Alcoba, G. et al. [8] [9] However, most of the bites are reported by nonvenomous snakes and even as many as 40% bites inflicted by venomous snakes do not produce signs of envenoming.[31]. Anim. Out of 69,097 deaths that could be coded to the ICD codes above, 5711 (8.3%) were coded to unspecified venomous animal contact and needed to be redistributed. [65] The highly venomous beaked sea snake is responsible for more than 50% of all sea snake bites, as well as the majority of envenomings and fatalities. Only 13% of bites occur on the legs or feet. had primary responsibility for applying analytical methods to produce estimates. The risk to field biologists working in Central America is estimated at one bite per 500,000 hours of field work. It is believed that up to 1,500 definite or suspected snakebites occur in Australia each year, of which about 200 are serious enough to warrant antivenom therapy. Bawaskar, H. S., Bawaskar, P. H. & Bawaskar, P. H. Primary health care for snakebite in India is inadequate. The saw-scaled viper is estimated to kill about 5,000 people every year - more than any other kind of snake. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the final report. World J. Nephrol. Sharma, S. K. et al. For example, in South Asia, snakebite envenomation is closely tied to monsoon season, which should guide health system infrastructure planning and antivenom distribution, among other interventions13. Map showing the global distribution of snakebite morbidity. Snakebite envenoming in humanitarian crises and migration: a scoping review and the Mdecins Sans Frontires experience. Snakes of Medical Importance include those with highly dangerous venom resulting in high rates of morbidity and mortality, or those that are common agents in snakebite. Once the submodels were conducted and predictive validity was measured, then an ensemble model was developed out of the submodels. All available information for each input source is available by selecting the source from the alphabetically ordered list. In drier regions of the continent, such as sahels and savannas, the saw-scaled vipers inflict up to 90% of all bites. Snakebite mortality in India: a nationally representative mortality survey. In the Neotropics, the lance-headed vipers inflict the majority of fatal bites, although of the many known species, only two, the common lancehead and terciopelo, are responsible for most fatalities. Significant investments in data collection, research, and public health intervention are required to better quantify the magnitude of snakebite envenoming. 10, e0004813 (2016). Toxicon X 910, 100072 (2021). The national average incidence of venomous snake bites in the United States is roughly 4 bites per 100,000 persons,[49] and about 5 deaths per year total (1 death per 65 million people). For . Sea snake | Types, Habitat, & Facts | Britannica The strategy focuses on activities in countries and regions where snakebite envenoming occurs, supported by technical units from WHO. VA and VR are both imperfect methods for counting deaths from snakebite envenoming and represent another limitation in our study. The killer of the most people. Guidelines for accurate and transparent health estimates reporting: the GATHER statement. In WHOs 2019 Strategy for Prevention and Control of Snakebite Envenoming in sub-Saharan Africa, updated and precise epidemiological data were outlined as a need moving forward to better guide appropriate and efficient implementation of antivenom interventions33. After redistribution, there were 29,040 deaths attributable to snakebites, an increase of 7.5%. GBD 2019 did not publish state-level estimates for China, and each state iscolored based onChinas national estimate. Stanaway, J. D. et al. This is contributed to by socio-economic and cultural factors that influence treatment-seeking behaviour with many victims opting for traditional practices rather than hospital care. Snakebite envenoming is an important cause of preventable death. Addressing the global snakebite crisis with geo-spatial analyses - Recent advances and future direction. Trop. [15] The black mamba, in particular, is among the most venomous snakes in the world and one of the most aggressive. In situations where data on snakebite envenoming is poor, it is difficult to accurately determine the need for antivenoms. 2020. R. Soc. Dis. had primary responsibility for seeking, cataloging, extracting, or cleaning data and fordesigning or coding figures and tables. M Ausloos and C Herteliu are partially supported by a grant from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Google Scholar. List of fatal snake bites in the United States - Wikipedia A subset was time-varying (indicated by superscript TV). Next, mortality due to snakebite envenoming was modeled using GBD cause of death ensemble modeling (CODEm). 