Intended for healthcare professionals


Sixty seconds on … snakebite

BMJ 2017; 357 doi: (Published 27 June 2017) Cite this as: BMJ 2017;357:j3065
  1. Anne Gulland
  1. London

Takes me back to my student days—dancing to The Wonder Stuff in the union bar, wearing my DMs, and supping on a pint of snakebite and black

No, you idiot. Not the drink but the injury caused by the long, slithery animal. The World Health Organization has just put snakebite envenoming on its list of the world’s top 20 neglected tropical diseases in what campaigners are hailing as a long overdue decision.

Silly me. They’re both pretty nasty though

Exactly. Around five million people are thought to be bitten by snakes every year, 125 000 of whom will die, with a further 400 000 being permanently disabled or disfigured. Those living in the poorest countries are most affected by the problem. According to the Global Snakebite Initiative the death toll is highest in India, where 15 000 people were killed by snakebites in 2008. Snakes are also a problem in sub-Saharan Africa, China, and Mexico.

So what does being on the list of NTDs mean?

More money, effort, and attention will be directed to the problem. Since being included on the list, the eradication of guinea worm disease is within reach—in 2016 there were just 25 cases, compared with more than 800 000 in 1989. The number of cases of Buruli ulcer, another one on the list of 20 diseases, fell from 5156 in 2008 to 2037 in 2015.

So how is WHO going to tackle this problem?

Campaigners hope it will try to solve the lack of affordable antivenom. The French pharmaceutical company Sanofi stopped producing the only antivenom proven to be safe and effective at treating bites from different types of snakes across sub-Saharan Africa because of lack of profitability. There are also calls for more action on preventive measures such as bed nets, protective footwear, and repellents, as well as community awareness of what to do in the event of a snakebite and how to identify different snakes.

While we’re at it—what’s the difference between venomous and poisonous?

Venomous creatures bite, stab, or sting their prey whereas you have to eat or touch poisonous animals to feel their effects. Any other homework questions?

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