Many people live in fear of snakes, especially of venomous species that can inflict a lethal bite. There is evidence that our fear of snakes is innate, because our ancestors have been preyed upon by them for millions of years, even before we were primates. Other evidence suggests a significant learned component to ophidiophobia. Either way, few people today are at risk of being eaten by snakes, but bites from venomous snakes are still fairly common. However, in my experience fear of snakes is way out of proportion to the actual risk they pose, especially among my fellow North Americans. It's surprisingly hard to find good information on the prevalence of venomous snakebite (hereafter, just 'snakebite'), but it's getting easier, and I was able to gather almost 100 papers that include data on the subject, which I've synthesized here. As a result, this article has many footnotes, and because I used so many references to prepare this article I've provided a selected list at the end of this post, with a link to the full list.
Map of snake envenomings per year, from Wikimedia Commons |
Copperheads (Agkistrodon contortrix) bite a few hundred people a year in my home state of North Carolina, more than in any other state. Fatalities are exceedingly uncommon. |
Western Diamondback Rattlesnakes (Crotalus atrox) are large and widespread in the southwestern USA. Contrary to the popular myth, a recent study showed that larger rattlesnakes cause more serious bites than smaller ones, which makes sense because they have more venom to inject (see also unpublished data from the Hayes lab at Loma Linda University showing the same trend and also that smaller bite victims have more serious bites). |
Figure from Gibbons & Dorcas (2002) |
some sources say up to 8,000) bites occur, putting your chances of being bitten by a venomous snake in the USA at about 1 in 100,000 (1 in 40,000 with higher bite estimate).3 If you live in southern or southeastern Asia, you're more justified in having a fear of snakes. In India, at least 80,000 and possibly as many as 165,000 people are bitten by snakes each year (1 in 7,000-14,000). India's venomous snake fauna isn't that much more diverse than the USA's, but medical care isn't as good, and it has about 4 times as many people, many of whom live in rural areas and work in agricultural or pastoral professions, both of which really increase your chances of being bitten. Even in India, "only" about 10,000-15,000 people a year die from snakebite (edit: a more recent study that estimated snakebite mortality in India using household surveys instead of hospital records came up with a figure of ~46,000 deaths in 2005, which is probably more accurate because many victims elect to use traditional therapy in their village and most do not die in government hospitals, where the data are collected; for a more thoughtful discourse on snakebite in India, click here), meaning that about 4 out of 5 (edit: using the newer data, between 1 in 4 and 1 in 2) snakebite victims survive. Taking into account your chances of being bitten and your chances of dying from the bite, many countries in sub-Saharan Africa, Asia, and Latin America are risky places to live. Snakebite in these places is a legitimate public health concern. The USA is the least risky country in terms of snakebite. The only safer countries are places like Ireland, New Zealand, Madagascar, and oceanic islands in the Pacific & Caribbean, where no venomous snakes occur. Snakebite risk in the USA is thousands of times lower than it is in many parts of the world, and it would be even lower if people modified their behavior in a few key ways, starting with not attempting to kill every snake they see.
The USA (bottom left) is the safest country in the world in terms of snakebite risk. Countries without any venomous snakes not shown. Data from Kasturiratne et al. 2008 Click for larger version |
Black Mambas (Dendroaspis polylepis) are among Africa's most dangerous snakes, but they still kill fewer people than hippos or mosquitos |
CroFab antivenom used to treat most snakebites in the USA |
Yet more than 1 in 20 people in the USA have a pathological fear of snakes, as defined by criteria including uncontrollable, greater than justified, and significantly interferes with a person’s routine, occupational or academic functioning, or social activities or relationships. Leading to situations like this recent news story and this bizarre interaction between a man, a gun, and a snake. Risk perception is influenced by many things, including the rarity of the event, how much control people think they have, the adverseness of the outcomes, and whether the risk is voluntarily or not. For example, people in the United States underestimate the risks associated with having a handgun at home by 100-fold, and overestimate the risks of living close to a nuclear reactor by 10-fold. Ironically, evidence suggests that two of these things (how much control you have and how voluntary the risk is) are actually quite high for snakebite, despite popular perception that they are low.
fady to kill any snake (edit: although apparently superstitions still abound). In contrast, in Australia people seem to have a relatively high level of respect for snakes and don't seem to mess with them solely out of machismo the way they do in the USA. Venomous snakebites are relatively rare, which is remarkable considering that the majority of snakes in Australia are venomous. I heard a story recently about a newly-hired Australian CEO of an American mining company. When the new boss asked about the snake policy, the employees jokingly replied that it was "a No. 2 shovel". The Australian CEO was not amused, because at his previous company Down Under routinely relocated much more dangerous snakes at their job sites. He instituted a company-wide training program to teach safe venomous snake practices. These classes are also available to the general public in some areas, especially in southern Africa.
