India recorded 1.2 million snakebite deaths in the past two decades

70% of them are from eight States, says study, and they mainly occurred in rural areas

India recorded a staggering 1.2 million snakebite deaths in the 20-year period from 2000 to 2019 with an average of 58,000 deaths caused by snakebite annually. Around 70% of these deaths occurred in limited, low altitude, rural areas of eight States — Bihar, Jharkhand, Madhya Pradesh, Odisha, Uttar Pradesh, Andhra Pradesh (including Telangana), Rajasthan and Gujarat.

The study, conducted by the Centre for Global Health Research (CGHR) at the University of Toronto, Canada, with Indian and U.K. partners, also points out that half of all the snakebite deaths occurred during the monsoon period from June to September. The paper titled ‘Trends in snakebite deaths in India from 2000 to 2019 in a nationally representative mortality study’ indicated that most of the envenomation (the process by which venom is injected by the bite or sting of a venomous animal) was by Russell’s vipers followed by kraits and cobras.

The study indicated that snakebite deaths occurred mostly in rural areas (97%), were more common in males (59%) than females (41%), and peaked at ages 15-29 years (25%).

The numbers for annual snakebite deaths were highest in the States of Uttar Pradesh (8,700), Andhra Pradesh (5,200) and Bihar (4,500), it further added.

In the largest ever such survey published in 2011 and titled ‘Snakebite Mortality in India: A Nationally Representative Mortality Survey’, researchers of the Million Death Study estimated 46,000 annual snakebite deaths in India. The World Health Organization (WHO) recognises snakebite as a top-priority neglected tropical disease (NTD).

‘Need to act now’

Romulus Whitaker, from the Centre for Herpetology/Madras Crocodile Bank and one of authors of the new study told The Hindu that the research not only adds a fresh perspective to the earlier study but also revises the number of annual snakebite deaths in the country from 46,000 to 58,000.

“Since deaths are restricted mainly to lower altitude, intensely agricultural areas, during a single season of each year, this should make the annual epidemics easier to manage. India’s tremendous snakebite burden is staring us in the face and we need to act now!” Mr. Whitaker said.

The study also indicated that the Government of India’s data while relying on reporting from public hospitals captured only 10% of the expected hospital-based deaths.

“Our study directly quantified and identified the populations most affected by fatal snakebites in India. We showed that the overall lifetime risk of being killed by snakebite is about 1 in 250, but in some areas, the lifetime risk reaches 1 in 100,” said Prabhat Jha, Director of the CGHR at Unity Health Toronto and one of the authors of the paper.

‘Snake-safe’ harvests

The primary victims of snakebites are rural farmers and their families. Experts suggest that targeting certain areas and educating people with simple methods such as ‘snake-safe’ harvest practices — using rubber boots and gloves, mosquito nets and rechargeable torches (or mobile phone flashlights) — could reduce the risk of snakebites. The new study calls for improved knowledge of the distribution of venomous snake species as well as the human consequences of bites.

“An enhanced snake species database with habitat details, clear photographs and geographical distribution is now downloadable as an Android phone app from indiansnakes.org. India has sufficient capacity to manufacture large volumes of anti-venom. Better understanding of the distribution of India’s many venomous snake species could help in the design and development of more appropriate anti-venoms,” said Jose Louise, founder of the website indiansnakes.org.

Anti-venoms needed

Mr. Louise also added that Indian anti-venoms neutralise venom from only spectacled cobra (there are three other Indian cobra species), common krait (there are seven other krait species), Russell’s viper and saw-scaled viper, whereas there are 12 other snake species causing fatal bites in the country that are not covered by current anti-venoms.