NEW SCIENTIST (UK) 04 November 08 Snake bite is a 'neglected tropical disease' (Ewen Callaway)

Snakes kill more people than either dengue fever or skin cancer, according to a new worldwide estimate.

Cobras, vipers, black mambas and other venomous snakes take between 20,000 and 94,000 lives each year, and bite another 421,000 to 1,841,000 people.

However, the economic toll of snakebites could be far greater than many infectious diseases, says Janaka de Silva, an epidemiologist at the University of Kelaniya in Ragama, Sri Lanka, who spearheaded the new report.

De Silva is hoping the study will raise the profile of snakebites. "We want to get the snake bite classified as a neglected tropical disease," he says.

His team trolled published papers, national and regional health data, and hospital records to establish a snake bite death rate for 169 countries where attacks are a problem.

Because snake bite data for many of these countries, particularly in Africa, did not exist, the team extrapolated figures based on data from neighbouring countries, and produced an upper and lower estimate for snake bite victims.

Snakebites were most common in tropical areas, which are generally home to more venomous snakes than temperate regions.

However, increased rural development in many of these countries also fosters more contact between people and snakes. Factor in dispersed healthcare centres with little money to stock anti-venom or other treatments, and you have the makings of an epidemic, de Silva says.

Reliance on traditional treatments can also result in higher death rates in some countries, he says.

And while worldwide snake bite deaths pale in comparison to pandemics such as malaria and HIV, or chronic disease such as cancer, many victims of snakebites suffer physical maiming for the rest of their lives.

"Disability is much higher than in infectious disease," de Silva says. "In infectious diseases you either die or recover."

Journal reference: PLoS Medicine (DOI: 10.1371/journal.pmed.0050218)

http://www.newscientist.com/article/dn15118-snake-bite-is-a-neglected-tropical-disease.html?DCMP=ILC-hmts&nsref=news6_head_dn15118



BBC (London, UK) 04 November 08 S Asia is 'worst for snake bites'

South Asia has the highest number of casualties from snake bites in the world, a new study suggests.

It found that more than 400,000 people a year are poisoned by snake bites worldwide, with 20,000 deaths annually.

The research published by the US based Public Library of Science Medicine involved data from 68 countries.

India, with its population of over a billion people, accounted for the highest estimated number of bites and deaths for a single country.

Researchers led by Janaka De Silva at the University of Kelaniya in Sri Lanka say that conservative estimates suggest 421,000 cases of "envenoming" - or venom released through biting - occur each year, with 20,000 people dying as a result of being poisoned by snake bites.

India had the highest number of people poisoned - just over 80,000, resulting in 11,000 deaths - followed by Sri Lanka with 33,000 people poisoned. Most victims are male.

Researchers say the numbers could be higher because many snakebites are not reported - especially in rural areas where many victims do not have access to good health care and rely on traditional remedies.

"The fact that snakebite varies geographically and seasonally, that it is mainly a rural tropical phenomenon where reporting and record keeping is poor and that health-seeking behaviour is diverse with traditional treatments being sometimes preferred to Western medicine, all contribute to the difficulties faced when studying its epidemiology," the report says.

"The true magnitude of the public health threat posed by snakebites in these countries (and elsewhere in the world) is unknown, which makes it hard for public health officials to optimise the prevention and treatment of snakebites in their respective countries."

Of the 3,000 or so snake species that exist in the world, the report says, about 600 are venomous. They exist on every continent except Antarctica.

http://news.bbc.co.uk/2/hi/south_asia/7708888.stm

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