Adder bites. A report of 68 cases

Area of Science:

• Herpetology
• Toxicology
• Clinical Medicine

Background:

• The adder (Vipera Berus) is Scandinavia's sole native venomous snake.
• Understanding adder bite severity and treatment efficacy is crucial for public health.

Purpose of the Study:

• To assess the severity of Vipera Berus bites.
• To characterize common symptoms following adder envenomation.
• To evaluate the effectiveness of current treatment strategies for adder bites.

Main Methods:

• Retrospective review of 68 confirmed adder bite cases.
• Data collected from patients treated at Turku University Hospital (1995-2000).

Main Results:

• No fatalities were recorded in the study cohort.
• Severe symptoms occurred in 10% of patients; moderate in 21%, mild in 34%, and minor in 35%.
• Children under 10 were the most affected age group, with severe poisonings most common in young children. Signs of severe envenomation included rapid edema, gastrointestinal issues, hypotension, and early leukocytosis.
• Ovine Fab antivenom was effective and safe for treating severe Vipera Berus poisonings.

Conclusions:

• Adder bites can lead to severe symptoms in adults.
• All patients require a minimum observation period of several hours post-bite, with early fluid therapy recommended.
• Antivenom therapy should be considered for severe envenomations.
• Rapidly progressing symptoms and early leukocytosis are indicators of a higher likelihood of severe reactions to adder bites.