An Unnecessary Russell’s Viper Bite on the Tongue Due to Live Snake Worship and Dangerous First Aid Emphasise the Urgent Need for Stringent Policies

Arathisenthil, S.V.; Williams, Jarred; Williams, Harry F.; Thirumalaikolundusubramanian, Ponniah; Patel, Ketan; Vaiyapuri, Sakthivel

doi:10.3390/toxins14120817

“…Additionally, the relationship between these key factors is complex, highly dynamic, and context-dependent, which must take into account the religious and cultural aspects of the most affected populations. Mythical and religious beliefs play a key role in the development of snake phobia and consequently, in SBE burden [29]. As a result, synergistic actions, and efforts, such as conflict prevention strategies, community-based programs, sustainable coexistence promotion techniques, snake conservation initiatives and multilevel investigations of the different factors or priority elements mentioned above are crucial to minimise the huge impact of this challenge [30].…”

Section: Discussionmentioning

confidence: 99%

Assessing the prevalence of snake phobia among the general population in India

Salim,

Chandrasekharuni,

Almeida

et al. 2024

Preprint

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BackgroundA specific phobia is an anxiety disorder that is characterised by persistent and excessive fear in the presence of the object of the phobia. Animal phobias are the most prevalent forms of specific phobia among humans. Fear of snakes is present in non-human primates which suggests its evolutionary origins as the ability to detect the threat of snakes was critical for survival. Snake phobia is a critical factor in protecting snakes and mitigating snakebite burden. To date, only one standardised psychometric test [the Snake Questionnaire (SNAQ) developed in 1974] has been used to quantify snake phobia. Here, we estimated the level of snake phobia in India, where snakebites are highly prevalent using a modified version of the SNAQ (SNAQ12), which has previously demonstrated internal consistency, excellent reliability, and good discrimination between phobics and non-phobics in Hungary although it has never been tested among the general population in a snakebite-endemic country.Methodology/principal findingsSNAQ12 was developed both in English and Tamil and validated by testing on several individuals. Then, the questionnaire was disseminated to members of the public through various methods including social media and in person through academic and clinical organisations. We received a total of 2032 responses, comprising 1086 [53.4%] males and 946 [46.6%] females.Conclusions/significanceThe results demonstrated good internal consistency in determining phobia amongst the population. The data suggests that males are more likely to be snake-phobic than females, in contrast to previous research that suggested that females are usually more snake-phobic. The use of the SNAQ12 allowed us to easily discriminate between individuals with phobia and non-clinical controls. This tool can be used as part of the One Health approach to better understand the relationships between snake phobia and snakebites and their impact on the mental health and well-being of vulnerable populations.Author SummarySnakebite envenoming often occurs due to unnecessary human-snake conflicts. Fear of snakes is a key factor in driving this conflict which frequently results in killing snakes. To protect humans from snakebites and snakes from humans, it is critical to estimate the level of snake phobia among vulnerable communities. Therefore, in this study, we used a robust online questionnaire (SNAQ12) to measure the level of snake phobia among members of the public in India, which is a snakebite-endemic country. SNAQ12 was developed in English and a local language, Tamil and validated before disseminating to members of the public through several methods. We received over 2000 responses, and the data analysis confirmed the internal consistency and robustness of this questionnaire for Indian communities. The data demonstrated that males are more phobic to snakes than females in India. The phobia was not dependent on any other factors such as age and education levels. While this study has some limitations, it forms the basis for further research to determine the level of phobia before and after snakebites and develop robust strategies to tackle this condition. We believe that preventing and treating snake phobia will aid in mitigating snakebite burden and snake conservation in India.

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Merrem's Hump-Nosed Viper (Hypnale hypnale) Bite on the Tongue of an Infant Leading to Upper Airway Obstruction: An Unusual Presentation

Gunawardena,

Samarathunga,

Bandara

et al. 2024

Wilderness & Environmental Medicine

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Snakebites in unusual anatomical locations may lead to life-threatening consequences. Merrem's hump-nosed viper ( Hypnale hypnale) is a medically important snake in Sri Lanka and India that causes many bites and envenomings. Their bites occur almost exclusively on upper and lower limbs and commonly result in local effects, with some patients developing systemic envenoming. No antivenom is available for treating envenoming by H. hypnale. We report an unusual case of H. hypnale bite on the tongue of a 10-month-old infant resulting in rapid local swelling of the tongue and floor of the mouth, requiring prompt intervention to prevent life-threatening upper airway obstruction. Early tracheostomy prevented upper airway obstruction and, along with supportive steroid therapy and antibiotics, led to a complete resolution of the local effects of the infant without permanent disability, despite the unavailability of antivenom.

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Snake phobia among the general population of Tamil Nadu, India

Salim,

Chandrasekharuni,

Almeida

et al. 2024

PLoS Negl Trop Dis

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Background A specific phobia is an anxiety disorder that is characterised by persistent and excessive fear in the presence of the object of the phobia. Animal phobias are the most prevalent forms of specific phobia among humans. Fear of snakes (snake phobia) is present in non-human primates which suggests its evolutionary origins as the ability to detect the threat of snakes was critical for survival. Snake phobia is a critical factor in protecting snakes and mitigating snakebite burden. To date, only one standardised psychometric test [the Snake Questionnaire (SNAQ) developed in 1974] has been used to quantify snake phobia although this was not performed in snakebite-endemic countries. In this study, we aimed to determine snake phobia in India, where snakebites and resulting deaths, disabilities and socioeconomic impacts are high. Methodology/Principal findings A modified version of the SNAQ (i.e. SNAQ12), which has previously demonstrated internal consistency, excellent reliability, and good discrimination between phobics and non-phobics in Europe was used in this study. SNAQ12 was developed both in English and Tamil and validated by testing on several individuals. Then, the final questionnaire was disseminated to members of the public through various methods including social media and in person through academic and clinical organisations. We received a total of 2032 responses, comprising 1086 [53.4%] males and 946 [46.6%] females, and these data were analysed to determine various aspects of snake phobia in the study population. Conclusions/Significance The results demonstrated good internal consistency in using SNAQ12 to determine the phobia amongst the tested population. The data suggests that males are more snake-phobic in all age groups than females in India, in contrast to previous research that suggested that females are usually more snake-phobic. No other critical factors contribute to snake phobia in this study population. The use of the SNAQ12 allowed us to easily discriminate between individuals with phobia and non-clinical controls. This tool can be used as part of the One Health approach to better understand the relationships between snake phobia and snakebites and their impact on the mental health and well-being of vulnerable populations.

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An Unnecessary Russell’s Viper Bite on the Tongue Due to Live Snake Worship and Dangerous First Aid Emphasise the Urgent Need for Stringent Policies

Cited by 5 publications

References 22 publications

Assessing the prevalence of snake phobia among the general population in India

Assessing the prevalence of snake phobia among the general population in India

Merrem's Hump-Nosed Viper (Hypnale hypnale) Bite on the Tongue of an Infant Leading to Upper Airway Obstruction: An Unusual Presentation

Snake phobia among the general population of Tamil Nadu, India

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