Antivenom production and snake bite treatment in India ineffective, finds recent study

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What happens if a King Cobra (Ophiophagus hannah) bites you during a trek through an Indian forest? You are left to die even if you reach a hospital within minutes, since there is virtually no  antivenom produced in India for wide distribution to treat King cobra bites, shows a new study. Leave alone King cobra, which is a rare sight reserved for lucky ones, a usual Indian cobra bite from a North Indian city can also finish you off for similar reasons.

Antivenom production and snake bite treatment in a country which is home to several species of fatally poisonous snakes and an upper estimated annual snake bite deaths of 50000, are in a pathetic state, indicates a research article published in the latest issue of current Science journal.

Indian Cobra (Naja naja)
Image: Indian Biodiversity Talks

The study conducted by famous herpetologist Romulus Whittaker and his son and conservation biologist Samir Whittaker points out that the  antivenom production in India is based on the venom of the snakes present in the southern part of the country which makes it less effective in the treatment of snakebites in other parts of the country.

Venom supply, rate and quality of antivenom production, antivenom potency are way too low than the requirements. According to the article, a major part of the snake venom is sourced from Irula Snake Catchers Industrial Cooperative Society in Chennai which is the largest legally acknowledged entity providing venom for the seven antivenom producing pharmaceutical companies in the country. It causes two issues – scarcity in venom supply and ineffective venom samples for antivenom production for snake bite treatment in other regions.

Geographical difference in snake venom composition

In India, there are four major snakes which– Indian Cobra (Naja naja), Common Krait (Bungarus caeruleus), Russell's viper (Daboia russelii) and Indian saw-scaled viper (Echis carinatus) – known as the big four -which can deliver fatal bites.

However, the strength of venom differs even within the same species in different parts of the country. According to the study, Russel’s Viper found in northern and western parts of the country are twice as venomous as their southern counter parts. The case is same with Indian Cobra. Cobras from eastern parts of India are more venomous than those from other parts. It makes the antivenom made by venom samples from South India less effective in other parts, often causing death of the victim.

Indian Cobra (Naja naja) found in South India
Image: Indian Biodiversity Talks

The difference in the venom composition among the sub species among the four most venomous snakes is also causing the issue. The study shows that there are at least four cobras, eight different species of Kraits, two sub species of Saw-scaled vipers and a single species of Russell ’s viper in the country, as per most latest taxonomical data.  Further studies should be carried out to understand the difference in the venom composition between these species and the effectiveness of presently producing antivenom against these different species, it says.

Other venomous snakes in India

The study also indicates that there could be a need to produce antivenom for at least some other snake species found in India since they also found to be capable of injecting lethal amounts of venom. Since there are rare reported instances of death from bites of sea snakes and King Cobra, presently there is no antivenom produced in India to treat any such situation.  “The average venom yields indicate that, although antivenom is not made specifically for these species or variants, all of them can inject potentially lethal quantities of venom”, says the study.

Need of the hour

The changing potency of antivenom produced in India is also an aspect which needs urgent attention. According to the study, the potency of cobra antivenom was 0.60 mg/ml before 1950s which has now turned into just 0.60 mg/ml while that of Russell’s Vipers was 2 mg/ml earlier and 0.45 mg/ml now. The standards of antivenom potency and quality of antivenom production in the country should be refined based on further studies, points out the researchers.

The study calls for urgent need to make sufficient units to produce venom for producing enough quantities of antivenom in India, by making snake catchers’ societies in line with the Irula society. This will help meet the treatment needs of bites from regionally present species more effectively and will curb clandestine venom producing operations that take place in the country now, says the study.  

Read More: How to avoid snakebites