There has been a considerable increase in the number of people being treated for snakebite at Government Rajaji Hospital (GRH) in the last three months. During this period, out of the total of 582 people who were treated for snakebite at the hospital, 27 people have died.
The increase in the number of cases can be attributed to a rise in agricultural activity in monsoon, when the man-snake conflict is at its peak. However, the incidence of deaths due to snakebite is a major point of concern, say experts. Timely diagnosis and treatment of snakebite are essential to prevent physical disability or death, they say.
Hospital Dean J. Sangumani says that most number of cases are reported from rural areas such as Melur, Sholavandan and Natham regions and the victims are mostly farmers and daily wage workers.
Among the four major snake species in India - Indian cobra, krait, Russell’s viper and saw-scaled viper - data shows that most number of snakebite cases were caused by Russell’s viper.
Besides mortality, snakebite survivors often have to live with severe morbidity, including tissue damage and necrosis and amputations. “If a farmer or a daily wage worker is affected, it affects their entire family and causes a multi-dimensional problem,” says P.R. Vishwanath of Oorvanam, a non-governmental organisation involved in snake rescue.
The most important aspect is the timely treatment of snakebite cases, says Sakthivel Vaiyapuri, Associate Professor, School of Pharmacy, University of Reading, the United Kingdom, who has been campaigning to spread awareness of snakebite across the State for the last one year.
“After a snakebite, the patient has to be rushed to the hospital as soon as possible, preferably within two hours,” he says.
GRH data
However, data from the GRH shows that a huge percentage of people come for treatment only 12 hours after the snakebite. For instance, in September, around 20% of patients reached GRH only 12 hours after the snakebite. “In rural areas, people still tend to believe in myths and stereotypes and do not visit a hospital for nearly a day or two, until the symptoms worsen,” says M. Natarajan, Head of the Department of Medicine, GRH.
Challenges
During the golden hours, it is essential to give anti snake venom (ASV) to patients as soon as possible as it will provide some respite before reaching a tertiary healthcare unit, says Mr. Vaiyapuri. “Many Primary Health Centres are not equipped with ASV. Even if they possess ASV, the doctors do not treat the patients as they fear opposition from patients due to allergies caused because of ASV,” he says.
The other major challenge is the lack of a proper diagnosis kit for snakebite in the country, he says. “Not every snakebite is venomous. However, we do not have a kit to identify it and we come to conclusion based on clinical assumptions,” he said.
A large number of organisations are working worldwide to address these issues, he said.
