While leptospirosis, dengue fever, measles, and other infectious diseases dominated the headlines, one deadly threat quietly persisted in the background—largely unnoticed, rarely discussed, and almost never reported. It is a disease that kills hundreds of Filipinos each year yet remains invisible in public discourse: snakebites.
Approximately 550 Filipinos die from snake bites each year out of roughly 13,000 total reported incidents. But this figure, Dr. Tiglao stresses, barely scratches the surface. “It does not include those undocumented and improperly documented ones. Snakebite incidences alone may reach thousands if data are gathered throughout the Philippines. It’s just the tip of the iceberg.”
Snakebites rarely make it to official records for one simple reason: most victims live in rural areas, far from hospitals, and even farther from systems that track health data. Many of those who die never reach a clinic. Their deaths remain unreported, their stories untold.
“Mainly because snakebites are happening in the outskirts, in the community where most of the patients would rather go to traditional healers than consult with physicians,” Dr. Tiglao explains.
In many rural communities, traditional healers are the first—and sometimes only—source of care. Cultural beliefs, lack of transportation, and the high cost of medical treatment all contribute to this reliance. By the time victims seek hospital care, it is often too late.
“It is also bothersome to note that this is a disease of the poor,” Dr. Tiglao adds. “Those inflicted are farmers and mountain inhabitants who do not have access to immediate medical care. That’s the reason why it is not properly documented and underreported. It is not even part of the reportable cases. With lack of data or documentation, presto, the disease does not exist.”
The Philippines is not alone in underestimating snakebites. Worldwide, the true incidence of venomous bites is difficult to ascertain. The Geneva-based World Health Organization (WHO) estimates 5.4 million snakebite victims annually, resulting in 80,000 to 130,000 deaths. Another 400,000 survivors suffer permanent disabilities—loss of limbs, chronic pain, or long-term organ damage.
Science Daily even reports that snakebite deaths in some developing countries are “comparable to that of AIDS.” Yet despite these staggering numbers, snakebites remain one of the world’s most neglected health issues.
Snakes have existed since time immemorial, slithering through mythology, religion, and medicine. In the Bible, the serpent in the Garden of Eden symbolizes temptation. Moses’ bronze serpent became a symbol of healing. Even today, the caduceus—two snakes entwined around a staff—remains a universal emblem of medicine.
“Snakes are sometimes perceived as evil, but they are also perceived as medicine,” actor Nicolas Cage once said. “The venom can also be healing.”
But in the Philippines, snakes are more than symbols. They are part of the country’s rich biodiversity. With over 2,900 species worldwide, snakes thrive in tropical ecosystems like ours. Most Philippine species are harmless, but the country is home to some of the deadliest snakes in the world, making venomous bites a serious—though largely unpublicized—health hazard.
About 19 venomous snake species have been identified in the country. They fall into four major categories:
Cobras: Recognizable by their iconic hoods, cobras deliver bites that are immediately painful. Symptoms include drowsiness, drooling, blurred vision, difficulty speaking, and respiratory arrest—sometimes within minutes. In Samar, spitting cobras are common, capable of spraying venom up to two meters, potentially causing blindness if it reaches the eyes.
Pit Vipers: Brightly colored and often found in trees, pit vipers possess hinged fangs and hemotoxic venom that destroys tissue and blood cells. Unlike most snakes, they give birth to live young.
Sea Snakes: Though highly venomous—some species more toxic than cobras—sea snakes are generally non-aggressive. Fatalities are rare because they inject small amounts of venom.
Snake venom is essentially modified saliva, evolved to immobilize prey and begin digestion. During a bite, venom travels from glands through ducts into the fangs and then into the victim.
The WHO warns that venom can cause paralysis leading to respiratory failure, bleeding disorders and fatal hemorrhage, irreversible kidney failure, and severe tissue damage resulting in limb loss.
Antivenom is the only specific treatment for venomous bites. But it is far from perfect. “Each of the world’s 250 species of venomous snakes produces a unique cocktail of toxins that must be counteracted by a specific antivenom,” Science Magazine notes.
Producing antivenom is laborious: venom is milked from snakes, injected into horses, and antibodies are harvested from the animals’ blood.
Yet antivenoms face several challenges. They are expensive. They require refrigeration. They must be administered by trained professionals. They can cause allergic reactions or anaphylactic shock. They may trigger serum sickness days after treatment.
In the Philippines, availability is even more limited. “Filipinos must be aware that we have three species of cobra and all are being treated with one antivenom,” Dr. Tiglao says. “The antivenoms are limited to specific hospitals, mostly government institutions. For other species of snakes, we do not have antivenom for them. So, if you are bitten by a pit viper, no antivenom is available in the country.”
Despite the grim statistics, snakebites are preventable and treatable when handled correctly. Dr. Tiglao shares essential first-aid measures: (1) Reassure the patient to stay calm; (2) Immobilize the bitten limb; (3) Seek hospital care immediately; and (4) Provide doctors with details: symptoms, first aid applied, location of bite, and characteristics or photos of the snake. These simple steps can save lives—if victims can reach medical care in time.
Snakebites may not dominate headlines, but they claim lives quietly and consistently. They strike the poor, the rural, the unseen. They thrive in the gaps of the healthcare system—where documentation is weak, access is limited, and awareness is low.
For Dr. Tiglao and other advocates, the message is clear: snakebites exist, and they matter. The Philippines must recognize this silent epidemic, strengthen surveillance, improve antivenom access, and educate communities. Only then can the country confront a deadly threat that has long remained hidden in the shadows.