As people and wildlife come to share more and more space, snake-human interactions are inevitable. The future of conservation will probably be in maximizing compatibility between humans and wildlife rather than preserving pristine areas, we will need to get a lot better about behaving ourselves to keep ourselves safe from the defense mechanisms of wildlife, starting with educating ourselves about the real risks that underlie our fears. Everyone should read these guidelines for snakebite prevention and first aid. I would add to this: don't kill snakes! It only puts you at risk. Don't try to kill them, don't let your friends kill them, don't let your family members kill them. They won't try to kill you. I promise.
For more about snakebite research and treatment, check out Dr. Leslie Boyer's blog and Bill Hayes's snakebite research page.
1 Venomous snakes that are striking at their prey practically always inject venom, and some evidence suggests that they can precisely meter their venom so that they inject exactly the right amount needed to kill each particular prey item, based on its mass. Fortunately for humans, there are no venomous snakes large enough to consider us prey. Dry bites to humans may result from the snake's deliberate decision to withhold venom or from kinematic constraints that reduce the duration and coordination of fang contact when striking a large, vertical object.↩
2 Although global snakebite statistics frequently list 0 fatalities out of 200-300 snakebites for Canada, this seems not to be quite accurate. In Ontario, at least two people have been killed by Timber Rattlesnakes (Crotalus horridus), a soldier who was bitten at the battle of Lundy's Lane near Niagara Falls in 1814, and an American Indian chief prior to 1850. Two or three people have been killed by bites from Massasaugas (Sistrurus catenatus) in Ontario, all before 1962, and between 0 and 10 people were bitten annually from 1971-2007, mostly men aged 10-29. In 1981, a man who was "quite intoxicated" was killed by a bite from a Northern Pacific Rattlesnake (Crotalus oreganus) on the Nk’meep reserve near the town of Osoyoos in British Columbia's Okanagan Valley. He was the first person to be bitten by a native venomous snake in BC in over 50 years. The only other Canadian provinces that are home to venomous snakes are the Prairie Provinces of Alberta and Saskatchewan, where no recorded deaths have occurred from Prairie Rattlesnake (Crotalus viridis) bites. So we can conclude that native snakebites in modern Canada are even more infrequent than but follow the same basic pattern as those in the USA.↩
3 In the US, relative to dying from heart disease (1 in 5), cancer (1 in 7), in a motor vehicle accident (1 in 80), in a fall (1 in 185), from a gunshot (1 in 300), by drowning (1 in 1100), by choking (1 in 4400), from drinking too much alcohol (1 in 10,900), by a sting from a wasp, bee, or hornet (1 in 63,000), from being struck by lightning (1 in 80,000), from a dog bite (1 in 120,000), or in an earthquake (1 in 150,000), you are very unlikely to be killed by a snake (1 in 480,000). The only less-likely causes of death are being trapped in a low-oxygen environment (1 in 548,000), being killed by ignition or melting of nightwear (1 in 767,000), and being bitten by a spider (1 in 960,000). These odds are for your entire lifetime; your annual chance of being killed by a venomous snake is more like 1 in 50 million. Worldwide, they're more like 1 in 200,000, which is a lot higher but still pretty low overall. ↩
ACKNOWLEDGMENTS
Thanks to Julia Riley and James Baxter-Gilbert for providing me with information on deaths from snakebite in Canada, to Wes Anderson, James Van Dyke, and Xav Glaudas for sharing with me with their impressions of people's fear of snakes outside of North America, and to Matt Clancy, John Worthington-Hill, Larsa D., Todd Pierson, and Pierson Hill for the use of their photography. If you're so inclined, check out David Steen's post on why it doesn't make sense to kill venomous snakes in your yard here and Jessica Tingle's historical view of the subject here.
SELECTED REFERENCES
(click here for a longer list of references pertaining to snakebite [last updated February 2017])
(click here for a longer list of references pertaining to snakebite [last updated February 2017])
Scientific illustrator Liz Nixon made this infographic
featuring facts in this post!
Click here for a larger version.
