Snake bites kill 46K in India yearly
Kounteya Sinha, The Times of India.
TNN Dec 6, 2011, 03.58AM IST
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CHICAGO: Fatal snake bites have become a major public health concern in India. What's worse, it is vastly under-reported, according to a study presented on Monday.
The American Society of Tropical Medicine and Hygiene said in India 46,000 people are dying every year from snakebites against the official figure of only 2,000
More than 2.5 lakh cases of snake bites are reported every year. Those who survive the bite on the spot, subsequently die due to delay, unable to reach a hospital within the crucial golden hour or due to lack of treatment, resulting in overdose of anti-venom.
The statistics are shocking, considering India is neither home to the largest number snakes in the world nor is there a shortage of anti-venom in the country.
India had finalized a national policy that would ensure fast and effective use of anti-venom, besides making it available to healthcare centres in backward villages. The policy was to help train doctors who had inadequate knowledge on how to deal with the neuro-toxic shock that the patient experiences following a snake bite besides providing guidelines for hospitals conducting research on the subject.
However, the Union health ministry is yet to aggressively push its implementation.
Ulrich Kuch from Biodiversity and Climate Research Centre in Frankfurt said snake bite victims often do not go to hospitals because they have to travel too far, anti-venom is scarce in many regions, or the treatment can be too expensive. "People are dying in their villages without bothering the health system. They simply don't show up in the statistics," Dr Kuch said. "In the 21st century, snakebite is the most neglected of all the neglected tropical diseases," said David Warrell from University of Oxford. "The deaths and suffering from venomous snakebites remain largely invisible to the global health community," he added.
In the absence of significant global initiatives, scientists and research institutions are taking it upon themselves to develop solutions in Asia. Scientists presented promising data on rapid diagnostic tests being developed to allow physicians to make fast decisions on whether to give anti-venom and which type to use. Now, standard practice is to wait until symptoms of envenomation appear before giving anti-venom because it can have serious side-effects and the supply is scarce.
However, the venom of certain species irreversibly destroys parts of the nervous system before envenomation becomes clinically apparent, making the resulting life-threatening paralysis resistant to anti-venom treatment. With a 20-minute strip test that shows if venom was injected and by which species, doctors can administer anti-venom immediately after such bites before patients become severely ill or die. The tests are easy to use in rural, poor settings.
The tests discussed at the forum would detect bites from two deadly snakes - the Russell's viper and the krait. The krait test is in preliminary stages for potential use in south Asia. The Russell's viper test successfully completed preclinical testing with a clinical trial expected next year. It has been designed for Myanmar with plans to adapt it for wider use throughout south-east Asia.
Another successful programme uses volunteer motorcycle drivers to rush victims in south-eastern Nepal to a community-based snakebite treatment centre. Data presented at the conference showed that the programme substantially reduced the snakebite death-rate - from 10.5% to 0.5% compared to no decrease in other villages surveyed. The programme began in 2003 after a study found that 80% of deaths due to snakebites in villages surveyed occurred outside a medical centre and that half of those victims died on the way to the health facility. Researchers established a programme, where volunteer motorbike owners race snakebite victims 24-hours-a-day to the Damak Red Cross Health Centre for fast medical care. The programme was expanded to 40 villages, and this year began in south central Nepal with hopes of it being replicated in India.
The World Health Organization estimates that up to five million people suffer from snakebites each year, resulting in 300,000 cases of permanent disability and about 100,000 deaths.
But two recent studies - one from India and the other from Bangladesh - reveal that the magnitude of the problem is far greater than official statistics show.
ASTMH says the key reason for the low count is that many snakebite victims are treated or die without seeking or reaching health facilities. The Bangladeshi study says it records 700,000 snakebites and 6,000 deaths annually, which is far higher than previous estimates. Also only 3% of those treated went directly to a physician or a hospital. About 86% saw a "snake charmer".
India is home to 13 snake varieties that are highly poisonous of which five make up the deadly list of the common snakes biting humans - Common Cobra, Krait Cobra, Russells Viper, Saw Scaled Viper and Hump Nose Pit Viper.
The worst-affected states are Kerala, Maharashtra, Tamil Nadu, Odisha, Assam and West Bengal. A health ministry official told TOI, "The first few minutes after a snake-bite are crucial. Because there are no uniform guidelines, hospitals cause delay before the patient is put on effective treatment. Instead of going to the nearest hospital, villagers trust traditional healers who are often quacks."
The expert added, "Often, anti-venom is administered, which results in trauma as the antidote can result in side-effects. Chemicals such as potassium permanganate and tourniquet, and also using the mouth suction method leads to gangrene and poisoning."
