Venomous snakebites in the Croatian North Dalmatia region

Karlo, Robert; Dželalija, Boris; Župančić, Božidar; Bačić, Ivan; Dunatov, Tihomir; Kanjer, Ante; Skarica, R; Sabalić, Srećko; Bukvić, Nado; Nikolić, Harry; Augustin, Goran

doi:10.1007/s00508-011-0085-x

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…These studies also report a combination of local toxic and general toxic manifestations, with prevalence of the local, mildto-severe and severe cases of envenomation which are relatively rare, just as rare as the fatal outcome of the snakebites. 10,12,13 In contrast to the studies of other Balkan regions, a prevalent manifestation of a mild clinical form of intoxication was found in our study, manifested by the local toxic features of edema, erythema, pain, haemorrhage, lymphangitis and regional lymphadenitis. Local necrosis was identifi ed only in one patient who sustained a snakebite administering a large amount of venom and who was provided a late medical aid.…”

Section: Discussioncontrasting

confidence: 99%

Snake Venom Poisoning in the Plovdiv Region from 2004 to 2012

Iliev¹,

Tufkova²,

Zagorov³

et al. 2014

Folia Medica

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Section: Discussioncontrasting

confidence: 99%

Snake Venom Poisoning in the Plovdiv Region from 2004 to 2012

Iliev¹,

Tufkova²,

Zagorov³

et al. 2014

Folia Medica

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“…Annual adjusted incidence in France is reported from 0.51 to 3.35/100 000 (Chippaux, 2012). A similar incidence of snakebite to that in our cohort occurs in the Croatian North Dalmatia region: 93 in 10 years (Karlo et al, 2011). Differences between the countries are not reasonably explained merely by varying occurrence of vipers and population density in rural areas, but they are also related to the methodology of snakebite reporting and statistical processing.…”

Section: Discussionsupporting

confidence: 79%

Common Viper Bites in the Czech Republic - Epidemiological and Clinical Aspects during 15 Year Period (1999–2013)

et al. 2014

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The aim of this study was to analyse most important epidemiological and clinical aspects of registered snakebites caused by a native common European viper Vipera berus in the Czech Republic over a period of 15 years (1999–2013). Data have been collected retrospectively from a database of the Toxinology Centre belonging to the General University Hospital in Prague. In total, 191 cases of snakebites caused by common viper were registered during the study period. Systemic envenoming occurred in 49 (25.7%) patients, local envenoming without systemic symptoms was recorded in 91 (47.6%) and asymptomatic dry bites were seen in 51 (26.7%) cases, respectively. Twenty-four patients (12.6% of all bites) were treated with administration of antivenom. None of the victims died as a result of snakebite during the observation period. Native viper snakes usually did not cause serious harm to the patients, with the exception of children. Antivenom should be administered in all cases with systemic manifestations, in children even with serious local affection and administered as soon as possible. Envenomed patients should be admitted to the hospital and treated at least under supervision of specialists with experience in snakebite treatment, who can indicate and provide administration of the antivenom.

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“…While snakebite in Europe is much less common than in African or Asiatic counties, it is still a potentially deadly medical emergency (5,6). Common symptoms of envenomations from these vipers include local effects at the bite site such as swelling (edema), necrosis, and compartment syndrome (sometimes requiring fasciotomy), and/or systemic effects such as blood disturbances (coagulotoxicity), neuromuscular paralysis, myotoxicity, and hypotension (7)(8)(9)(10)(11)(12)(13). Severe envenomations can lead to amputation and/or death (7)(8)(9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

“…The genus Vipera is notable for being extremely widespread, radiating across Europe and Central Asia since its emergence 13 million years ago and having complex geographical histories ( 14 , 20 – 22 ). Of particular clinical importance for human envenomings is coagulopathy ( 7 – 9 , 12 , 13 ). Documentation of Factor X activating P-IIId SVMP in at least one species ( V. ammodytes ) is consistent with its ability to produce severe coagulopathy ( 23 ).…”

Section: Introductionmentioning

confidence: 99%

Venom-Induced Blood Disturbances by Palearctic Viperid Snakes, and Their Relative Neutralization by Antivenoms and Enzyme-Inhibitors

et al. 2021

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Palearctic vipers are medically significant snakes in the genera Daboia, Macrovipera, Montivipera, and Vipera which occur throughout Europe, Central Asia, Near and Middle East. While the ancestral condition is that of a small-bodied, lowland species, extensive diversification has occurred in body size, and niche specialization. Using 27 venom samples and a panel of in vitro coagulation assays, we evaluated the relative coagulotoxic potency of Palearctic viper venoms and compared their neutralization by three antivenoms (Insoserp Europe, VIPERFAV and ViperaTAb) and two metalloprotease inhibitors (prinomastat and DMPS). We show that variation in morphology parallels variation in the Factor X activating procoagulant toxicity, with the three convergent evolutions of larger body sizes (Daboia genus, Macrovipera genus, and Vipera ammodytes uniquely within the Vipera genus) were each accompanied by a significant increase in procoagulant potency. In contrast, the two convergent evolutions of high altitude specialization (the Montivipera genus and Vipera latastei uniquely within the Vipera genus) were each accompanied by a shift away from procoagulant action, with the Montivipera species being particularly potently anticoagulant. Inoserp Europe and VIPERFAV antivenoms were both effective against a broad range of Vipera species, with Inoserp able to neutralize additional species relative to VIPERFAV, reflective of its more complex antivenom immunization mixture. In contrast, ViperaTAb was extremely potent in neutralizing V. berus but, reflective of this being a monovalent antivenom, it was not effective against other Vipera species. The enzyme inhibitor prinomastat efficiently neutralized the metalloprotease-driven Factor X activation of the procoagulant venoms. In contrast, DMPS (2,3-dimercapto-1-propanesulfonic acid), which as been suggested as another potential treatment option in the absence of antivenom, DMPS failed against all venoms tested. Overall, our results highlight the evolutionary variations within Palearctic vipers and help to inform clinical management of viper envenomation.

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Venomous snakebites in the Croatian North Dalmatia region

Cited by 9 publications

References 33 publications

Snake Venom Poisoning in the Plovdiv Region from 2004 to 2012

Snake Venom Poisoning in the Plovdiv Region from 2004 to 2012

Common Viper Bites in the Czech Republic - Epidemiological and Clinical Aspects during 15 Year Period (1999–2013)

Venom-Induced Blood Disturbances by Palearctic Viperid Snakes, and Their Relative Neutralization by Antivenoms and Enzyme-Inhibitors

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