3 L Cases, 2,000 Deaths A Year: Snakebite Now 'Notifiable Disease', Reporting By States & UTs Mandatory

According to a letter written by the health secretary, Punya Salila Srivastava, “A mandatory notification of all snakebite cases and deaths is required to strengthen snakebite surveillance. It will help the stakeholders gauge accurate burden, high-risk areas, factors responsible for deaths of snakebite victims, etc, resulting in improved clinical management of snakebite victims."

Srivastava wrote this letter to all states and union territories on November 27 while adding that notification of snakebite cases and deaths will also improve reporting from private health facilities. Considering this, the ministry has informed all states and UTs to make snakebite cases and deaths a “notifiable disease" under the relevant provisions of the State Public Health Act or other applicable legislation, “making it mandatory for all government and private health facilities (including medical colleges) to report all suspected and probable snakebite cases and deaths…" A robust surveillance system, the ministry believes, is essential for accurately tracking snakebite incidents and deaths, “which will provide valuable data to inform and evaluate the effectiveness of interventions."

Burden of snakebites & how it can be controlled

Snakebites, Srivastava highlighted, are an issue of public health concern and in certain cases, they cause mortality, morbidity, and disability, and farmers and tribal populations, among others, are at higher risk. The venomous snakebite can cause paralysis, haemorrhage, tissue damage, and irreversible kidney failures. Also, pregnant women are highly sensitive to haemorrhage due to venomous snakebites, as it can cause miscarriage.

India has more than 310 species of snakes, mostly non-venomous. However, 66 species are labelled as hostile or mildly hostile, and the majority of the snakebites result from four species, collectively named “Big 4". These four species are Russell’s viper (Daboia russelii), spectacled cobra (Naja naja), common krait (Bungarus caeruleus) and saw-scaled viper (Echis carinatus). To address the issue of snakebite, the ministry of health and family welfare this year launched the National Action Plan for Prevention & Control of Snakebite Envenoming (NAPSE) from India by 2030, which aims to halve snakebite-related deaths by that year.

How govt is readying mechanism to prevent snakebites

NAPSE has defined the strategic components, roles and responsibilities of various stakeholders involved in snakebite management, control and prevention, which includes strengthening the surveillance of snakebite cases and deaths in India. It also aims to systematically reduce snakebites’ envenoming risk through sustained availability of anti-snake venom, capacity building, referral mechanisms, and public education.

“The guidance document has already been in the implementation stage," a senior official in the health ministry told News18. “While the guidance document contains all details and all strategies have been planned based on that only, the strategy not only improves healthcare facilities for the timely and appropriate management and referral of snakebite cases but also includes initiatives to increase community awareness. It also includes capacity building for healthcare experts, veterinarians, and wildlife officers among others."

The document, NAPSE, has been designed in consultation with experts from multiple sectors, including Avinash C Visvanathan (Friends of Snakes Society, Telangana), Leena Menghaney (Médecins Sans Frontières), Dr Divyesh Mundra (former officer at Bharat Serums and Vaccines Limited), and Sumanth Bindumadhav (The Liana Trust and HSI/India).