New ICMR Study: Snakebite Death Rate 20 Times Lower Than Earlier Estimate

A new study funded by the Indian Council for Medical Research (ICMR) indicates that deaths from snakebites in India are significantly rarer than previously estimated. The study, conducted across 11 states, found a mortality rate of approximately 0.3 per 100,000 population — far lower than the earlier estimate of 6 per 100,000 derived from the Registrar General of India's One-Million-Death study covering 1998–2014.

The research, published in Nature Communications, is based on a cross-sectional survey where data was collected continuously for one year in each of the 11 states. ASHAs (accredited social health activists) and family members of victims who consented to participate helped identify cases. The survey is yet to be completed in Meghalaya and West Bengal.

Key findings reveal that 43% of snakebite deaths occurred outside hospital settings or while the victim was in transit. Additionally, snakebite envenomation (SBE) disproportionately affects the impoverished, with 53% of victims below the poverty line. Among the 7,094 snakebites recorded across 25 project districts, 2.7% resulted in death, of which 57% occurred in hospitals.

The study highlights that the earlier One-Million-Death estimate may have been grossly overestimated. For instance, in Kerala (population 35 million), only 31 deaths from SBE were recorded in 2024–25, compared to the 2,100 predicted by the old estimate. Extrapolating the survey results to the national level suggests a total of 120,852 snakebites annually across India.

However, the study's authors caution that this lower number may be due to the limited coverage of the survey — only 13 of 28 states are included, and large states like Uttar Pradesh, Bihar, and Madhya Pradesh, which historically report high fatalities, are not part of the study. India bears the largest global burden of snakebite envenomation, accounting for nearly half of the world's snakebite deaths, primarily due to its large agrarian population.

The 'big four' venomous species responsible for most envenomations in India are the Indian cobra, common krait, Russell's viper, and saw-scaled viper. Demographically, 64.1% of victims were male, the highest proportion in the 30–39 age group (20.9%), and most bites occurred during the monsoon season (62%). Unskilled labour was the most common occupation (25.4%), followed by agriculture/farming (24.5%). The study underscores the need for improved access to healthcare in rural areas and better awareness to prevent snakebite deaths.