's scope is essential for effective solutions," says Menon. The ICMR survey will cover 84 million people across 14 states and employ Accredited Social Health Activists (ASHA) to gather data on snakebite incidences, mortality rates, and the socio-economic burden.

A significant reason for underreporting snakebite cases is that many victims seek treatment from faith healers instead of medical facilities. Priyanka Kadam, an advisor to the NGO Snakebite Healing and Education Society, emphasizes that these unofficial treatments aren’t recorded.

An analysis in Madhya Pradesh from 2020 to 2022 revealed the state government compensated about $28 million annually for 2,846 snakebite deaths, drastically higher than the official report of 330. These figures suggest a severe discrepancy, with an estimated 5,200 deaths likely occurring annually.

Heat maps of snakebite deaths in Madhya Pradesh show Sagar and Satna with the highest mortality rates, indicating an urgent need for better reporting and resource allocation.

Understanding the economic implications of snakebites can facilitate access to polyvalent antivenoms (PAV) and enhance reporting among rural populations. Karthikeyan Vasudevan from the Laboratory for Conservation of Endangered Species in Hyderabad points out that existing estimates of snakebite incidents are inadequate, suggesting the actual burden is much higher. This underlines the necessity for effective treatments and education in rural communities.

Current PAVs come from four snake species: the spectacled cobra, common krait, Russell viper, and Indian saw-scaled viper. However, the effectiveness of these antivenoms against lesser-known species poses a challenge in areas with other prevalent snakes.

Recent research from the Indian Institute of Science in Bengaluru shows that the venom potency of the Russell viper and the spectacled cobra varies significantly throughout their lives. Notably, newborn Russell vipers' venom is more toxic than older ones, suggesting different treatment strategies based on the snake's age and species. Lead researcher Kartik Sunagar emphasizes understanding venom dynamics for effective antivenom development.

An international team led by Sunagar has identified an antibody that can neutralize a broad spectrum of snake venom toxins. Meanwhile, a team at the Indian Institute of Technology, Delhi, is working on a peptide-based treatment that promises to be more stable and effective than current PAVs.

Despite research advances, inadequate medical infrastructure in rural areas hinders effective snakebite treatment. Poor antivenom storage and handling often render them ineffective. Kadam highlights that the sluggish procurement system for fresh stocks exacerbates the issue, leading to unavailability at critical points.

Advanced technologies could optimize PAV management, but accurate demand forecasting is essential. Vasudevan notes, "The production cycle and supply chain depend on knowing the number of people needing treatment in district hospitals."

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