The Kerala government has officially declared snakebite envenomation a critical public health concern under Section 28 of the Kerala Public Health Act, 2023. This landmark decision is set to significantly improve the state’s ability to document, collect data on, research, and manage snakebite incidents with a more data-driven approach.
This official gazette notification, issued on Friday, places Kerala alongside states like Tamil Nadu and Karnataka, which have also recently designated snakebites as notifiable diseases, requiring mandatory reporting.
Snakebite envenomation is an incredibly dangerous condition. Without prompt and effective medical attention, it can lead to severe permanent disabilities or even be fatal.
Concerning Statistics
According to the Health department, Kerala recorded 34 snakebite-related deaths in 2023–24, followed by 30 cases in 2024-25. While these numbers might appear low when compared to regions like Bihar, which sees hundreds of snakebite fatalities annually, the impact on Kerala’s population remains significant.
Despite the lower figures, snakebites are a major concern for Kerala. The World Health Organization classifies them as a neglected tropical disease, often highlighting underlying issues of poverty, inequality, and insufficient access to healthcare, making their control a state priority.
Nationally, the management of snakebite envenomation has seen notable advancements and new initiatives over the last two years.
For instance, March 2024 saw the Indian Government introduce the National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE). This ambitious plan aims to reduce snakebite deaths by half by 2030, fostering a multi-sectoral approach that combines prevention, prompt treatment, research, and surveillance across health, forest, wildlife, and agriculture departments. Building on this, in November 2024, the central government also mandated that snakebite envenomation be a notifiable condition nationwide.
Addressing Implementation Challenges
A senior Health official confirmed that with this formal notification, every instance of snakebite envenomation treated at any hospital in Kerala must now be reported to the Integrated Disease Surveillance Programme (IDSP) platform.
While NAPSE promotes making anti-snake venom (ASV) accessible at Primary Health Centres (PHCs), Kerala currently faces technical challenges in its direct administration at these facilities. ASV is only given for confirmed envenomation cases, which requires assessing the bite type and specific blood parameters – capabilities that many PHCs presently lack.
However, this situation is poised for change. Kerala is actively preparing to roll out a State-level action plan for snakebite envenomation, adopting the ‘One Health’ approach as recommended by NAPSE, with allocated funding already in place. This comprehensive plan includes strategies for consistently supplying ASV, bolstering healthcare systems (especially emergency services), and launching public awareness and education campaigns to systematically lower the risk of snakebites.
The polyvalent Anti-Snake Venom (ASV) currently manufactured in India is standardized to treat bites from four specific snake species: the Indian cobra, common krait, Russell’s viper, and saw-scaled viper. These four are widely considered responsible for most snakebite envenomation cases across the country.
A significant challenge remains: the existing ASV does not effectively neutralize the venom of the hump-nosed pit viper (Hypnale hypnale), a species increasingly linked to fatalities in Kerala. This gap not only leads to ineffective treatment but also risks adverse reactions if ASV is administered unnecessarily, potentially causing further complications.
Insights from a 2016 Study
A 2016 study conducted in Kerala, which analyzed the clinical characteristics of snakebite victims admitted to a tertiary care hospital, revealed that among cases where the snake species was identified (47.3% of total cases), D. russelii was responsible for 23.1% of bites, while H. hypnale accounted for 15.4%.
These findings underscore the urgent need for developing region-specific antivenoms to significantly improve treatment outcomes for snakebite victims and ensure their widespread availability. Furthermore, enhancing medical training for doctors to accurately identify snakebites, recognize envenomation symptoms, and manage cases effectively is another key area the state plans to prioritize.