Search

Understanding Antivenom with Gerry Martin

Chetana B P
Jul 11
6 min read

Our conversation with Gerry continues, turning to the science of antivenom and how we can build a safer relationship with these remarkable creatures. In India, where snakebite remains a major public health challenge, antivenom research is evolving to address longstanding gaps in effectiveness across the country’s diverse snake species. At the forefront of this work is The Liana Trust, whose research focuses on bridging these gaps and improving the next generation of snakebite treatments.

Gerry engaging with local community members about how simple preventative measures and greater awareness can significantly reduce the risk of snakebite. Photo: The Liana Trust

This has been really enlightening so far, Gerry. Thank you. Now that we have an understanding of snake venom and snakebite, I’d like to ask you about the reality of snakebite mitigation, starting with antivenom. How does it work?

Antivenom is basically an antibody that is created by injecting an animal with a sublethal dose of venom. The animal then generates antibodies that are very specific to the venom that has been injected into it, because antibodies bind to that specific venom molecule. So if I have antivenom that has been produced, for, say, a spectacled cobra, that antivenom will not work for a Russell’s viper.

An antibody binds to venom, preventing it from doing what it’s supposed to do. It then pretty much gets peed out. However, in India, it is very difficult to accurately identify the species responsible for a bite. So what we have is what is called a polyvalent antivenom, which works against the venom of four species: the spectacled cobra, the saw-scaled viper, the Russell’s viper, and the common krait.

Now, one of the issues is that there is variation within each of these species as well. A spectacled cobra here in Karnataka and a spectacled cobra in Punjab have different venoms. In some places, that variation doesn't matter. In some other places, it has meant that the antivenom that we produce, all from venom obtained from snakes in a 40-kilometer radius in coastal Tamil Nadu is not working very well in other parts of the country. So we do need to figure out how to manage that.

There are also many more medically significant snakes than we once thought.

We used to think it was the Big Four, but there are many more than that. There are at least 23 to 25 medically significant species in the country.

You mentioned that the venom used to produce antivenom comes from a small area in coastal Tamil Nadu. Can you tell us more about that? Is that the only place in the country where venom is sourced for antivenom production?

India currently has four legal venom suppliers. The oldest one is the Irula Snake Catchers Cooperative Society, although it is no longer a cooperative society. It has been taken over by the Cottage Industries Department in Tamil Nadu.

There is the Snakebite Research Institute in Gujarat, which, as far as I know, is quite advanced in venom production. There is also a private firm in West Bengal called Manosha that produces venom. And then there's us.

We definitely need more places that extract venom for making antivenom. And I strongly believe that venom extraction should not be commercialised, but should instead be carried out by the state or a social initiative. Aside from us, all the others in the country charge (quite heavily) for the venom they extract.

Venom extraction is a highly specialized process that requires expertise, precise handling techniques, and strict safety protocols. The venom collected plays a vital role in research, helping the scientists better understand snake venoms and improve the production of life-saving antivenoms. At the Liana Trust, venom extracted from snakes is provided free of cost to Premium Serums and Vaccines Pvt. Ltd. for the production of antivenom. Photo: The Liana Trust

Given the regional variation in venom, even within the same snake species, what should we be working towards to make antivenom more effective and accessible in a country as ecologically diverse as India?

India has a snakebite problem whose scale, diversity, and magnitude can be compared quite easily to that of the African continent. So it's very difficult to come up with a national silver bullet that will deal with all this.

We really do need to start thinking regionally.

The danger in deciding what our solutions should be is that we still don't have a good grasp of what the actual landscape of this problem looks like. Aside from venom variation within a species, there are also other species to consider. None of the Big Four snakes occur in the Andaman and Nicobar Islands.

Very few of them are found in the Northeast. The Western Himalayas have their own assemblage of snakes. Even in Karnataka, where we think it's just the Big Four, there is at least one other krait species and one pit viper species that are medically significant and cause human deaths.

So we really need to reassess what we know, or think we know, about snakes, their distribution, and how that affects human-snake conflict. Ideally, we need to be looking at regions. What those regions are is still up for debate.

How we figure all of this out, who gets what venom from where: the only thing I can say is that there's a ton of work left to be done.

The only way forward is through a great deal of collaborative, cohesive work across the country.

If we were to rethink living with snakes in India, what do you think needs to change? What should we be focusing on?

I think we need to go back to how we lived many, many years ago. I remember, when I was growing up, and this is a story I share often, I saw an old lady in the village next to our farm sweep a cobra out of her house. Then she went back to sifting her grains.

So I think there was an understanding of how to live with snakes, and I think that has gone. I think that the Green Revolution really changed a lot about how we lived and how we navigated the space around us. I'm not saying snakebites didn't happen then, but I do know that a lot of people knew how to live with snakes.

We also need to figure out what to do in case of a contingency. Communities need to know what to do in the event of a snakebite.

For that, we need to strengthen our medical infrastructure, research, and we need to strengthen education.

Meeting with Devandra, a snakebite survivor, to better understand the long-term impact of snakebite and how The Liana Trust can support survivors beyond emergency care. For many, lasting disabilities affect their ability to earn a living, so alternative livelihood opportunities, including beekeeping and poultry farming, are being explored to help families rebuild their futures. Photo: The Liana Trust

So, is it possible to coexist with venomous snakes? Yes. But it also depends on where you are and what work you do. It's easy for someone like us to coexist because we're not working with our hands and walking barefoot in knee-high grass or crops. If you're an agriculturalist, we need to figure out what needs to change about those working conditions.

For instance, in Kerala, numerous people were getting bitten by Russell's vipers while working in arecanut and coconut plantations. That's because of the large amount of mulch that accumulates there. The mulch is created by just leaving fallen fronds at the base of trees, which creates excellent habitat for Russell's vipers. So when someone walks through it, they get bitten.

What if we simply chopped or shredded the fronds? You would still get the same amount of mulch, but you wouldn’t be creating a space where Russell’s vipers could hide. Or you could put all the fronds on one side of the tree, where the tree would still receive the nutrients while also leaving a clear and safe path for people to work.

These are the kinds of things that we need to think about.

Very often, the answers are actually pretty simple.

A comic by The Liana Trust created to raise awareness about snakebite prevention and mitigation. Created by Chandini Chhabra and illustrated by Karunya Baskar. Download this free resource, and know more about their work here: https://www.thelianatrust.org/projects-8

Read part 1 in this series here:

Understanding Snake Venom with Gerry Martin