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Snakebites to Be Made a Notifiable Disease
Context:
The Union Health Ministry has recently urged states to classify snakebites as a notifiable disease.
What is a Notifiable Disease?
- Notifiable diseases are those that must be reported to the government due to their potential to cause outbreaks, lead to fatalities, or require quick investigation and public health action.
- The diseases commonly classified as notifiable include infections like tuberculosis, HIV, cholera, malaria, dengue, and hepatitis, which may pose significant health risks to the population.
Why are Snakebites Considered a ‘Disease’?
- Medical emergency: Snakebites can result in serious health issues like paralysis, haemorrhage, and tissue damage. Immediate treatment with antivenoms is crucial to prevent fatalities.
- Public health challenge: In India, snakebites are a leading cause of death, with an estimated 58,000 deaths annually.
- Fatal Snakes in India: India has over 310 species of snakes, of which 66 are venomous. Among them, four species—the Indian cobra, common krait, Russell’s viper, and saw-scaled viper—are responsible for the majority (90%) of fatal snakebites.
- The commercially available polyvalent antivenom works against venom from all four species, covering about 80% of snakebite cases.
Challenges in Treating Snakebites:
- Delayed Treatment: Victims often fail to seek medical treatment in time, sometimes opting for traditional or faith-based healers instead of reaching healthcare facilities.
- Inadequate Training: Many healthcare providers are not adequately trained to treat snakebites, and diagnostic tests to confirm a snakebite are often unavailable.
- Antivenom Shortages: Antivenoms used to counteract snake venom in India are primarily produced using venom from snakes caught by the Irula tribe, who collect venom in Tamil Nadu, Karnataka, and Kerala.
- However, the venom from different geographical areas may have different biochemical properties, affecting the effectiveness of the antivenom.
- Additionally, venom potency can vary by age of the snake, with neonate Russell’s vipers exhibiting higher toxicity than adults. This creates inconsistencies in antivenom effectiveness.
- Regional Snake Species: There are also regional snake species, particularly in the Northeast, such as the banded krait, monocled cobra, and green pit viper, for which commercially available antivenoms may not be effective.
- Antivenom Reactions: Even when antivenom is available, it can cause adverse reactions, complicating treatment further.
The National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE):
- Earlier this year, the government launched NAPSE with the goal of halving snakebite deaths by 2030.
- One of the key objectives of this plan is to enhance the surveillance of snakebite cases and deaths.
- By making snakebites notifiable, the government aims to gather accurate data on the burden of snakebites, identify high-risk areas, and improve clinical management.
Future Directions:
- Artificial antibodies and peptides: To address the limitations of current antivenoms, researchers are working on artificially produced antibodies and peptides that could neutralise toxins from a variety of snake species.
- There are also suggestions to set up venom collection banks across the country to better address regional venom differences and produce more effective antivenoms. However, the Wildlife (Protection) Act of 1972 restricts access to snakes, which poses a significant obstacle to establishing such banks.
