Kerala has officially declared venomous snakebites as a disease of public health importance, marking a significant step towards improving snakebite management in the state. This decision, formalized under Section 28 of the Kerala Public Health Act, 2023, makes Kerala one of the leading states in India, along with Tamil Nadu and Karnataka, to prioritize snakebite envenomation as a notifiable condition. The move is expected to enhance documentation, data collection, and research, leading to more effective, data-driven strategies for managing snakebite cases.
The decision comes after the Kerala High Court directed the state government to declare snakebites as a notifiable disease within two months, following a circular from the Union Health Ministry in November 2024. The directive was a response to petitions filed in 2019 after a tragic incident where a Class 5 student died from a snakebite in a government school in Wayanad.
Kerala faces a significant risk from venomous snakes, ranking second only to West Bengal in venomous snake diversity. The state records over 3,000 critical snakebite incidents annually, with 8,000 to 12,000 people admitted to government hospitals each year for treatment. Official data from the Forest Department’s SARPA app ("snake awareness, rescue and protection") reported 334 snakebite deaths between 2017 and 2019. While the number of fatalities has decreased in recent years, the classification aims to further reduce these numbers through coordinated action and improved medical response mechanisms.
The state government is taking a multi-faceted approach to tackle the issue. This includes mandatory hospital reporting of snakebite cases, strengthening anti-venom supply chains, and standardizing treatment protocols. Clinical management and reporting will align with the National Centre for Disease Control’s updated national guidelines for snakebite management, published in 2022. Improved medical training for doctors to identify snakebites and manage envenomation symptoms is another critical focus area.
Kerala's initiative also includes a focus on awareness and prevention. The Forest Department launched the 'Snake Envenomation Zero Mortality Kerala' project, aiming to eliminate snakebite deaths within five years. This involves creating awareness among the public and ensuring adequate facilities at local Primary Health Centres (PHCs). A key component of this initiative is the establishment of an anti-venom production facility in the state.
The types of venomous snakes prevalent in Kerala, including the Russell's viper, cobra, krait, and saw-scaled viper, pose significant threats. The hump-nosed pit viper, unique to the Western Ghats, is particularly concerning due to its venom being linked to severe renal complications and underreported deaths. The High Court has noted that there is no specific antivenom available for the hump-nosed pit viper. This highlights the need for region-specific antivenoms and improved treatment strategies.
The High Court has directed the state to ensure a reliable supply of anti-venom in primary health centers, community health centers, and district hospitals, particularly in rural areas where snakebites are most common. The government will also designate state and district-level nodal officers to collect and present data to a joint committee, which will regularly review and update guidelines and monitor implementation.
By declaring snakebite envenomation a public health priority, Kerala is aligning its health policy with the World Health Organization (WHO)’s global strategy to reduce snakebite-related deaths and disabilities by 50% by 2030. The WHO recognized snakebite envenomation as a Neglected Tropical Disease in 2017. This new classification empowers coordinated action between departments and improved medical response mechanisms, which is vital for a state where rural and agricultural regions face continued risk from venomous snakes.
