title: Adder bites. A report of 68 cases.
abstract: OBJECTIVE
  The adder (Vipera Berus) is the only venomous snake that exists naturally in Scandinavia. The aim of this study is to estimate the severity of adder bites, to form a general picture of symptoms of bites and to find out how effective the present treatment methods of adder bites are.
  
  
  METHODS
  68 true adder bites treated in Turku University Hospital during the years 1995-2000 were reviewed retrospectively.
  
  
  RESULTS
  There were no deaths in this material. A bite caused severe symptoms to 10% of the patients. The symptoms were moderate in 21%, mild in 34% and minor in 35% of the cases. Children under 10 years were the proportionally biggest age group and severe poisonings were most frequent among small children. Rapidly progressive oedema, gastrointestinal symptoms, hypotension and early leucocytosis were signs of more severe poisonings. Antivenom therapy with specific ovine Fab antivenom proved to be an effective and safe treatment in severe poisonings.
  
  
  CONCLUSIONS
  An adder bite may also cause severe symptoms for adults. All patients should be observed at least few hours after the bite and parental fluid therapy should be started at an early stage. In the treatment of severe poisonings an antivenom therapy should be considered. Rapidly progressive symptoms and early leucocytosis may serve as a warning signal for higher probability of severe reactions.
authors.affiliation: University of Turku, Faculty of Medicine, Turku, Finland. juha.gronlund@utu.fi
authors.forename: J
authors.initials: J
authors.lastname: Grönlund
authors.forename: A
authors.initials: A
authors.lastname: Vuori
authors.forename: S
authors.initials: S
authors.lastname: Nieminen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D002648:Child; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012909:Snake Bites / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D012910:Snake Venoms / Q000506:poisoning; D017819:Viperidae
chemical_list: D000997:Antivenins; D012910:Snake Venoms