By Deb Prasad Pandey

Snakes are profoundly embedded in Nepalese culture, tradition and religion. Hindu people worship the Nag (king of snakes) in Nag Panchami (the snake festival) by pasting the colorful postures of snakes on the main door of the house and milk and money are offered to the priest and snake charmers to feed the snakes that is celebrated in July in mid monsoon. This is believed and performed so as to avoid the snakebite and to assure plenty of rain fall for their crops. The fang of the snake is recognized as symbol of power and is facet on the throne of His Majesty the King. It is said that the snake will punish any one who wishes to harm the King.

Nag Panchami : a Hindu devotee pasting the picture of Nag, the serpent deity above the main gate of his house. It is believed that worship of the serpent deity on this day protects the house of lighting, fire and the family members from snakes and scorpions, Wednesday, Aug 10 05. nepalnews.com/rh

Nepal has rich repository of snakes due to its strategic place on map of Asia where it is positioned at the meeting point of two zoogeographic realms, Oriental to the south and Palaearctic to the north. The other important factors for the diverse snakes are Nepal’s varied and unique topography and climate.

In Nepal, there are more than 89 species of snakes with 21 of them poisonous. These snakes are included in 8 families. All poisonous snakes belong to family elapidae and viperidae. The family elapidae contains cobra, krait and coral snake and possess powerful neurotoxins, while viperidae includes viper and pit vipers which possess haemotoxins.

The cobras are represented by two genera and three species (Naja naja, Naja kauthia, Ophiphagus hannah) while only one genus and five species of kraits (B. bungaroides, B. caeruleus, B. fasciatus, B. lividus, B. niger) are found in Nepal. Viperidae family consists of five genera and 12 species. The Russell’s viper (Daboia russelii) venom comprises of powerful enzymes like proteinases and non-enzymes (e.g. hemorrhagins) and are responsible for bleeding manifestations. In Nepal most of the snakebite cases are due to elapidae family. However, as Russell’s viper is found in Nepal, the complications related to its bite also occur.

Globally, Snakebite is a significant public health problem although it is difficult to be defined the actual number of snakebite cases. It is estimated that the true incidence of snake envenomation could exceed 5 million per year. About 100,000 of these develop severe yell. The global inconsistency in the epidemiological data reflects variations in health reporting accuracy as well as the diversity of economic and ecological state of affairs.

In Asia alone, it has been estimated that four million snake bites occurs each year of which 50% are envenomed resulting in 100,000 annual deaths.

A baseline epidemiological study conducted from 1980 to 1985 in 15 district hospitals in collaboration with the WHO found 3189 treated cases of which 144 victims. It has been estimated that 150 to 200 ophitoxaemia related deaths occur annually in Nepalese hospitals. The WHO estimated over 20,000 cases and 1000 deaths from ophitoxaemia in Nepal.

Till 2003 there is only one community based study on snakebite in Nepal. This community-based survey was undertaken in randomly selected 74,825 people from a reference population totaling 1,600,000 from 3 districts in Eastern Nepal. 143 snakebites, including 75 bites with signs of envenomation and 20 deaths were reported.

Hospital records fall far below than the actual number because of dependence on traditional healers and practitioners for treatment. It has been reported that in most developing countries, up to 80% of individuals bitten by snakes first consult traditional practitioners before visiting a medical center. Existing epidemiological data in Nepal is scarce and rely exclusively on hospital registrar analysis, which underestimates the true impact of snakebite in the community.

Snakebite is a major but neglected public health problem. Accurate records to determine the exact epidemiology or even mortality in snakebite cases are also generally unavailable which complicate the public health problem. Sparse studies have been conducted so far as to know the snakebite epidemiology in Nepal.