Better snakebite data needed to save lives and limbs

Extreme temperatures and drought are affecting snake habitats, including in Iraq’s marshes (pictured), leading the animals closer to human habitats, especially in rural and periurban settings.  Photo credit: WHO/K. NasserExtreme temperatures and drought are affecting snake habitats, including in Iraq’s marshes (pictured), leading the animals closer to human habitats, especially in rural and periurban settings. Photo credit: WHO/K. Nasser2 September 2024  – Globally, someone is bitten by a snake every 10 seconds, according to estimates. Snakebite envenoming is a potentially life-threatening disease caused by toxins in the bite of a venomous snake. Snake bites are estimated to cause about 81 000 to 138 000 deaths and 400 000 permanent disabilities globally each year.

Snake bites are a neglected public health issue worldwide and especially in the Eastern Mediterranean Region. Snake bites disproportionately affect vulnerable groups like rural communities, children and crisis-affected populations.

Solutions include improving education and awareness among communities living in areas with venomous snakes, and training health workers in snakebite management. Also, quality assured antivenoms for endemic snake species should be available at health facilities within 4–6 hours’ travel time of at-risk communities.

Killing snakes is not a solution. Snakes are important predators, particularly of common pests that can affect agricultural production and food security. Snakes are thus essential to maintain balance in ecosystems.

Evidence on snake bites is patchy or lacking for many low- and middle-income countries. But the available data for the Eastern Mediterranean Region are even weaker than for other parts of the world.

Data are needed to inform targeted interventions. For example, data can be used to ensure that hospitals near high-risk areas have appropriate antivenoms, especially at those times of year when most snake bites occur. Without reliable data, it is difficult to make the case for greater visibility and investments to address the snakebite burden in the Region.

Addressing evidence gaps for the Region

A review by WHO authors of published evidence on snake bites in the Eastern Mediterranean Region identified 170 626 bites in 20 countries over 23 years. Among studies reporting deaths, a total of 2551 fatalities were recorded.

But we know that these figures are gross underestimates, as only the bites recorded in published scientific literature are included. Indeed, the review found that evidence was concentrated in a few countries only and limited or absent for most of the Region.

Moreover, only a small share of studies had information on the presence or absence of long-term health consequences of envenoming. These include amputation, deformed extremities, mobility problems, chronic renal damage and visual impairments. This evidence gap reveals the need for greater surveillance efforts to identify people with long-term complications, to better meet their specific needs.

Not all studies identified the implicated snake species or reported on the types and sources of antivenoms used. These notable gaps must also be addressed.

Increased frequency of natural disasters and extreme weather events is already affecting the abundance and activity patterns of snakes, bringing them closer to humans, and this will increase over time. In Iraq, for example, extreme heat and water shortages have pushed snakes closer to human settlements, putting humans and cattle in danger. Further, ongoing conflicts, humanitarian crises and migration in the Region all place vulnerable groups such as internally displaced people and refugees at risk of encounters with venomous snakes.

By investing in improved snakebite surveillance, countries can better allocate the limited available resources for prevention and treatment to where they are needed most and better predict the impacts of ongoing changes. WHO is committed to work with countries to use data to improve snakebite prevention and control so that cases are reduced, treatment is available for those who need it, and unnecessary deaths and disabilities are avoided.

Related links

Health topic: Snakebite envenoming

Fact sheet: Snakebite envenoming

Update on snakebite and climate change

From fangs to antidotes: A scoping review on snakebite burden, species, and antivenoms in the Eastern Mediterranean Region