A Review: Snake Bite

Abstract

With millions of victims each year and high rates of morbidity and mortality, snake bites are a serious but little-known public health issue, especially in tropical and subtropical areas. Numerous clinical symptoms, such as local tissue necrosis, coagulopathy, neurotoxicity, renal failure, and, in extreme cases, death, can arise from poisonous snake envenomation. The snake species and the venom\'s makeup have a significant impact on the kind and intensity of symptoms. Effective management requires accurate identification, timely antivenom administration, and prompt first assistance. Rural communities have long employed a variety of herbal and traditional medicines in addition to conventional care, yet little is known about their clinical effectiveness.Programs to lower the death rate from snake bites have been started by the World Health Organization (WHO) and a number of national governments. These initiatives include better access to antivenom, healthcare training, and public education. The species and categorization of venomous snakes, the pathophysiology and composition of snake venom, clinical characteristics, diagnostic techniques, and current treatment protocols—including the use of antivenom therapy—are all covered in this overview. Future research directions, government and WHO activities, and the role of traditional medicine are also examined. The necessity of creating broad-spectrum antivenoms, better diagnostic instruments, and community-based awareness campaigns is emphasized. In order to combat this neglected tropical illness and meet WHO\'s target of halving the global burden by 2030, multidisciplinary approaches integrating contemporary medicine, traditional knowledge, and international cooperation are essential.

Introduction

Overview:
Snake bites are a serious global health issue, particularly in tropical and subtropical regions like India, where they cause up to 138,000 deaths annually and leave over 400,000 people disabled. Despite its high impact, snake bite envenomation is classified as a Neglected Tropical Disease (NTD) by the WHO, with cases often underreported, especially in rural areas.

Key Points:

1. Types and Classification of Snakes

• Only 15% of ~3,000 snake species are venomous.

• Venomous families:

  • Elapidae (e.g., cobras, kraits): Neurotoxic venom—causes paralysis, respiratory failure.

  • Viperidae (e.g., Russell’s viper): Hemotoxic venom—leads to bleeding, kidney failure.

  • Hydrophiidae (sea snakes): Myotoxic venom—damages muscles, causes rhabdomyolysis.

  • Colubridae: Mostly non-lethal, mildly venomous species.

2. Venom Composition

• Snake venom is a complex mix of proteins, peptides, enzymes (e.g., proteases, phospholipase A2).

• Effects:

  • Neurotoxins: Impair nerve signals.

  • Hemotoxins: Affect blood/clotting.

  • Cytotoxins: Destroy cells.

  • Myotoxins: Break down muscle.

3. Pathophysiology and Symptoms

• Symptoms depend on snake type and venom:

  • Neurotoxic: Ptosis, difficulty breathing, paralysis.

  • Hemotoxic: Bleeding, DIC, kidney injury.

  • Cytotoxic: Swelling, necrosis.

  • Myotoxic: Muscle damage, dark urine, kidney failure.

• Systemic symptoms can escalate to multi-organ failure or death.

4. Diagnosis

• Based on bite history, symptoms, and 20-minute Whole Blood Clotting Test (20WBCT).

• Lab tests (CBC, renal function, coagulation) help assess severity.

5. First Aid and Emergency Care

• Immobilize limb below heart level.

• Avoid cutting, sucking, or tourniquets.

• Keep calm and seek immediate medical help.

• Do not use traditional remedies as primary care.

6. Treatment

• Antivenom is the only specific treatment.

• Supportive care: IV fluids, pain management, respiratory support, antibiotics.

• Watch for allergic reactions to antivenom (e.g., anaphylaxis).

• Polyvalent antivenoms used in India target the "Big Four" snakes.

7. Complications

• Can include:

  • Acute kidney injury, DIC, gangrene, amputation.

  • Neurological damage, sepsis, chronic disability, and psychological trauma.

Additional Insights:

Traditional Remedies:

• Plants like Rauwolfia serpentina and Hemidesmus indicus are used in folklore.

• Their effectiveness is not scientifically proven, and delays in treatment can be fatal.

Global and Government Initiatives:

• WHO aims to reduce snake bite deaths and disabilities by 50% by 2030.

• Efforts include free antivenom distribution, rural health worker training, and public education campaigns.

Future Directions:

• Broad-spectrum antivenoms with fewer side effects.

• Herbal alternatives backed by scientific research.

• Rapid diagnostic tools for venom detection.

• Genomic/proteomic analysis of venom for better treatments.

• Snake bite vaccines.

• AI-based tools for snake identification and treatment planning.

• Community education and surveillance models to improve early response.

Conclusion

Snake bites continue to be a serious but frequently disregarded public health issue, especially in tropical and rural areas with limited access to prompt medical care. Due to a lack of knowledge, postponed medical intervention, and insufficient healthcare infrastructure, snake bites continue to result in high rates of morbidity and fatality even though they are preventable and curable. Clinical signs and symptoms might range from localized swelling and necrosis to systemic consequences such neurotoxicity, coagulopathy, and renal failure, contingent on the snake species and venom type. Reducing complications and preserving lives requires early diagnosis, proper first aid, and timely antivenom delivery. Even though contemporary medicine offers efficient treatment choices, some cultures still use traditional herbal treatments. After careful consideration, these ought to be verified by science and maybe combined with allopathic treatment. Snake bite deaths have decreased as a result of World Health Organization and national government initiatives, such as training, education, the free provision of antivenom; nonetheless, more work is required. The creation of broad-spectrum antivenoms, quick diagnostic methods, and the promise of plant-based treatments must be the main areas of future study. Important aspects of managing snake bites include bolstering public health systems, increasing awareness, and guaranteeing that care is accessible in isolated locations. Ultimately, to meet WHO\' s goal of halving snake bite fatalities and disability by 2030, a multidisciplinary strategy integrating contemporary research, traditional knowledge, public health tactics, and international collaboration is necessary. The secret to turning snake bites from an ignored problem into a controllable hazard will be ongoing research and community involvement.

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Copyright

Copyright © 2025 Mr. Saurabh Gophane, Ms. Ketakee More, Ms. Arti Gadade, Mr. Nitin Gawai. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.