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This study complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) recommendations (Supplementary Information pp 20-22)41. List of fatal snake bites in the United States - Wikipedia The distribution map is based on published reference texts, scientific journals, museum collection databases, and consultations with zoologists and snakebite experts from around the world31. [2][11][13] Children and the elderly are the most likely to die. GBD 2019 did not publish state-level estimates for China, and each state iscolored based onChinas national estimate. The widespread and common eastern brown snake is one of Australia's most venomous elapids. Approximately 550 people in Australia are admitted to public hospitals with snake bites each year, and there is an average of two deaths per annum. In brief, we used a subset of the data for venomous animal contact to identify snakebite-specific mortality, as well as other animal-specific mortality, and evaluated these data using models that captured spatiotemporal patterns to estimate mortality for four different animals (snakes, bees, scorpions, spiders) and for a fifth residual category (other venomous animal contact). We discuss our results in light of the WHO goal of halving the number of deaths and cases of snakebite envenoming by 2030 by forecasting the disease burden to 2050. Redistributed animal deaths were added to the number of properly coded deaths for each animal. Challenges and prospects of snake antivenom supply in sub-Saharan Africa. It is not a comprehensive list. The WHO Snakebite Information and Data Platform maps out the habitats of over 200 medically important venomous snakes, out of the 600 venomous snakes and 3000 overall species of snakes. The Lab Saving the World From Snake Bites | Science - Smithsonian Magazine K Krishan is supported by the UGC Centre of Advanced Study (Phase II), awarded to the Department of Anthropology, Panjab University, Chandigarh, India. Still University, Mesa, AZ, USA, Department of Medical Parasitology, Abadan University of Medical Sciences, Abadan, Iran, Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran, School of Public Health, Medical, and Veterinary Sciences, James Cook University, Douglas, QLD, Australia, Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India, Abhay Motiramji Gaidhane&Zahiruddin Quazi Syed, Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia, School of Public Health, Haramaya University, Harar, Ethiopia, Student Research Committee, Iran University of Medical Sciences, Tehran, Iran, Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India, School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates, Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh, Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan, Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China, School of Business, London South Bank University, London, UK, Department of Community Medicine, University of Ibadan, Ibadan, Nigeria, Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia, The George Institute for Global Health, University of New South Wales, New Delhi, India, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India, Department of Epidemiology and Biostatistics, Health Services Academy, Islamabad, Pakistan, Global Evidence Synthesis Initiative, Datta Meghe Institute of Medical Sciences, Wardha, India, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK, Department of Anthropology, Panjab University, Chandigarh, India, Public Health Foundation of India, Gurugram, India, G. Anil Kumar,Rakhi Dandona&Lalit Dandona, Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India, Unit of Genetics and Public Health, Institute of Medical Sciences, Las Tablas, Panama, Pathology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, Department of Forensic Medicine, Shri Dharmasthala Manjunatheshwara University, Dharwad, India, Department of Forensic Medicine, Rajiv Gandhi University of Health Sciences, Bangalore, India, Doheny Eye Institute, University of California Los Angeles, Los Angeles, CA, USA, Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland, University of Helsinki, Helsinki, Finland, Pacific Institute for Research & Evaluation, Calverton, MD, USA, School of Public Health, Curtin University, Perth, WA, Australia, Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran, Department of Forensic Medicine & Toxicology, A.J. In December 2015 a programme to evaluate the potential safety and effectiveness of current antivenom products intended for use in sub-Saharan Africa The supply of antivenom is inadequate in sub-Saharan Africa and the cost for a dose is often prohibitively expensive, leaving victims of snakebite envenomation without treatment options22. Nature Communications (Nat Commun) [19] Important African cobra species include the Cape cobra and the black-necked spitting cobra. In the past two decades, more than 1.2 million people have died from snake bites in India alone, according . We conducted each regression by sex and region separately and added a cubic spline on age. J. Fam. GBD 2019 did not publish state-level estimates for China, so each state is colored based on Chinas national estimate. . [21] In forested areas of Guinea, cobras may inflict more than 30% of all venomous bites. Covariates are also included to guide predictions where data are sparse or absent. Also, it's very rare for a snake to bite above the ankle. By 2030, we predict the global age-standardized rate will non-significantly decrease by 8.6% (9.6 to 20.1). 