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Snake Venom and Antivenoms
Context:
India records an estimated 58,000 deaths annually due to venomous snakebites, making it the ‘snakebite capital’ of the world.
More on News:
- In one tragic incident, five-year-old Mayuri from Uttara Kannada, Karnataka, lost her life due to a delay in receiving antivenom and unsafe conditions at her Anganwadi.
- The majority of these deaths are caused by the Big Four species: Indian cobra (Naja naja), Common krait (Bungarus caeruleus), Russell’s viper (Daboia russelii), Saw-scaled viper (Echis genus).
- The country faces about 1.2 million snakebite deaths over a span of 14 years, with certain risk factors such as agricultural work and poor infrastructure contributing to this staggering mortality rate.
What Makes Snake Venom Deadly?
- Snake venom is a complex mixture of toxic proteins that evolved to immobilise and digest prey and to defend against threats. The venom contains:
- Haemotoxins: These toxins damage blood cells and disrupt clotting, potentially leading to internal bleeding.
- Neurotoxins: These block nerve signals, leading to paralysis and potentially respiratory failure.
- Cytotoxins: These toxins destroy tissue at the bite site, causing severe damage.
- When a snake bites, the venom injected into the victim can lead to rapid deterioration of the body, often resulting in death without prompt medical intervention.
What Are Antivenoms?
- Antivenoms (or antivenins) are medicines used to treat venomous snakebites. They are produced by injecting small amounts of venom into animals (usually horses), which then generate antibodies.
- These antibodies are purified and used as antivenoms to neutralise the venom’s toxic effects.
How Do Antivenoms Work?
- Antivenoms work by binding to the venom’s toxins, neutralising their harmful effects and allowing the body to clear them.
- For antivenom treatment to be effective, medical personnel must know the snake species involved and the amount of venom injected.
- Polyvalent antivenoms (PVAs), which target multiple species, are commonly used in India but may have limited effectiveness for less common snake species.
- Production Process:
- Venom Extraction: Venomous snakes are captured and “milked” for venom.
- Immunising Horses: Horses are injected with small amounts of venom over time, stimulating their immune systems to produce antibodies.
- Antibody Extraction: The antibodies from the horse’s blood are purified and formulated into antivenoms.
Challenges in Snakebite Treatment
- Accessibility: In remote areas, people may have to travel long distances to access healthcare facilities with antivenoms. This delay, coupled with logistical issues like inadequate storage and distribution systems, worsens the situation.
- Cost and Availability: Manufacturing antivenoms are expensive, and in rural areas, lack of cold storage can cause antivenoms to degrade, making them ineffective.
- Cultural Barriers: In some regions, superstitions and cultural practices delay proper medical treatment, contributing to higher death rates.
Innovation and Future of Antivenoms
- Recombinant DNA technology is being explored to produce synthetic antivenoms free from animal proteins, offering greater safety and effectiveness.
- The use of Artificial Intelligence (AI) and computer-designed proteins could accelerate antivenom development, enabling faster, more effective treatments.
- Region-specific antivenoms are being developed by mapping the venom compositions of different snake species to create more targeted treatments.
- Portable venom-detection kits and rapid diagnostic tools are also being developed to improve the timely administration of antivenoms.
Way Forward
- Investment in research, public education, and improving healthcare infrastructure are crucial to addressing the snakebite crisis in India.
- With advances in science and better healthcare delivery, tragedies like Mayuri’s death could become preventable in the future.
The National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE)
- Vision: The primary goal is to reduce snakebite deaths by half by 2030.
- Collaborative Approach: The plan adopts a ‘One Health’ approach, involving collaboration between healthcare professionals, researchers, governmental agencies, non-governmental organisations, wildlife experts, and community leaders.
- Strategies: Key strategies include capacity building of health professionals, promoting accessibility to treatments, strengthening emergency care services, and enhancing surveillance of snakebite cases.
- Awareness and Education: The plan includes initiatives to raise awareness about snakebite prevention and management through educational materials, community outreach activities, and a dedicated Snakebite Helpline.
- Regional Venom Centers: Establishment and strengthening of Regional Venom Centers to ensure prompt and effective management of snakebite cases.