================================================
CHICAGO: Fatal snake bites have become a major public health concern in India. What's worse, it is vastly under-reported, according to a study presented on Monday.
The American Society of Tropical Medicine and Hygiene said in India 46,000 people are dying every year from snakebites against the official figure of only 2,000
More than 2.5 lakh cases of snake bites are reported every year. Those who survive the bite on the spot, subsequently die due to delay, unable to reach a hospital within the crucial golden hour or due to lack of treatment, resulting in overdose of anti-venom.
The statistics are shocking, considering India is neither home to the largest number snakes in the world nor is there a shortage of anti-venom in the country.
India had finalized a national policy that would ensure fast and effective use of anti-venom, besides making it available to healthcare centres in backward villages. The policy was to help train doctors who had inadequate knowledge on how to deal with the neuro-toxic shock that the patient experiences following a snake bite besides providing guidelines for hospitals conducting research on the subject.
However, the Union health ministry is yet to aggressively push its implementation.
Ulrich Kuch from Biodiversity and Climate Research Centre in Frankfurt said snake bite victims often do not go to hospitals because they have to travel too far, anti-venom is scarce in many regions, or the treatment can be too expensive. "People are dying in their villages without bothering the health system. They simply don't show up in the statistics," Dr Kuch said. "In the 21st century, snakebite is the most neglected of all the neglected tropical diseases," said David Warrell from University of Oxford. "The deaths and suffering from venomous snakebites remain largely invisible to the global health community," he added.
In the absence of significant global initiatives, scientists and research institutions are taking it upon themselves to develop solutions in Asia. Scientists presented promising data on rapid diagnostic tests being developed to allow physicians to make fast decisions on whether to give anti-venom and which type to use. Now, standard practice is to wait until symptoms of envenomation appear before giving anti-venom because it can have serious side-effects and the supply is scarce.
However, the venom of certain species irreversibly destroys parts of the nervous system before envenomation becomes clinically apparent, making the resulting life-threatening paralysis resistant to anti-venom treatment. With a 20-minute strip test that shows if venom was injected and by which species, doctors can administer anti-venom immediately after such bites before patients become severely ill or die. The tests are easy to use in rural, poor settings.
The tests discussed at the forum would detect bites from two deadly snakes - the Russell's viper and the krait. The krait test is in preliminary stages for potential use in south Asia. The Russell's viper test successfully completed preclinical testing with a clinical trial expected next year. It has been designed for Myanmar with plans to adapt it for wider use throughout south-east Asia.
Another successful programme uses volunteer motorcycle drivers to rush victims in south-eastern Nepal to a community-based snakebite treatment centre. Data presented at the conference showed that the programme substantially reduced the snakebite death-rate - from 10.5% to 0.5% compared to no decrease in other villages surveyed. The programme began in 2003 after a study found that 80% of deaths due to snakebites in villages surveyed occurred outside a medical centre and that half of those victims died on the way to the health facility. Researchers established a programme, where volunteer motorbike owners race snakebite victims 24-hours-a-day to the Damak Red Cross Health Centre for fast medical care. The programme was expanded to 40 villages, and this year began in south central Nepal with hopes of it being replicated in India.
The World Health Organization estimates that up to five million people suffer from snakebites each year, resulting in 300,000 cases of permanent disability and about 100,000 deaths.
But two recent studies - one from India and the other from Bangladesh - reveal that the magnitude of the problem is far greater than official statistics show.
ASTMH says the key reason for the low count is that many snakebite victims are treated or die without seeking or reaching health facilities. The Bangladeshi study says it records 700,000 snakebites and 6,000 deaths annually, which is far higher than previous estimates. Also only 3% of those treated went directly to a physician or a hospital. About 86% saw a "snake charmer".
India is home to 13 snake varieties that are highly poisonous of which five make up the deadly list of the common snakes biting humans - Common Cobra, Krait Cobra, Russells Viper, Saw Scaled Viper and Hump Nose Pit Viper.
The worst-affected states are Kerala, Maharashtra, Tamil Nadu, Odisha, Assam and West Bengal. A health ministry official told TOI, "The first few minutes after a snake-bite are crucial. Because there are no uniform guidelines, hospitals cause delay before the patient is put on effective treatment. Instead of going to the nearest hospital, villagers trust traditional healers who are often quacks."
The expert added, "Often, anti-venom is administered, which results in trauma as the antidote can result in side-effects. Chemicals such as potassium permanganate and tourniquet, and also using the mouth suction method leads to gangrene and poisoning."
=================================================http://articles.timesofindia.indiatimes.com/2011-12-06/india/30481201_1_anti-venom-krait-snake-bites
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