Adder bites in children

A study of 136 cases of adder bite treated in Swedish hospitals during one year

The adder (Vipera verus) is the only naturally occurring poisonous snake in Sweden. During one year, 136 patients were hospitalized due to adder bites in a population of 5.3 mill. (63% of the total population). These patients could be traced through the central register on diagnosis codes and have been studied retrospectively. The main purpose of the investigation was to study the epidemiology and to estimate the degree of poisoning, thereby getting an idea of the frequency of really severe cases. Minor local symptoms occurred in 27% of the patients, whereas 46% suffered mild, 15% moderate and 12% severe poisonings. The average duration of hospitalization was 1.6, 3.8, 5.5 and 7.6 days, respectively, for these four groups. Shock, CNS disturbances, anaphylactic reactions, extensive edemas, renal dysfunction and severe anemia were typical findings in the group with severe reactions. Although no deaths occurred, the proportion of severe cases contrasts with the current conception that severe envenomation after adder bites is rare. The mortality due to adder bite has been low during the last decades. Earlier the situation was different, and during 1911-78 altogether 44 deaths due to adder bite were registered in Sweden.

Incidence, pathology, and treatment of adder (Vipera berus L.) bites in man

A review of published reports on the incidence, pathology, and treatment of adder (Vipera berus) bites in man in the United Kingdom and Europe produced numerous case studies but little information about the impact od adders as a threat to public health. Adder bites in man are not uncommon (at least 44/year and probably more than 90/year in the United Kingdom) and, although they have been recorded for every month of the year between February and October, envenoming is most likely to occur during June, July, and August. Most adder bites are on the hand (51.6%) or foot (38.2%). The effects of adder bite envenoming are now know. Effective treatment protocols can reduce both the length of time victims spend in hospital and the morbidity in the affected areas: they have resulted in a decline in the death rate over the last 30 years, so that deaths are now rare.

Adder bites in Aldershot

Each summer cases of adder bite occur in Aldershot and its surrounding areas. Many of these are brought to the Cambridge Military Hospital. This paper reports three cases that together illustrate the commonest clinical signs and symptoms. These include rapid swelling, malaise and anxiety. An important diagnostic indication is an early and marked leucocytosis. Treatment regimes are also reviewed with the advice ultimately being to "admit and monitor". The danger of early resort to antivenom is also examined and the principles of both treatment and first aid are developed.

Surgical treatment of adder bite

Two cases of children who suffered adder bites and who developed severe local complications are reported. One required a split skin graft and the other a decompression fasciotomy.

Acute renal failure in children following snake bite

Snake venom poisoning accounted for 1.4% of 4360 infants and children admitted to a south Indian hospital during the years 1976-1979 and was the commonest cause of acute renal failure encountered. Most of the 42 children with anuria following snake bite had evidence of intravascular coagulation and acute tubular necrosis. Russell's viper was the only snake recognized in all the cases of anuria in which species identification was possible. Renal failure complicating snake bite was relatively more frequent and more severe in children than in adults.