4, e603 (2010). However, some estimates put the number at 1.2 to 5.5 million snakebites, 421,000 envenomings, resulting in perhaps 20,000 deaths, but the actual number of deaths may be as high as 94,000. [29] Most victims who receive treatment by health care professionals have nevertheless delayed seeking medical attention for over 24 hours, and often up to 1 to 2 weeks. Assessing the true impact is further complicated by the fact that cases reported to health ministries by clinics and hospitals are often only a small proportion of the actual burden because many victims never reach primary care facilities, and are therefore unreported. Nicholas L. S. Roberts. The timing is right to end snakebite deaths in South Asia. PubMed Central Kasturiratne, A. et al. Prim.3, 17063 (2017). In Nepal, for example, where 90% of the population lives in rural areas, the Ministry of Health reported 480 snake bites resulting in 22 deaths for the year 2000, yet figures for Vollset, S. E. et al. Before the advent of a polyvalent antivenom produced by the South African Institute for Medical Research, black mamba envenomation was certain to cause fatality (100% rate). Incidence and mortality due to snakebite in the Americas For example, in South Asia, snakebite envenomation is closely tied to monsoon season, which should guide health system infrastructure planning and antivenom distribution, among other interventions13. was launched by the WHO. [2] However, in the United States, every state except Maine, Alaska, and Hawaii is home to at least one of 20 venomous snake species. collection and analysis, and integration of snakebite envenoming into the national health plans of affected countries. Of these, Bothrops asper is the most important species, partly because it is abundant in lowland areas and partly because it is frequently found in agricultural and pastoral areas where humans work. PLoS Negl. Jellyfish Gabriel Bouys / AFP/Getty Images 40 fatalities per year These jellyfish, called Pacific Sea Nettles, possess an extremely painful sting. Once data from all available sources were identified, data underwent the processing that occurs for all cause-of-death data in GBD, which includes noise reduction to reduce stochastic variation and redistribution of unspecified or incorrectly coded causes of death. British man dies from sea snake bite in Australia - BBC News Age-standardized snakebite envenoming mortality rate per 100,000 by region and Socio-demographic Index. N.L.S.R., R.D., L.D., S.L.J., D.M.P., S.I.H., T.V., and K.L.O. ISAF confirmed 57 unprovoked shark bites on humans and 32 provoked bites. High quality snake antivenoms are the most effective treatment to prevent or reverse most of the venomous effects of snake bites. Alcoba, G. et al. For example, Somalia (4.5 deaths per 100,000), Central African Republic (3.4 deaths per 100,000), Eritrea (2.9 deaths per 100,000), Chad (2.6 per 100,000), and South Sudan (2.3 deaths per 100,000) have some of the highest mortality rates globally. Every covariate was available for all 204 countries. High quality snake antivenoms are the most effective treatment to prevent or reverse most of the venomous effects of snake bites. Of the five dangerous groups, the highly venomous eastern brown snake, which is widespread and common in both rural and urban environments, is the most importantit is estimated to be responsible for up to 60% of all deaths caused by snakebite. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the final report. Asia Pac. For each location, age, sex, and year demographic, we aggregated the results from all five different animals to derive the proportion of overall venomous animal deaths due to snakebites. A significant challenge in manufacturing of antivenoms is the preparation of the correct immunogens (snake venoms). Correspondence to [2][47], The two-striped forest pit viper is an arboreal snake from the Amazon Basin. These estimates are consistent with previous research conducted with verbal autopsy mortality surveys, which were the source of data in India in our analysis as well9,10,11. Snakes In Bali: 6 Deadly & Venomous Bali Snakes - The World Travel Guy Our ensemble modeling framework allowed us to test multiple covariates for their association with snakebite envenoming mortality and provided important insights on the diseases epidemiology. 