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EXPLAINED: Common, But Mostly Under The Radar. What You Need To Know About Snakebite Cases In India

Salman Khan said he had to spend six hours for treatment at a hospital following the snakebite incident. (Photo: Viral Bhayani)

Salman Khan said he had to spend six hours for treatment at a hospital following the snakebite incident. (Photo: Viral Bhayani)

India sees a high-burden of snakebite cases, but most go unreported while reliance for treatment on faith healers and quacks leads to undesirable outcomes

The high-profile case of the snake bite suffered by Salman Khan has put the focus on a hazard said to be most commonly encountered in rural India. While the species to which the offending snake — it was released back into the wilderness after it was caught upon biting the Bollywood star — belonged is not known, the actor’s father said it was non-poisonous. Later, Khan told reporters that “it was a kind of poisonous snake" but that he had recovered well, even stepping out of his Panvel farmhouse on Mumbai’s outskirts to greet the media and well-wishers gathered there on his birthday. Snakebite deaths, mostly unreported, are said to claim thousands of lives in India every year even as the majority of the fatalities are attributed to all but four species. Here’s what you need to know.

How Many Snakebites Cases A Year Does India See?

Globally, says the World Health Organisation (WHO), snakebite cases number up to 5 million every year and end in between 81,000 and 138,000 deaths every year. India is said to account for about 50 per cent of all annual snakebite cases worldwide.

According to a 2020 study, India saw an estimated 1.2 million snakebite deaths from 2000 to 2019 at an average of about 58,000 fatalities per year. Further, a 2021 report based on a field study in Maharashtra notes that only a “very small proportion of snakebite cases were managed at government hospitals as the majority of the patients were referred to traditional faith healers".

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The Union Ministry of Health told Parliament last year that the main incidence of snakebite cases is among the rural populations and “is a common occupational hazard mainly in farmers, plantation workers, herders and labourers leading to significant morbidity and mortality". The ministry, too, noted that its occurrence “remains largely unreported".

The ministry had shared provisional data from the Integrated Disease Surveillance Programme (IDSP) showing that a total of 2,20,872 snake-bite cases were reported during the year 2019. Further, citing Central Bureau of Health Intelligence (CBHI) data, it said that the number of snakebite cases reported in the three years till 2018 were: 1.78 lakh in 2016; 1.58 lakh in 2017; 1.64 lakh in 2018, leading to 1,068, 1,060 and 885 deaths, respectively.

The ministry said that West Bengal had the highest burden of reported snakebite cases and deaths followed by Andhra Pradesh with Bihar a distant third.

What Are The Main Venomous Snake Species In India?

A Union Health Ministry document of 2016 says that of the more than 2,000 species of snakes in the world, about 300 are found in India. Of the species found in India, 52 are venomous, it adds, noting that venomous snakes in India belong to three families — elapidae, viperidae and hydrophidae. WHO says that the ‘big four’ from these three familes — Indian cobra, Indian krait, Russell’s viper and saw-scaled viper — account for around 90 per cent of snakebites in India.

The ministry says that the clinical effects of poisoning, or envenoming, by same species of snake are “almost similar except a few regional variations". It says that kraits are active during night hours, often biting a person sleeping on the floor while “maximum viper and cobra bites occur during the day or early darkness" in fields or among crops.

What Are Mitigating Actions That Have Been Taken?

According to the Union Health Ministry, all states and Union Territories have been advised to report all snakebite cases under IDSP and include anti-snake venom serum (ASVS) in the list of essential drugs “and procure these drugs locally for supply to health facilities under National Health Mission (NHM)".

The ministry told Parliament that anti-snake venom is produced in India by both the public and private sector institutes. Among the private firms manufacturing ASVS are the likes of the Pune-based Serum Institute of India and Biological E of Hyderabad, which are also involved in the production of Covid-19 vaccines.

But the ministry had told Parliament last year, citing “information available in public domain", that one study had shown that “currently marketed anti-venoms were found to exhibit poor dose efficacy and venom recognition potential against the venom of neglected snake species while the marketed anti-venom formulations are meant for the commonly found four snake species".

The 2021 report that studied snakebite cases in an administrative block in Palghar district of Maharashtra, said that “inappropriate perception, inadequate awareness, and knowledge about snakes and snakebites may predispose the tribal community to increased risks of venomous snakebites".

It pointed out that “unproven and harmful methods for snakebite treatment practiced by the community and traditional faith healers could be dangerous leading to high mortality" while calling for “a multi-sectoral approach of community awareness, mapping of vulnerable populations, capacity building of health care facility, empowerment of health care workers" to reduce the mortality and morbidity due to snakebite in India.

WHO in 2017 added snakebite envenoming to its priority list of neglected tropical diseases (NTDs) and has set a target of reducing by half the number of deaths due to snakebite envenoming by 2030 across the world.

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first published:December 27, 2021, 11:57 IST