Snakebite kills between 274,000 and 513,000 people every year, according to a new global estimate from Dileepa Ediriweera of the Liverpool School of Tropical Medicine and colleagues. The same work counts at least 2.1 million envenomings annually and as many as 7 million, and more than 800,000 survivors left with long-term disabilities such as amputations.
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Those totals are several times the figures that guided health policy for the past decade and a half. The authors argue that earlier estimates substantially undercounted the problem, mostly because so many bites happen far from any clinic.
Low and high estimates from 79 countries of data
The study, published in PLOS Medicine as “Estimates of global burden of snakebite: A literature review and geostatistical modelling study,” searched literature in any language up to March 31, 2025. It found 90 data sources, with envenoming data from 79 countries and mortality data from 70. Of 170 countries with venomous snakes, 91 lacked robust envenoming data and 100 lacked robust mortality data. Where a source gave only total bites, the team assumed half were envenomings.
Ediriweera’s group then built a geostatistical model that fills the gaps using climate, snake species richness and socioeconomic indicators, and adjusted for under-reporting by comparing hospital and regional statistics with community surveys. The result is a floor and a ceiling rather than a single number: 2.1 million envenomings and 274,000 deaths at the low end, 7 million and 513,000 at the high end.
Sub-Saharan Africa and the 45 percent
The ScienceDaily write-up, adapted from the authors’ own article, says sub-Saharan Africa accounts for about 45 percent of global envenomings and deaths, and that people there are envenomed and die at nearly three times the rate seen in South Asia. Nigeria, the Democratic Republic of Congo and Ethiopia are named as high-burden countries. Low-income countries show the highest incidence and mortality rates in the paper. South Asia and Southeast Asia also rank among the most affected regions, as they did in the 2008 study, and the 2008 conservative estimate had India alone at about 81,000 envenomings and nearly 11,000 deaths a year. The newer paper places sub-Saharan Africa at a rate close to three times that of South Asia, a comparison that depends heavily on how much under-reporting the model assumes for each region. Because so few African countries record bites, that adjustment carries more weight there than anywhere else in the dataset.
Over half of the countries with venomous snakes do not record bites or envenomings at all. That blind spot explains why the model leans on environment and poverty indicators, and why the authors conclude that better epidemiological data are most needed in sub-Saharan Africa.
Medically important genera in the region include Echis, the saw-scaled vipers, along with the puff adder, cobras and mambas. The Echis genus ranges across dry parts of Africa north of the equator, the Middle East, Pakistan, India and Sri Lanka, and its venom causes bleeding disorders that can last for days to weeks. Most bites occur after dark, when the snakes are active, and victims in remote farming areas may be many hours from a hospital stocked with the right antivenom. A bite from a saw-scaled viper can cause bleeding anywhere in the body, including intracranial hemorrhage a few days later, which is why delay in treatment matters so much.
From the 2008 baseline to the World Health Organization’s figures
The new paper is a re-evaluation 17 years after the same research network published its first global estimate in PLOS Medicine in 2008. That study put envenomings at a minimum of 421,000 a year and possibly 1,841,000, with deaths from 20,000 up to 94,000. The new low estimate for deaths, 274,000, is nearly three times the 2008 ceiling of 94,000.
The World Health Organization fact sheet still lists 81,410 to 137,880 deaths a year, about 5.4 million bites and 1.8 to 2.7 million envenomings. It says most deaths and serious consequences of snakebite are entirely preventable with high-quality antivenom, and warns that antivenom supply failure is considered imminent in Africa and parts of Asia as some manufacturers have stopped production and prices have risen sharply. The fact sheet adds that Asia sees up to 2 million envenomings a year, that Africa has an estimated 435,000 to 580,000 bites needing treatment, and that revised estimates for India alone reach up to 1.2 million snakebite deaths between 2000 and 2019, an average of 58,000 a year. About three times as many people as die suffer amputations or other permanent disabilities. The agency’s road map aims to halve snakebite deaths and disability by 2030.
The gap between 513,000 and 137,880 is the central dispute the paper raises. The authors themselves list sparse and uneven data and modeling assumptions as limitations, so the true toll sits somewhere inside a very wide band until more countries start counting bites.
This article was produced with the assistance of AI and reviewed by Morning Overview editors prior to publication.
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