A Nationwide Study of<i>Vipera Berus</i>Bites During One Year—Epidemiology and Morbidity of 231 Cases

Karlson-Stiber, Christine; Salmonson, Heléne; Persson, Hans

doi:10.1080/15563650500394597

Cited by 78 publications

(75 citation statements)

References 28 publications

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“…Such specific therapy may dramatically reduce the consequences of the envenomation [5][6][7]. Although antivenoms against B. multicinctus are available in China and Taiwan, clinical reports regarding their efficacy have only rarely been published [3,8,9].…”

Section: Introductionmentioning

confidence: 99%

A Controlled Clinical Trial of A Novel Antivenom in Patients Envenomed by Bungarus multicinctus

et al. 2010

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In northern Vietnam, a majority of severely envenomed patients are bitten by Bungarus multicinctus. Hitherto, these victims have received supportive care only. The aims of this study were to assess the possible efficacy and side effects of a new antivenom. This trial (ClinicalTrials.gov Identifier: NCT00811239) was performed during [2004][2005][2006] at an ICU in Hanoi. For ethical reasons, the study was not randomized. All patients who fulfilled the inclusion criteria during 2004-2005 were prospectively enrolled, carefully recorded, and treated with optimal supportive therapy (control group). The patients who entered the study 2006 were treated with antivenom in addition to supportive care (antivenom group). The inclusion criteria were: envenomation by B. multicinctus, presence of systemic envenomation, and (during 2006) provision of written informed consent. Predefined endpoints were number of patients requiring mechanical ventilation, duration of mechanical ventilation, length of ICU stay, duration of muscle paralysis, and number of patients with ventilatorassociated pneumonia. Eighty-one patients were included, 54 during 2004-2005 and 27 during 2006. Baseline characteristics were similar in the groups. The antivenomgroup patients had a shorter duration of muscle paralysis of the limbs (p<0.001), of the diaphragm (p<0.001), and of ptosis (p<0.001). The duration of mechanical ventilation and length of ICU stay were shorter in the antivenom group (p<0.001). The rate of ventilator-associated pneumonia was lower in the antivenom group (p<0.02). However, the relative number of patients requiring mechanical ventilation was not reduced in the antivenom group. The rate of adverse reactions to the antivenom was 7.4%. A favorable efficacy and acceptable safety of this antivenom were demonstrated.

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Section: Introductionmentioning

confidence: 99%

A Controlled Clinical Trial of A Novel Antivenom in Patients Envenomed by Bungarus multicinctus

et al. 2010

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“…Karlson-Stiber and others (2006) states that local necrosis is uncommon in human beings bitten by V berus , and the extensive tissue necrosis in this case was therefore remarkable.…”

Section: Discussionmentioning

confidence: 59%

“…Immunoassays for the detection of V berus venom in serum samples have been described in a horse (Arbuckle and Theakston 1992) and in human beings (Sjöström and others 1996) but are not available for clinical use (C. Karlson-Stiber, personal communication). The absence of clinical signs two hours after a bite is consistent with no envenomation (Karlson-Stiber and others 2006). …”

Section: Discussionmentioning

confidence: 94%

“…In comparison with a similar study by Persson and Irestedt (1981), a more benign course appeared to correlate with antivenom treatment. Antiserum is indicated not only with severe systemic signs, but also with severe or rapidly spreading local signs (Børresen and others 1979, Reading 1996, Warrell 2005, Karlson-Stiber and others 2006). According to Reading (1996), antiserum should be given whenever there are signs of systemic envenomation, even if they appear several days after the bite.…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of the grading proposed by Karlson-Stiber and others (2006) (Table 1), the response to envenomation was minor in one of the horses, moderate in three and severe in three. Two of the three severely envenomed horses were initially graded as moderate, but developed severe, life-threatening complications consistent with severe envenomation.…”

Section: Case Reportmentioning

confidence: 99%

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Effects of bites by the European adder (Vipera berus) in seven Swedish horses

Anlén¹

2008

Veterinary Record

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The effects on seven horses of bites by the European adder (Vipera berus) are described and compared with previously available information. The clinical signs varied from local swelling and mild systemic signs to severe systemic signs, including systemic inflammatory response, severe tissue necrosis, ventricular tachycardia and dysphagia. Two of the horses were treated with 'Zagreb' antiserum, and three that were not treated with antiserum were euthanased owing to complications related to the bites.

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Terrestrial Snakes (Suborder: Serpentes)

Barceloux

2008

Medical Toxicology of Natural Substances

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A Nationwide Study ofVipera BerusBites During One Year—Epidemiology and Morbidity of 231 Cases

Abstract: Incidence and other epidemiological data were similar to those 20 years ago, whereas the clinical course was more benign. It seems reasonable to believe that this is due to the introduction of effective antivenoms.

Cited by 78 publications

References 28 publications

A Controlled Clinical Trial of A Novel Antivenom in Patients Envenomed by Bungarus multicinctus

A Controlled Clinical Trial of A Novel Antivenom in Patients Envenomed by Bungarus multicinctus

Effects of bites by the European adder (Vipera berus) in seven Swedish horses

Terrestrial Snakes (Suborder: Serpentes)

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