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Figure 3: Estimated deaths and standardized death rates in states with high prevalence of snakebite deaths, 2005 Death rates are standardised to 2005 UN population estimates for India. The vertical bars represent the state wise estimated deaths (in thousands). Total snakebite deaths for the 13 states with high-prevalence of snakebite death are 42,800 or 93% of the national total (these states have about 85% of the total estimated population of India). States where the snakebite death rate was below 3/100,000 or where populations are less than 10 million are not shown. The states with high-prevalence of snakebite deaths are: AP-Andhra Pradesh, BR-Bihar, CG559 Chhattisgarh, GJ-Gujarat, JH-Jharkhand, KA-Karnataka, MP Madhya Pradesh, MH560 Maharashtra, OR-Orissa, RJ- Rajasthan, TN-Tamil Nadu, UP-Uttar Pradesh, WB561 West Bengal. Source: Mohapatra B, Warrell DA, Suraweera W, Bhatia P, Dhingra N, et al. (2011) Snakebite Mortality in India: A Nationally Representative Mortality Survey. PLoS Negl Trop Dis 5(4): e1018. doi:10.1371/journal.pntd.0001018
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Faiz MA, Ghose A, Ahsan MF, Rahman MR, Amin MR, Hassan MM, Chowdhury MA, Kuch U, Rocha T, Harris JB, Theakston RD, Warrell DA. The greater black krait (Bungarus niger), a newly recognized cause of neuro-myotoxic snake bite envenoming in Bangladesh. Brain. 2010 Nov;133(11):3181-93
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Scott A. Weinstein, David A. Warrell, Julian White, Daniel E. Keyler. “Venomous” Bites from Non-Venomous Snakes: A Critical Analysis of Risk and Management of “Colubrid” Snake Bites. Burlington, USA, Elsevier, 2011 (in press)
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WHO SEARO Guidelines for the management of snake-bites. WHO Regional Office for South-East Asia, 2nd Ed 2010.
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WHO AFRO Guidelines: Prevention and Clinical Management of Snakebite in Africa. WHO Regional Office for Africa Brazzaville, 2010.
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WHO Recommendations on Rabies Post-Exposure Treatment and the Correct technique of Intradermal Immunization against Rabies
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Rabies and Envenomings A Neglected Public Health Issue Report of a Consultative Meeting WHO Geneva 10 January 2007

David Warrell

FRCP, FMedSci

Emeritus Professor of Tropical Medicine Honorary Fellow of St Cross College University of Oxford; Principal Fellow Australian Venom Research Unit, University of Melbourne

Research on the incidence, morbidity and mortality of snake bites in Africa, Asia, Oceania and Latin America; and on the clinical presentation, pathophysiology, treatment and prevention of envenoming by snakes and other venomous animals. Current sites of active research are Nepal, Bangladesh and Papua New Guinea. The key component of snake bite treatment is provision of specific antivenom. New antivenoms for treatment of saw-scaled viper bites in Nigeria and of taipan bites in Papua New Guinea have been developed and have or are being clinically tested. Recent findings in India give support to the belief that snake bite is the most neglected of all neglected tropical diseases and deserves reprioritisation. This programme is aimed at producing evidence relevant to establishing the true status of snake bite as a public health problem.

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