The Government of Kerala has officially notified snakebite envenomation as a disease of utmost public health importance under Section 28 of the Kerala Public Health Act, 2023. This step enables better documentation, data collection, research, and data-driven management of snakebite cases across the State. The Government of Kerala issued the gazette notification on Friday, marking a significant milestone in the State’s public health policy.
Strengthening Surveillance and Reporting
With this notification, hospitals in Kerala must now enter all reported snakebite envenomation cases into the Integrated Disease Surveillance Programme (IDSP) platform. A senior Health Department official said this will ensure comprehensive monitoring and prompt response to snakebite incidents.
Regional Context and Mortality Data
Kerala reported 34 deaths due to snakebites in 2023–24 and 30 deaths in 2024–25, as per Health Department records. While these numbers are lower than those in states like Bihar—where hundreds of deaths occur annually—snakebites continue to represent a serious public health challenge. The World Health Organization (WHO) classifies snakebite envenoming as a neglected tropical disease. It highlights the condition’s strong link to poverty, inequality, and limited access to healthcare.
Aligning with the National Action Plan
As reported by The Hindu, this move aligns with the National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE), launched by the Government of India in March 2024. NAPSE aims to halve snakebite mortality by 2030 through coordinated efforts in prevention, early treatment, research, and surveillance across the health, forest, wildlife, and agriculture sectors. Following this, the Centre declared snakebite envenomation a notifiable disease in November 2024.
Overcoming Technical Challenges in Treatment
Although NAPSE recommends making anti-snake venom (ASV) available at primary health centres (PHCs), Kerala faces technical limitations in administering ASV at this level. ASV can be given only in confirmed envenomation cases, which require specific clinical evaluation and blood tests—facilities that PHCs currently lack.
State-Level Action Plan Underway
Kerala is preparing to implement a State-level Action Plan for Snakebite Envenomation. It is based on the One Health approach outlined in NAPSE. Funds have already been sanctioned for this initiative. The plan focuses on ensuring a sustained ASV supply and strengthening emergency response systems. It also promotes public education and awareness to systematically reduce snakebite risk.
Need for Region-Specific Antivenoms
India’s polyvalent ASV is currently standardised to treat bites from four major snake species. These include the Indian cobra, common krait, Russell’s viper, and saw-scaled viper. These species are responsible for most envenomation cases nationwide.
This ASV does not neutralise the venom of the hump-nosed pit viper (Hypnale hypnale). This species has emerged as a significant threat in Kerala. Using ineffective or inappropriate ASV can cause adverse reactions and medical complications.
Evidence Supporting Regional Solutions
A 2016 study conducted in Kerala highlighted the need for region-specific antivenoms. The research, which analysed snakebite cases in a tertiary care hospital, revealed that among the 47.3% of identified species, Russell’s viper (D. russelii) accounted for 23.1% and hump-nosed pit viper (H. hypnale) for 15.4% of cases. These findings underscore the urgent requirement for locally effective antivenoms. It has enhanced clinical training for doctors in identifying snakebite species, recognising symptoms of envenomation, and managing treatment effectively.
A Step Toward Safer, Smarter Public Health
By declaring snakebite envenomation a disease of public health importance, Kerala has taken a proactive step toward reducing preventable deaths. The State aims to set a national example in addressing one of India’s most neglected yet deadly public health challenges. It plans to achieve this through integrated surveillance, targeted research, and strengthened healthcare capacity.