Hyderabad: One in every two deaths caused by snake bite globally every year occurs in India. Such a mortality rate, without doubt the highest in the world, can be blamed on ill-trained doctors at the country’s local health-care centres and lack of access to antivenin—the antidote to venom—and medical care in time, say experts.
“Globally, the snake bite incidence has been about one million annually, of which one lakh people die. In India alone, the bite rate is at 2.5 lakh per annum, of which 50,000 die. About 20,000 each die in Pakistan and continental Africa,” said Ian D. Simpson, a toxicologist with the World Health Organization (WHO).
Staff at primary health-care centres in rural India are ill-trained to effectively treat snake bite victims, Dr Simpson said. “Most of them are not confident of carrying out the treatment and refer the victims to a secondary or a tertiary health centre,” the WHO official said.
Victims often have to travel to district hospitals and the time taken during the journey puts their lives at risk.
Worldwide, efforts have begun to make the drugs more effective and less toxic and administrators are moving towards species-specific antivenin. In India too, where most of the snake bite deaths are caused by just four snakes—the Cobra, Common Krait, Russell’s Viper and Saw-scaled Viper—companies such as Serum Vins Bioproducts have begun making snake-specific antidotes.
“In India, we market a polyvalent (which interacts with more than one kind of antigen) anti-venom against four snake species, while we market a combination product for 10 snake species in Africa,” says Ajit Nair, head of international business at Vins Bioproducts. Other makers of antivenin include the Serum Institute, Biological Evans, Bharat Serum and Haffkine Biopharmaceutical Corp.
Storage is another issue. Liquid antidotes, which account for 60% of the antivenin used in India, have a shelf life of two years if kept under refrigeration. But variants dried by freezing in vacuum can last for five years and do not require refrigeration.
Wrong diagnosis and prescription of antidotes can also be dangerous, especially when the snake is not poisonous. “Studies indicate as high as 40% of the patients who get anti-venoms do not require them at all. Side effects from such anti-venoms treatments can lead to patients turning deaf and suffering severe allergies,” Dr Simpson added.