Context: The Union Health Ministry has urged states to make snakebites a notifiable disease.
Relevance of the Topic: Prelims- Notifiable diseases; Some basic facts about Snakebites.
Major Highlights:
- Snakebites are a major public health challenge in the country. Some three to four million cases of snakebites are reported every year, and an estimated 58,000 persons die because of them annually.
- Earlier in 2024, the Central government launched the National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE) with the aim of halving snakebite deaths by 2030. NAPSE recommended that snakebites should be made a notifiable disease.
Which types of diseases are considered notifiable?
- Notifiable disease is a disease that is legally required to be reported to the government by both private and public hospitals.
- State governments are responsible to declare a disease as a notifiable disease, and the list of notifiable diseases differs from state to state.
- Registered medical practitioners must notify such diseases, typically in a standard form within three days, or notify verbally via phone within 24 hours if urgent.
- Every government hospital, private hospital, laboratory, and clinic will have to report cases of the disease to the local government authorities.
- Any failure to report a notifiable disease is a criminal offence and the state government can take necessary actions against defaulters.
- Usually, diseases are declared notifiable if they:
- Have the potential to cause an outbreak
- Leads to significant mortality
- Require rapid investigation and public health action.
- Notifiable diseases in India: Cholera, diphtheria, encephalitis, leprosy, meningitis, pertussis (whooping cough), plague, tuberculosis, AIDS, hepatitis, measles, yellow fever, malaria, dengue.
Why is snakebite considered a ‘disease’?
- Snakebites can lead to acute medical emergencies that require immediate care. They can cause severe paralysis that can prevent breathing, can lead to a fatal haemorrhage, and damage different tissues.
- Snakebites need to be treated with antivenoms to prevent death and severe symptoms.
Which snakes can be fatal?
- There are more than 310 species of snakes in India — 66 of them are venomous and 42 are mildly venomous.
- Almost 90% of snakebites in the country are caused by the ‘Big Four’ — the Indian cobra, common krait, Russell’s viper, and saw-scaled viper.
- The commercially available polyvalent antivenom contains venom from all four species, and is effective against 80% of snakebites.
- Most snakebites happen in densely populated, low-altitude, agricultural areas in states including Bihar, Jharkhand, Madhya Pradesh, Odisha, Uttar Pradesh, Andhra Pradesh, Telangana, Rajasthan, and Gujarat.
Why does the Centre want snakebites to be made notifiable?
- To strengthen snakebite surveillance:
- Making snakebites notifiable is expected to lead to proper surveillance, and to help determine the precise numbers of snakebite cases and deaths across India.
- The government can then use this information to effectively manage, prevent, and control cases of snakebites.
- Adequate antivenoms can be provided to various regions, and proper training can be imparted in areas where snakebites are frequent.
What are the challenges of treating snakebites?
- Inadequate Treatment:
- Snakebite victims either do not reach a healthcare centre in time or many reach out to faith-based healers instead.
- In many cases, staff at healthcare centres are not adequately trained in treating snakebites.
- Tests for confirming snakebites are also not available.
- Limitations of Anti-venoms:
- The venom used to make the antivenom in India mostly comes from snakes caught by the Irula tribe, who live in Tamil Nadu, Karnataka, and Kerala. However, venom from the same type of snake can vary depending on the region, making the antivenom less effective in other areas.
- Commercially available antivenom does not work against some local snake species. E.g., green pit viper in the Northeast.
- Antivenoms themselves can cause various reactions.
- Challenges in Venom collection:
- Experts have suggested setting up zonal venom collection banks across the country to develop antivenoms that can cover the regional differences. However, The Wild Life (Protection) Act, 1972, limits access to snakes, making it difficult to set up such banks.
Note:
Researchers are now developing artificially produced antibodies that can help neutralise the toxins across various snake species. They are also looking at artificially designed peptides to fight the toxin.