development. A core outcome set (minimal list of consensus outcomes that should be used in future intervention research) for snakebite in South Asia is being developed. Epidemiology Earlier estimates for snakebite vary from 1.2 to 5.5 million , with 421,000 to 2.5 million being envenomings, and causing 20,000 to 125,000 deaths. More recent modelling estimates that in 2019, about 63,400 people died globally from snakebite, with 51,100 of these deaths happenning in India. Since reporting is not mandatory in much of the world, the data on the frequency of snakebites is not precise. Many people who survive bites have permanent tissue damage caused by venom, leading to disability. Most snake envenomings and fatalities occur in South Asia, Southeast Asia, and sub-Saharan Africa, with India reporting the most snakebite deaths of any country. Available evidence on the effect of climate change on the epidemiology of snakebite is limited but it is expected that there willll be a geographic shift in risk of snakebite: northwards in North America and southwards in South America and in Mozambique, and increase in incidence of bite in Sri Lanka. Most snakebites are caused by non-venomous snakes. Of the roughly 3,000 known species of snake found worldwide, only 15% are considered dangerous to humans. Snakes are found on every continent except Antarctica. The most diverse and widely distributed snake family, the colubrids, has approximately 700 venomous species, but only five genera—boomslangs, twig snakes, keelback snakes, green snakes, and slender snakes—have caused human fatalities. Worldwide, snakebites occur most frequently in the summer season when snakes are active and humans are outdoors. Agricultural and tropical regions report more snakebites than anywhere else. In the United States, those bitten are typically male and between 17 and 27 years of age. Children and the elderly are the most likely to die. Mechanics When venomous snakes bite a target, they secrete venom through their venom delivery system. The venom delivery system generally consists of two venom glands, a compressor muscle, venom ducts, a fang sheath, and fangs. The primary and accessory venom glands store the venom quantities required during envenomation. The compressor muscle contracts during bites to increase the pressure throughout the venom delivery system. The pressurized venom travels through the primary venom duct to the secondary venom duct that leads down through the fang sheath and fang. The venom is then expelled through the exit orifice of the fang. The total