85% of bites are to the hands and fingers. . Of the roughly 3,700 known species of snake found worldwide, only 15% are considered dangerous to humans. For example, in Cambodia, only a single verbal autopsy study including venomous animal mortality has been conducted to our knowledge30, which did not find a single death due to snakebite envenoming, despite the presence of multiple venomous snakes in the country31. a GBD 2019 estimates ofthe age-standardizedmortality rate from venomous animal contact for both sexes combined in 2019. b Estimated age-standardizedproportion of all venomous animal contact deaths due to only snakebitesin 2019. [32][33] According to the most conservative estimates, at least 81,000 snake envenomings and 11,000 fatalities occur in India each year, making it the most heavily affected country in the world. Anton Thau/Bavaria-Verlag. Our mortality estimates demonstrate that preventing snakebite envenoming death depends on not just the existence of antivenom, but also its dissemination to rural areas and the health systems capacity to provide wound care and necessary medical treatment for victims with secondary complications such as neurotoxic respiratory failure or acute kidney injury requiring dialysis29. Toxicon 109, 5162 (2016). F Carvalho and E Fernandes acknowledge Fundao para a Cincia e a Tecnologia, I.P., in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO, and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; and FCT/MCTES (Ministrio da Cincia, Tecnologia e Ensino Superior) through the project UIDB/50006/2020. [38] Several venomous colubrids exist in Australia as well, such as the brown tree snake, although they have geographically limited distributions and only very rarely deliver a medically significant bite. Of the Atractaspididae, Atractaspis is the species involved in the majority of bites. Mortality due to snakebite and other venomous animals in the Indian state of Bihar: findings from a representative mortality study. 26, i125i153 (2020). Inj. Ralph, R. et al. Another creature belonging to the "small but deadly" category is the freshwater snail, which is responsible for more than 200,000 deaths a year more deaths than sharks, lions and wolves combined. After being removed from the category A neglected tropical disease (NTD) list in 2013, snakebite envenoming was reinstated in 2017 in response to antivenom shortages and advocacy from researchers and international NGOs2,3. We used nationally representative and complete VR data from Sri Lanka in our estimation process; however, official death statistics have been shown to miss many snakebite envenoming deaths or miscode them as another cause. Trends in snakebite deaths in India from 2000 to 2019 in a - eLife The death of a trawler fisherman in Australian waters during 2018 was reported to be the region's first sea snake fatality since a pearl diver was killed in 1935. We have also provided maps of the data included in our models in Supplementary Figs. Why snails are one of the world's deadliest creatures Fast moving and aggressive if threatened, it is responsible for more than half of the country's fatal bites. Bagcchi, S. Experts call for snakebite to be re-established as a neglected tropical disease. This aim will be achieved through four key objectives: A primer on the WHO response was published in the journal PLoS Neglected Tropical Diseases in February 2019 (4). Health systems in many countries where snake bites are common often lack the infrastructure and resources to collect robust statistical data on the problem. 80 species of snakes found in Bangladesh; among them only few are venomous. A deadly shortage of venom antidote has spurred a little-known group of scientists in Costa Rica to action 100,000 people die from venomous snakebites each year, a problem the Instituto. [43] The best estimate is that the annual incidence of snakebites in Europe (including European Russia and Turkey) is 1.06 [0.971.15] per 100,000 inhabitants,[42] only about 15% of which are severe bites. Signs of a problem include bumpy skin or scales that appear inflamed. Uttar Pradesh had the greatest absolute number of deaths of any state in India in 2019, with 12,000 deaths (523016,100). If material is not included in the articles Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. A comparison of hospital-registered deaths in one district of Sri Lanka to data from the Registrar-Generals office on deaths demonstrated that 62.5% 15. 15, e0008756 (2021). 13. World Health Organization. Dis. No steps were made to align GBD 2019 mortality estimates with the predicted forecast from 2020, and predictions were made on the average annualized rate of change and the age-sex demographic composition of each region. We first reviewed all cause of death data that could be mapped directly to snakebites or other venomous animals. [65] Over 50% of bites inflicted by sea snakes, which are generally not aggressive, occur when fishermen attempt to remove snakes which have become tangled in fishing nets. According to mortality estimates from GBD 2019, these results would make snakebite envenomation the ninth greatest cause of death in Nepal and the greatest cause of death among injuries, ahead of the mortality rate due to falls, self-harm, and road injuries15. Suraweera, W. et al. Trends in snakebite deaths in India from 2000 to 2019 in a nationally representative mortality study. Source data are provided with this paper for Figs. India had the greatest number of deaths in 2019, equal to an ASMR of 4.0 per 100,000 (2.35.0). Victims who do reach a hospital often have insufficient access to dialysis, ventilators, and blood transfusions, which are essential to deal with the complications of envenoming18,20. Western, Central, and Eastern sub-Saharan Africa had the next-highest mortality from snakebite envenoming, with 1.4 deaths (1.02.1), 1.3 deaths (0.81.8), and 1.2 deaths (0.81.6) per 100,000, respectively. The strategy itself was subsequently launched in May 2019, and electronic copies of the road map areavailable here. Toxins Incl. Goyet, S. et al. South Asia had the greatest burden, with 54,600 deaths (95% UI 31,80068,300) and 2.54 million YLLs (1.48 million3.21 million), accounting for 86% (7692) of global deaths and 86% (7891) of global YLLs (see Supplementary Data file). One recent study in the Terai region of Nepal, which is a low-altitude zone with a monsoon climate where agriculture is the primary occupation, found that the mortality rate of snakebite envenomation was 22.4 per 100,000, over five times our estimate for India13. Article Information on whether or not venomous snakes inhabited a country was extracted from the World Health Organization Snakebite Information and Data Platform, which is available here: https://www.who.int/teams/control-of-neglected-tropical-diseases/snakebite-envenoming/snakebite-information-and-data-platform/overview#tab=tab_1. A Snakebite Envenoming Working Group established that same year was tasked with informing the development of a strategic WHO road map on snakebites. Improved data collection should be prioritized to help target interventions, improve burden estimation, and monitor progress. Only 22! 100(7): 693695. 1. Source data are provided as a Source Data file. Since these snakes are nocturnal and fossorial, living in burrows underground, bites remain rare, peaking at 1 to 3% in certain areas of the Sudanian savanna. Laksham, K. B. Unmanned aerial vehicle (drones) in public health: a SWOT analysis. Med. regulatory control of antivenoms and their distribution policies. The weaknesses in some regulatory systems that leads to licensing of ineffective or incorrect products is sometimes coupled to poor procurement practices and inefficient Trop. Study estimates more than one million Indians died from snakebite Elife. Increased collaboration between researchers and local health institutions should be prioritized to bolster the availability of data, demonstrate the unmet need for antivenom, and rigorously monitor and evaluate interventions. Algorithms for enhancing public health utility of national causes-of-death data. Fullman, N. et al. [15] The puff adder is responsible for the most fatalities overall,[16] although saw-scaled vipers (Echis spp) inflict more bites in North African countries, where the puff adder is typically not found. Assessing the true impact is further complicated by the fact that cases reported to health ministries by clinics and hospitals are often only a small proportion of the actual burden because many victims never reach primary care facilities, and are therefore unreported. After obtaining all possible data, we applied the same cause of death noise reduction processing described above to the raw animal-specific data15. While the VR data we used in Sri Lanka likely underestimated the true community-level disease burden, Ediriweera et als study demonstrate the limitations in the ability of verbal autopsy to calculate precise and accurate rates of rare events like snakebite envenomation deaths. The WHO Snakebite Information and Data Platform maps out the habitats of over 200 medically important venomous snakes, out of the 600 venomous snakes and 3000 overall species of snakes. [1] The Malayan pit viper and banded krait are two other species involved in a significant number of venomous bites. [50] The state of North Carolina has the highest frequency of reported snakebites, averaging approximately 19 bites per 100,000 persons. A combination of factors has led to the present crisis. Longbottom, J. et al. N.L.S.R., E.K.J., and S.M.Z. In the Oceanian realm, only Micronesia and Tonga, where at least 10 envenomations occur annually, face an appreciable burden of snakebite. The entry into some markets of inappropriate, untested, or even fake antivenom products has also undermined confidence in antivenom therapy generally. Chuat, M. et al. Key points: Harry Evans, from the UK, died on a trawler after being bitten by a sea snake His mother told media he was "living his dream" in the NT prior to his death Snakes In Bali: 6 Deadly & Venomous Bali Snakes - The World Travel Guy At the regional level, there was a log-linear relationship between theSocio-demographic Index (SDI) of a region and the regions age-standardized snakebite envenoming mortality rate in 2019 (Fig. [7] Many people who survive bites nevertheless suffer from permanent tissue damage caused by venom, leading to disability. & Parashar, A. Clinicopathological spectrum of snake bite-induced acute kidney injury from India. The black mamba is the species with the highest mortality rate in every single nation in which it occurs, despite not being responsible for the most numerous snakebites. E.K.J., A.A., F.A., C.L.A., D.A., J.A., M.A., A.B., D.C., H.T.D., L.E., A.E., F.F., A.M.G., B.G.G., A.G., M.G., C.H., M.N.K., R.K., K.K., G.A.K., N.M., R.G.M., T.R.M., A.H.M., F.N.M., M.Moradi., C.T.N., H.L.T.N., J.R.P., H.Q.P., Z.Q.S., V.R., S.J.R., D.L.R., S.R., A.M.S., M.S., D.C.S., S.S., M.A.S., V.Y.S., A.A.S., A.S., M.A.S., M.R.T., B.X.T., R.S.T., M.N., R.D., L.D., D.M.P., C.J.L.M., and K.L.O. Children often suffer more severe effects than adults, due to their smaller body mass.
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