Snakebites: Extent, Significance & First Aid
Snakebites around the World
Snakebite numbers: There are more than 3,000 species of snakes, out of which about 600 are venomous. The complete data on the number of snakebites in all countries is not fully available, the lowest global estimate is 1.2 million snakebites every year (higher estimate is 5.5. million).
Deaths: Snakebites cause at least 20,000 deaths every year. The estimate of deaths is as high as 94,000 every year. Snakes are present across most of the countries around the world. A large number of people particularly in developing countries of the tropics are bitten leading to a very high burden of venom associated disease, disability and deaths.
Disease and Disability: The lowest estimated number of people who suffer from envenoming (symptoms, disease and disability caused by snake venom) is about half a million every year. The higher estimate of envenoming is about 2 million every year. Venoms of different poisonous snakes affect various body systems including blood coagulation disorders causing internal organ bleeding and damage, kidney and at times acute renal failure, nervous system and at times leading to convulsions and paralysis.
Loss of livelihood and production: In addition to the disease, disability and death, snakebites cause decrease in production in already disadvantaged communities due to the fact that most of the people who are bitten by snakes are farmers and workers in rural areas of developing countries in Asia and Africa.
Unfortunately, still a neglected disease: Snakebite victims are mostly the poor farmers, living in rural and remote areas of the developing countries. Hence, the snakebite problem has not been given the due importance by the countries, international technical and funding agencies and WHO. It has been only since 2009 that the WHO listed snakebite as a ‘neglected disease’.
Snakebites in Myanmar
Myanmar is in the region (Myanmar, Thailand, India, Pakistan, Bangladesh, Indonesia) where the burden of snakebite is highest compared to the burden in any other region of the world. In Myanmar many highly venomous snakes, including Viper, Cobra and Krait, are common, and a larger number of people get bitten by these venomous snakes. Due to the challenges in collecting complete information from remote and rural locations it has been difficult to identify the exact number of venomous snakebites as many victims are in rural and remote areas and may suffer from disease, disability and death without ever reporting to the health centre. A lower estimate is about 10,000 cases of snakebites. The reported deaths are about 500 every year, with an additional large number of people suffering from acute and long term complications and disabilities.
In Myanmar, snakebites are more common in Mandaly, Bago, Sagaing, Ayeyarwady and Yangon divisions. About 70% of the bites are caused by Russell’s viper (Daboia Russelli, Siamensis). Therefore, mortality from snakebites in Myanmar is high (10% of the victims die). In fact, a prospective study of 500 snakebite victims revealed that the death rate among snakebite victims in Myanmar may be as high as 50%. The factor causing such high fatality rate includes, among others, inadequate or incorrect first aid, delays in transporting the victim to a well-equipped health care facility with staff well trained to manage envenoming, shortage of anti-venom, poor quality or absence of the relevant anti-venom.
Even a bite by a non-poisonous snake may cause severe allergic reaction and/or infection. Therefore, all snakebites are to be considered as emergencies with appropriate first aid and quick transfer of the victim to a health service for assessment and effective management with anti-venom by a trained health care provider.
Keep the bitten person still and calm, as this slows down the spread of venom
Keep the bitten site (e.g. hand, foot) below the level of the heart
Cover the bite with a clean dry dressing or apply a pressure pad if available
- it delays the toxins reaching the blood and body systems
Immobilise the bitten limb with a splint
Transport to medical care as quickly as possible
Do not apply tourniquets as they are dangerous and cause
Do not slash the wound with a knife
Do not suck out the venom
Do not apply ice or water
Do not drink coffee or alcohol
Avoid traditional treatments as it often causes delays in accessing the effective treatment