Snakebites Make The List Of 'Neglected Tropical Diseases'

By Courtney Columbus

Published June 24, 2017 at 6:00 AM CDT

Echis carinatus — aka the carpet viper — is a venomous species that strikes humans in parts of the Middle East and Africa.

Snakebites kill more than 100,000 people per year, the World Health Organization estimates. The organization recently took a step to reduce that number by adding venomous snake bites to its list of neglected tropical diseases – a classification that could help get more resources allocated to fighting this public health problem.

(WHO did acknowledge that snakebites aren't a disease but "an injury" but the "envenoming" — the injection of the snake's venom — can be considered a disease.)

Doctors Without Borders, which had previously criticized the global health community for not paying enough attention to snakebites, welcomed the announcement.

In sub-Saharan Africa, the best estimate is that 20,000 to 32,000 people die from snakebites each year, says Julien Potet, a neglected tropical diseases policy adviser at Doctors Without Borders, where he focuses on sub-Saharan Africa and the Middle East. It can take several hours for victims in sub-Saharan Africa to reach clinics, Potet says, and he worries about a lack of access to anti-venom.

Banywich Bone, 18, of South Sudan was bitten by a snake while sleeping at home. His left leg had to be amputated above the knee after the wound became infected.

According to WHO, many snakebite victims are farmers and people in poor, rural communities far from capital cities. Farmers, including migrant workers, are sometimes bitten while walking through fields. Some of them sleep in the fields where they work, putting them at greater risk for bites, he says.

Potet remembers the case of a teenage boy in the lowlands of Ethiopia who had been walking back from the fields to his village at night, without a flashlight and with no boots. A snake bit him on the ankle. About 12 hours passed between the time when the snake bit the boy and the time he arrived at the hospital, because the family had struggled to find someone to take the boy to the hospital during the night. A farm manager finally brought the boy to the hospital on a farm tractor.

This boy's story isn't so unusual — it can take victims 6 to 12 hours to get to the hospital after a snake bite, Potet says.

"In some cases, it may be too late," he says.

In this case, the teenage boy was treated in time and survived.

Still, Potet says, "We need to reduce as much as possible the time between the bite and the treatment."

The cost of treatment for snake bites can also deter victims from seeking help, Potet says. Clinics or hospitals may charge from $80 to $150. Doctors Without Borders provides free treatment for snake bites.

A common source of poisonous bites in some parts of Africa is the carpet viper, he says. It's one of the snakes whose venom can cause bleeding and prevent blood from coagulating.

Potet also worries about the supply of anti-venom in sub-Saharan Africa.

"As the [African] market is not very lucrative for pharmaceutical companies," he says, "some of the companies recently stopped production."

Anti-venom quality can also be a concern. Some products are put on the market without robust testing, he says.

WHO is conducting a formal evaluation of anti-venom products intended for use in sub-Saharan Africa in an effort to improve the quality.

Then there's the matter of prevention. It's actually very basic, says Potet: using flashlights when walking home at night from fields, wearing boots and shoes in the fields and educating people so they know to seek treatment as quickly as possible — and stressing that local healers cannot substitute for anti-venom treatment.

Other diseases on the list of neglected tropical diseases include rabies, scabies and leprosy.