Treatment of bites by adders and exotic venomous snakes

doi:10.1136/bmj.331.7527.1244

BMJ 2005;331:1244-1247 (26 November), doi:10.1136/bmj.331.7527.1244

Clinical review

Treatment of bites by adders and exotic venomous snakes

David A Warrell, professor of tropical medicine and infectious diseases¹

¹ Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU david.warrell@ndm.oxford.ac.uk

The first 150 words of the full text of this article appear below.

Introduction

Every year, hundreds of people and unknown numbers of dogs andother domestic animals in England, Wales, and Scotland are bittenby our only indigenous venomous snake, the adder (Vipera berus)(fig 1). UK poisons centres are consulted about an average of100 human and a dozen veterinary cases each year. In about 70%of patients, envenoming is negligible or purely local, causingpain, swelling, and inflammation of the bitten digit. Only 14fatalities have been reported since 1876,¹ the last in a 5 yearold child in 1975,^w1 but adder bites should not be underestimated.On rare occasions, envenoming can be life threatening, especiallyin children, and many adults experience prolonged discomfortand disability after the bite.

Fig 1 Adder or viper (Vipera berus)

Apart from the exotic venomous snakes held legally by zoos,research establishments, and licensed private individuals, largenumbers of dangerous snakes . . . [Full text of this article]

Sources and selection criteria

Adder bites

Exotic snake bites

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