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Gibbons, J. W. and M. E. Dorcas. 2002. Defensive behavior of Cottonmouths (Agkistrodon piscivorus) toward humans. Copeia 2002:195-198 <link>
Glaudas, X., T. M. Farrell, and P. G. May. 2005. The defensive behavior of free–ranging pygmy rattlesnakes (Sistrurus miliarius). Copeia 2005:196-200 <link>
Hayes, W. K., S. S. Herbert, G. C. Rehling, and J. F. Gennaro. 2002. Factors that influence venom expenditure in viperids and other snake species during predator and defensive contexts. Pages 207-234 in G. W. Schuett, M. Höggren, M. E. Douglas, and H. W. Greene, editors. Biology of the Vipers. Eagle Mountain Publishers, Eagle Mountain, UT <link>
Isbell, L. A. 2006. Snakes as agents of evolutionary change in primate brains. Journal of Human Evolution 51:1-35 <link>
Janes Jr, D. N., S. P. Bush, and G. R. Kolluru. 2010. Large snake size suggests increased snakebite severity in patients bitten by rattlesnakes in southern California. Wilderness and Environmental Medicine 21:120-126 <link>
Juckett, G. and J. G. Hancox. 2002. Venomous snakebites in the United States: management review and update. America Family Physician 65:1367-1375 <link>
Janes Jr, D. N., S. P. Bush, and G. R. Kolluru. 2010. Large snake size suggests increased snakebite severity in patients bitten by rattlesnakes in southern California. Wilderness and Environmental Medicine 21:120-126 <link>
Juckett, G. and J. G. Hancox. 2002. Venomous snakebites in the United States: management review and update. America Family Physician 65:1367-1375 <link>
Kasturiratne, A., A. R. Wickremasinghe, N. de Silva, N. K. Gunawardena, A. Pathmeswaran, R. Premaratna, L. Savioli, D. G. Lalloo, and H. J. de Silva. 2008. The global burden of snakebite: a literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Medicine 5:e218 <link>
Morandi, N. and J. Williams. 1997. Snakebite injuries: contributing factors and intentionality of exposure. Wilderness and Environmental Medicine 8:152-155 <link>
Parrish, H. M. 1966. Incidence of treated snakebites in the United States. Public Health Reports 81:269-276 <link>
Ruha, A.-M., K. C. Kleinschmidt, S. Greene, M. B. Spyres, J. Brent, P. Wax, A. Padilla-Jones, and S. Campleman. 2017. The epidemiology, clinical course, and management of snakebites in the North American Snakebite Registry. Journal of Medical Toxicology 13:309-320. <link>
Swaroop, S. and B. Grab. 1954. Snakebite Mortality in the World. Bulletin of the World Health Organization 10:35-76 <link>
Tierney, K. J. and M. K. Connolly. 2013. A review of the evidence for a biological basis for snake fears in humans. The Psychological Record 63:919-928 <link>
Parrish, H. M. 1966. Incidence of treated snakebites in the United States. Public Health Reports 81:269-276 <link>
Ruha, A.-M., K. C. Kleinschmidt, S. Greene, M. B. Spyres, J. Brent, P. Wax, A. Padilla-Jones, and S. Campleman. 2017. The epidemiology, clinical course, and management of snakebites in the North American Snakebite Registry. Journal of Medical Toxicology 13:309-320. <link>
Swaroop, S. and B. Grab. 1954. Snakebite Mortality in the World. Bulletin of the World Health Organization 10:35-76 <link>
Tierney, K. J. and M. K. Connolly. 2013. A review of the evidence for a biological basis for snake fears in humans. The Psychological Record 63:919-928 <link>
Van Le, Q., L. A. Isbell, J. Matsumoto, M. Nguyen, E. Hori, R. S. Maior, C. Tomaz, A. H. Tran, T. Ono, and H. Nishijo. 2013. Pulvinar neurons reveal neurobiological evidence of past selection for rapid detection of snakes. Proceedings of the National Academy of Sciences DOI: 10.1073/pnas.1312648110 <link>
Walker, J. P. and R. L. Morrison. 2011. Current management of copperhead snakebite. Journal of the American College of Surgeons 212:470-474 <link>
Wasko, D. K. and S. G. Bullard. 2016. An Analysis of Media-Reported Venomous Snakebites in the United States, 2011-2013. Wilderness and Environmental Medicine 27:219-226. <link>Walker, J. P. and R. L. Morrison. 2011. Current management of copperhead snakebite. Journal of the American College of Surgeons 212:470-474 <link>