20,000 of about 55,000 deaths worldwide - occur in India each year, most of those . [65] While the majority of species live close to shorelines or coral reefs, the fully pelagic yellow-bellied sea snake can be found in the open ocean. Am. [12] Dendroaspis polylepis is classified as the snake of highest medical importance by the World Health Organization in Africa. See ST-GPR parameters in the Supplementary Information for further details on ST-GPR hyperparameter weighting equations and covariate selection. Preventing and treating the problem is complex and requires collaboration among the fields of public health, medicine, ecology, and laboratory science. Elife. 4). However, while it is updated iteratively, it is not complete and only contains approximately 200 venomous snakes deemed medically important, out of 600 venomous snakes. Toxicon X 13, 100089 (2022). Both studies had similar limitations due to data scarcity, are likely underestimates of the true number of deaths, and emphasize the urgent need for better epidemiological assessments to provide a more accurate estimation of the true disease burden due to snakebite envenoming in high-risk areas like sub-Saharan Africa, South Asia, and Southeast Asia. [8] Most snake envenomings and fatalities occur in South Asia, Southeast Asia, and sub-Saharan Africa, with India reporting the most snakebite deaths of any country. Lancet 392, 673684 (2018). It may be the first recorded death from a sea snake in Australia. If a country only contained one of these 400 venomous snakes that was capable of a rare fatal envenomation and not one of the 200 medically important snakes, then we would be erroneously zeroing out that location. Med. Male beaked sea snakes have two penises, referred to as hemipenes. South Asia had the greatest burden, with 54,600 deaths (95% UI 31,80068,300) and 2.54 million YLLs (1.48 million3.21 million), accounting for 86% (7692) of global deaths and 86% (7891) of global YLLs (see Supplementary Data file). [65] Over 50% of bites inflicted by sea snakes, which are generally not aggressive, occur when fishermen attempt to remove snakes which have become tangled in fishing nets. [57], Although snakebite risk may be high, tourists and other visitors are rarely bitten. Many of the countries with the highest burden of snakebite envenoming in sub-Saharan Africa are also those recently or currently in the midst of conflicts and humanitarian crises that increase outdoor exposure and disrupt the health systems capacity for surveillance and treatment21,23. 2006. Toxins Incl. Lancet https://doi.org/10.1016/S0140-6736(20)30677-2 (2020). Snake bites and dog bites in Nepal: community based studies on snake bites and dog bites. In terms of appearance, Belcher's sea snake isn't very distinctive: It's covered from top to tail in low-contrast bands. [58] Treatment with antivenom has reduced the mortality from e.g. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Snakebite envenoming deaths are also rare enough that it is difficult for surveys to identify a sufficient number of deaths to estimate a robust mortality estimate. A summary of the GBD 2019 estimation approach for mortality from venomous animal contact follows. developedmethods or computational machinery. ST-GPR starts by fitting a mixed-effects linear prior and then fitting a second model based on the weighted residuals between the input data and the linear prior. However, there are wide variations across countries and within each of them. To account for uncertainty in the primary data, data processing, measurement error, and choice of model, every model in the process was run 1000 times to produce final estimates with 95% uncertainty intervals, which comprise the 2.5th and 97.5th percentiles of 1000 draws. [29], In Bangladesh, the incidence of snakebites is very high, like other tropical countries of Southeast Asia. Global mortality and years of life lost Snakebite envenoming accounted for 63,400 deaths (95% uncertainty interval [UI] 38,900-78,600) and 2.94 million YLLs (1.79 million-3.74 million) in 2019,. [46], Of the 120 known indigenous snake species in North America, only 20 are venomous to human beings, all belonging to the families Viperidae and Elapidae. Mortality from snakebite envenoming has decreased over the last 30 years, however, at an insufficient rate to meet the WHOs 2030 goal. It is categorised as an unintentional injury for . public health officials in determining what antivenoms are needed in their country and in drafting relevant national public health policies; national regulators in prioritizing antivenoms for registration and assessing safety, quality, and efficacy of antivenoms to meet national public health needs; procurement agencies in selecting appropriate antivenoms for national treatment needs; antivenom manufacturers in developing plans for production and sale of appropriate antivenoms; clinicians and health care professionals in treating snakebites; and. The World Health Organization (WHO) set a goal to halve snakebite mortality by 2030. This proportion was applied to the GBD 2019 venomous animal contact results from 1990 to 2019 to calculate the snakebite-specific mortality rate. Goyet, S. et al. [15] Approximately 1 million snakebites occur in sub-Saharan Africa each year,[29] resulting in up to 500,000 envenomations, 25,000 deaths and another 25,000 permanent disabilities.