Snakebite crisis in Assam: Study calls for urgent intervention
Tarini Dev Goswami
(tdgoswami@iasst.gov.in)
A recent ground-breaking study conducted by a team of scientists from IASST and clinicians from Demownt Community Health Centre, Assam, has shed light on the alarming scale of the snakebite problem in Assam, a biodiversity hotspot in India. Snakebite, categorized as a neglected tropical disease (NTD), disproportionately impacts marginalized populations in impoverished rural areas with limited access to healthcare services.
According to the World Health Organization (WHO), the reported figure of approximately 5.4 million snakebites annually worldwide significantly underestimates the true magnitude of the problem in the Indian subcontinent, particularly in Assam. The region has a wide range of venomous snakes, such as the Indian monocled cobra, banded krait, greater black krait, lesser black krait, king cobra, green pit viper, and Salazar’s pit viper. Unfortunately, the lack of reliable snakebite data hampers effective public health planning and resource allocation.
In response to this pressing issue, a team of scientists from the Institute of Advanced Study in Science and Technology (IASST), Guwahati, Tezpur University, Tezpur, Assam, and Amrita School of Nanosciences and Molecular Medicine, Kochi, Kerala, led by renowned toxicologist and Director of IASST Prof. Ashis K. Mukherjee, conducted a ground-breaking retrospective and observational study. The study, undertaken by a team comprising Hirakjyoti Kakati, Surajit Giri, Aparup Patra, Simanta J. Taye, Deepak Agarwalla, Hridoy Baruah, Gaurav Choudhary, Bhargab Kalita, and Ashis K. Mukherjee, presents a significant contribution to the understanding of the snakebite crisis in Assam. Collaborating with clinicians at the Demow Government Community Health Centre in Sivasagar, the study revealed alarming statistics. Over the past five years, an estimated 1011 patients have been bitten by snakes in this small area, with 13.7% of the bites being venomous.
While treatment with commercial polyvalent antivenom, administered in multiple vials (10–30), showed some success in saving the lives of patients bitten by cobras and kraits, it proved inadequate in neutralising the clinical effects, particularly coagulopathy caused by pit viper venom. This highlights the urgent need for region-specific antivenoms tailored to address the unique venom compositions found in the area. Developing such antivenoms is crucial to enhancing snakebite management and improving patient outcomes.
The study also emphasized the importance of forming Venom Response teams (VRT) comprising clinicians, herpetologists, and volunteers. These teams are vital to effectively managing snakebites in rural health centres. Prof. Mukherjee emphasized that this study serves as a wake-up call for primary and tertiary health centres nationwide to adopt a similar approach to reduce snakebite-related mortality and morbidity.
The collaborative effort between scientists and medical practitioners showcased the power of interdisciplinary cooperation in addressing complex health challenges. Prof. Mukherjee stressed the significance of active involvement from government policymakers and stakeholders to mitigate the snakebite problem in India effectively. Published in the July Toxicon (Elsevier) issue, this study serves as an urgent call to action.