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Adder bites. A report of 68 cases.

J Grönlund1, A Vuori, S Nieminen

  • 1University of Turku, Faculty of Medicine, Turku, Finland. juha.gronlund@utu.fi

Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society
|July 5, 2003
PubMed
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Vipera Berus (adder) bites in Scandinavia can cause severe symptoms, particularly in children. Early observation and antivenom therapy are effective for severe cases, with rapid symptom progression indicating higher risk.

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.

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  • 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.