As many as 7 million people could experience snake envenoming each year, a literature review and geostatistical modelling study has found. The researchers reviewed studies published up to 31 March 2025 and examined data from 79 countries.
The study estimates that 274,000 to 513,000 people die from envenoming each year. More than 800,000 survivors are left annually with permanent disabilities, including amputations.
Snake envenoming can be fatal and falls mainly on poor rural communities in tropical and subtropical regions where medical care is difficult to reach. Sub-Saharan Africa accounts for 45% of the global burden of envenomings and deaths, while Nigeria, the Democratic Republic of Congo and Ethiopia face the highest burden.
The scale is obscured because more than half of countries where venomous snakes pose a threat do not record how many people are bitten or envenomed. In rural sub-Saharan Africa and south Asia, victims may live hours from a clinic, have no transport or turn to traditional healers.
Rural residents have a relative risk of 3.2 compared with urban dwellers. Inadequate access to antivenom has a relative risk of 3.5, while arriving for treatment more than 2 hours after a bite has a relative risk of 2.1.
Farm workers can face several barriers at once: a lack of protective footwear, long journeys to clinics and antivenom that is scarce and costly. Lack of protective footwear carries a relative risk of 2.7. Males aged 15–34 years make up 57% of cases.
Early species-specific antivenom, alongside supportive care, reduces mortality from 5% to less than 1% in high-resource settings. The World Health Organization's 2016 snakebite guideline recommends giving antivenom within 2 hours of a bite for maximum effect.
Centres using protocolized care report mortality of 0.8%, compared with 5.3% in non-protocolized settings. The World Health Organization has set a target of halving snakebite mortality and disability by 2030.
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