Snakebites in India

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    Context

    About

    • As per ICMR study India has seen an estimated 1.2 million (12 lakh) snakebite deaths from 2000 to 2019, an average of 58,000.
    • India accounts for almost 50% of global snakebite deaths .
    • The snakebite envenoming (poisoning from snake bites) was classified by the World Health Organisation (WHO) as a high-priority neglected tropical disease.

    Snakebite Envenoming 

    • Snakebite envenoming is a potentially life-threatening disease caused by toxins in the bite of a venomous snake. 
    • Envenoming can also be caused by having venom sprayed into the eyes by certain species of snakes that have the ability to spit venom as a defence measure.
    • Snake venom contains a number of enzymes or proteinaceous substances, present in varying amounts according to the species of snake, which attack the blood, the nervous system, or other tissues. 

    Impacts of Snake biting

    • Some venoms produce direct toxic effects, but not all of them are lethal to human beings. Some are systemically lethal (e.g., the venom of the rattlesnake), whereas some are destructive primarily to tissue in the vicinity of the bite but may cause the development of gangrene.
    • In India the neglect and lack of attention on snakebites as a public health issue due to the socio-economic backgrounds of victims.
    • It is considered a poor person’s disease or a rural problem. People who get bitten by snakes are usually from marginalised communities, rural backgrounds, women, and children.
    • Big four medically significant snakes: It is a  theory that claims that four species of snakes in South Asia, Russell’s viper, saw-scaled viper, spectacled cobra, and the common krait bite people the most in this region.
    • In India, around 90% of snakebites are caused by the ‘big four’.

    Cure of SnakeBiting

    • Snake antivenoms are effective treatments to prevent or reverse most of the harmful effects of snakebite envenoming. They are included in the WHO Essential  Medicines List.
    • Antivenoms: Antivenoms are purified antibodies against venoms or venom components. Antivenoms are produced from antibodies made by animals to injected venoms. Antivenom is the only definitive treatment for effective bites by venomous snakes.
    • Antivenoms making process: To make life-saving antivenoms, scientists enlist the help of horses that live on specialized ranches.
      • The scientists inject the animals with a tiny, harmless dose of venom, which causes their immune systems to produce antibodies proteins that attack and disable the venom toxins.
      • Then the scientists can collect the antibodies and use them to treat people who have been bitten or stung.

    Challenges 

    • Lack of awareness, inadequate knowledge of prevention of snakebite and lack of first aid amongst the community lead to inefficient medical care. 
    • Peripheral healthcare workers, delay in receiving lifesaving treatment, and non-availability of trained medical officers for management of snakebite contribute to a higher number of deaths.
    • Superstitions about snake bites: The community had wrong perceptions on the identification of venomous snakes and snakebites. Belief in a snake god, ability of tamarind seeds or magnets to reduce the venom effect.
    • There was no Information, Education, and Communication (IEC) material available on the identification of venomous and non-venomous snakes, prevention, first aid, and treatment of snakebites in any of the government healthcare facilities.

    Steps taken 

    • Inclusion of snakebite management in the curriculum of training institutions of state public health departments in India, mandatory short-term training of medical graduates during their internship and also as a part of the induction training on joining state health services in India.
    • Snakebite prevention is to be included under a national programme by the Union government.
    • A multi-sectoral approach of community awareness, capacity building of healthcare facilities for reducing the mortality and morbidity due to snakebite envenoming in India.
    • Every village-level health centre has Anti Snake Venom  (ASV), which is the first stage of treatment, something that wasn’t easily available in rural India before.
    • Even WHO launched its roadmap with an aim to halve death and disability from snakebite by 2030.

    Source: The Hindu