By Usman Ahmad from Pakistan – Russell’s Viper Fangs, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=110267747
Burden of Snakebites and Management Issues in District Poonch, Jammu and Kashmir, India
Snakebite is a common and often devastating environmental and occupational health issue, particularly in rural India (Mohapatra et al. 2011; Warrell 2010). Globally, snakebites account for approximately 140,000 deaths annually, with disability rates two to three times higher. In India, the situation is especially alarming, with snakebite fatalities constituting nearly half of the global total and an
estimated 400,000 amputations or disabilities reported each year (Virtual Summit 2024). A significant portion of snakebite-related deaths remains unreported due to non-hospitalisation, reliance on traditional or unproven remedies, and inadequate healthcare infrastructure in remote regions. To address these challenges, the Ministry of Health and Family Welfare, in collaboration with the Ministry of Agriculture and Forestry, Government of India, launched the National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE) on March 12, 2024. This initiative aims to reduce snakebite-related deaths and disabilities in India by 50% by 2030. This study highlights the under-reporting of snakebite cases, the non-hospitalisation of victims, and the widespread use of local remedies for treatment. The burden of snakebite isclosely linked to the prevalence of medically significant snakespecies. Of the 236 snake species recorded in India, more than 15 are responsible for systemic envenoming (Virtual Summit 2024). In Jammu and Kashmir, 41 snake species have been documented (Sharma 2022), of which 21 species occur inPoonch district. These include three medically significantspecies: Daboia russelii, Bungarus caeruleus, and Naja oxiana (Sahi and Duda 1985; Whitaker and Captain 2015; Hussain 2024).
Snakebite continues to be a neglected public health concern requiring urgent, coordinated intervention to improve outcomes. While snakebites are common in rural areas, ischemic stroke as a complication of envenoming is under-recognised. Early detection of neurological issuesis crucial for effective treatment (Kumar et al. 2015). Snakebite-induced ischemic stroke, though uncommon, can lead to severe neurological sequelae if not promptly managed (Kumar et al. 2015; Paul et al. 2014). The case study included in this work describes a patient with delayed diagnosis of infarcts in the posteriorcirculation, resulting in a prolonged neurological deficitlasting 133 days and ultimately leading to death. This case underscores the urgent need for timely diagnosis and management of snakebite-induced complications.MethodologyThis study was conducted from January 2020 to December 2021. Data on snakebite cases and local remedies used were collected from healthcare centres and through interviews with local residents. Information on non-hospitalised cases and unrecorded deaths was obtained via social media (a dedicated WhatsApp group), direct contacts, and rescue calls. A WhatsApp group comprising volunteers, snake rescuers, and biodiversity enthusiasts from the study area was established to facilitate awareness and information gathering. Reported snakebite incidents were confirmed by directly contacting the affected families. Statistical analyses of the collected data were performed using factorial ANOVA and Duncan’s Multiple Range Test (DMRT) with MSTATC®.
