SNAKEBITE: INDIA’S MOST NEGLECTED TROPICAL ‘DISEASE’
India’s first national survey of the causes of death, the Million Death Study, undertaken in 2001-03 by the Registrar General of India and the Centre for Global Health Research gives an estimate of 46,000 annual deaths by snakebite in the country whereas the Government of India’s Central Bureau of Health Intelligence reports only 1,350 deaths each year for the period 2004 to 2009. This massive statistical disparity has important and urgent implications. There are four species groups of snakes (of the nearly 300 different species in India) primarily responsible for what is likely to be the highest death rate from snakebite in any country in the world, the ‘Big Four’: cobra (four species), krait (eight species), saw-scaled viper (two subspecies) and Russell’s viper. All are widely distributed throughout most of the country although areas like the far Northeast, the Himalayan region and the Andaman’s and Nicobar Islands have distinctive snake fauna.
The venom for producing antivenom comes mainly from the Irula Snake-catchers Industrial Cooperative Society at the Madras Crocodile Bank on Chennai’s East Coast Road. And herein lies one of the problems. Clinicians in other parts of the country are reporting that the antivenom they are using is relatively ineffective in counteracting the effects of a venomous bite. This could be explained by geographic variation in the composition of the venom of a single species.
Since snakebite is a rural problem, primarily affecting India’s farmers, rural labourers and their families it would make sense for antivenom and associated treatment to be available at Primary Health Centers and other rural medical facilities. However, this is often not the case and training in snake identification and snakebite treatment is woefully inadequate.
The Million Death Study puts it in a nutshell: “Snakebite remains an underestimated cause of accidental death in modern India. Community education, appropriate training of medical staff and better distribution of antivenom, especially to the 13 states with the highest prevalence, could reduce snakebite deaths in India.”
The Madras Crocodile Bank Trust and Centre for Herpetology (MCBT), in collaboration with scientists at the Indian Institute of Science (IIS), Vellore Institute of Technology (VIT), Ashoka Trust for Research in Ecology and the Environment (ATREE), the Australian Venom Research Unit (AVRU) from the University of Melbourne and the Global Snakebite Initiative have begun an ambitious project working with government and antivenom manufacturers to revolutionise the production of snake antivenoms for use in India. This multi-component project will combine science, conservation, and improved production of antivenom starting materials with preclinical and clinical trials of new antivenom formulations. In addition the project is exploring other key questions, particularly in relation to Russell’s viper which is responsible for many serious and fatal bites. Venom is being collected from different geographic areas around India, quickly frozen using a new GSI-developed protocol and then being studied to examine how effectively it is neutralised by the current Indian antivenoms. Detailed proteomic studies will follow. Results of these studies are also expected to contribute to improving the quality and potency of Indian antivenoms.
GSI and the MCBT hope to raise US$20,000 in 2016-17 to make it possible to complete the testing of venom from representative Indian Russell’s viper populations spread right across India. Without the data this important research will generate, making improvements to India’s current arsenal of antivenoms will be hampered, and many thousands more people will suffer from ineffective treatment.
HOW YOUR DONATION WILL HELP
By supporting this project in India, you will helping the GSI, Madras Crocodile Bank Trust and Centre for Herpetology, Indian Institute of Science and National Center for Biological Sciences to:
- Conduct the first comprehensive tests of current commercially available Indian snake antivenoms against venom from Russell’s vipers collected nationwide;
- Enable problems in the effectiveness of the current antivenoms to be identified, and make it possible to develop new immunisation mixtures for raising more broadly effective Indian antivenoms that ultimately may save the lives of thousands of Indian men, women and children.
100% of your donation will go directly to the Madras Crocodile Bank Trust and Centre for Herpetology to fund this important Indian snakebite project, if you select the MCBT as the designated recipient when you donate to the Global Snakebite Initiative. Donations of any amount are welcomed.
READ MORE: Snakebite mortality in India 2011