Snakebite envenoming

Every year, 49 000 people in rural India die from snakebite poisoning.2 Polyvalent snake antivenom is available for common venomous snakes, including the Indian cobra (Naja naja), Bungarus cœruleus (krait), and vipers (Russell's viper and saw-scaled viper). Because the venom detection kit (ELISA test) is not available for most clinicians a polyvalent snake antivenom is routinely administered to people bitten by venomous snakes. Morbidities attributable to snakebite are still high, and 44% of snakebite-associated mortalities are because of capillary leak syndrome characterised by swelling, hypotension, and haemoconcentration; and renal failure due to Russell 's viper poisoning.4 In 2017, WHO categorised snakebite as a high-priority neglected tropical disease and in May, 2018, WHO resolved to decrease the mortality and morbidity of snakebite poisoning and coordinate global efforts to control snakebite. By encouraging clinicians to participate in regular workshops on snakebite we have prevented the risk of anaphylaxic reactions to polyvalent snake antivenoms (by epinephrine prophylaxis and management of anaphylaxis), which was the major reason why clinicians avoided administering the antivenom to patients that required it.