[30]. The strategy focuses on activities in countries and regions where snakebite envenoming occurs, supported by technical units from WHO. PubMed Ameade, E. P. K., Bonney, I. Foreman, K. J. et al. Our estimate of 6790 deaths (95% UI 504010,100) in sub-Saharan Africa aligns closely with the meta-analysis by Chippaux, which estimated there were 7331 (51499568) annual deaths7. [49] Fewer than 1% of venomous snakebites in the United States are caused by coral snakes,[51] the rest being caused by the pit vipers (rattlesnakes, copperheads, and cottonmouths). Article The global number of snakebite deaths, although estimated at anywhere from 81,000 to 138,000 by the WHO, is likely even higher than that, according to. Snakebite envenoming caused 63,400 deaths (95% UI 38,90078,600) and 2.9 million YLLs (1.8 million3.7 million) in 2019, which makes it the deadliest NTD according to GBD 201915. 351, h5313 (2015). Sub-Saharan Africa also had a high burden of snakebite envenoming deaths across the entire continent. If material is not included in the articles Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Epidemiology of snakebites Map showing the approximate world distribution of snakes. In drier regions of the continent, such as sahels and savannas, the saw-scaled vipers inflict up to 90% of all bites. 10 deadliest animals to humans | BBC Wildlife - Discover Wildlife Weak regulation and the marketing of inappropriate or poor quality antivenoms has also resulted in a loss of confidence in some of the available antivenoms by clinicians, health managers, and patients, which has further eroded demand. Under-reporting of snake bite incidence and mortality is common. [18] Although antivenom saves many lives, mortality due to black mamba envenomation is still at 14%, even with antivenom treatment. Manag. of deaths from snakebite envenoming were not reported in hospital data (4). Human displacement from conflict likely leads to increased human-wildlife conflicts and decreased access to antivenom and other necessary medical care14,21. estimated have significant vulnerability due to poor health system infrastructure and the presence of snakes for which there is no effective antivenom. eLife 9, e54076 (2020). Around 81 000 to 138 000 people die each year because of snake bites, and around three times as many amputations and other permanent disabilities are caused by snakebites annually. The weaknesses in some regulatory systems that leads to licensing of ineffective or incorrect products is sometimes coupled to poor procurement practices and inefficient 2, 3 for maps of the volume of data used in the snakebite envenoming model and the type of data in each location. [36], Throughout Western Asia, the species responsible for the majority of bites tend to be more venomous than European snakes, but deaths are infrequent. World's Longest Snake Dies 3 Days After Capture | Live Science We redistributed deaths coded to ICD codes E905, E905.9, and X29which code for deaths due to unspecified venomous animalsby aggregating all the properly coded deaths by location, age, sex, and animal and applying the proportion of correctly coded deaths due to snakebites to the number of deaths coded for an unspecified venomous animal. Environmental indicators such as living at a lower elevation and latitude and socioeconomic indicators like education had strong negative associations with snakebite envenoming mortality (Supplementary Fig. Omitted incidents include cases where someone died from falling after receiving a bite. PLOS Negl Trop Dis. The states with the highest incidence of snake bites per million population per year are North Carolina at 157.8, followed by West Virginia at 105.3, Arkansas at 92.9, Oklahoma at 61, Virginia at 48.7, and Texas at 44.2. . Developing countries tell a different story. by 2030. There are between 81 410 and 137 89, 145150 (2013). But that's not all. Nonetheless, there are approximately [65][67] It is estimated that each year 15,000 to 75,000 fisherman are bitten by sea snakes. With more granular geospatial and temporal epidemiological data, streamlined and targeted interventions can be achieved, such as the use of education, rapid emergency transport for agricultural workers, antivenom delivery to high-risk areas, and rigorous evaluation of innovative interventions like antivenom delivery via drones to at-risk rural locations14,24,25,26,27. Dandona, R. et al. Conversely, we had official health statistics data that recorded an ICD-coded death due to snakebite envenoming in Chile and New Zealand, but based on the review of the WHO venomous snake distribution database and venomous snake habitats, we agreed that there were no endemic venomous snakes despite these recorded deaths. distribution strategies, further hindering access to antivenoms and creating shortages of safe, affordable and effective products. produce antivenom products, and for some, their departure from the market.