[Vipera berus bite-epidemiology, clinical symptoms and review of treatment methods].Przegl Epidemiol. 2010; 64(3):387-93.PE
Adder (Vipera berus), which belongs to the family Viperidae, is the only venomous snake occurs on Polish territory. Components of the venom exhibit proteolytic, fibrinolytic, and anticoagulant activity, and activity of phospholipase A2. They damage proteins, including proteins of the blood vessels walls, leukocytes and erythrocyte membranes. The clinical course of poisoning depends on the dose of venom, concomitant diseases, site of the bite, physical activity after the bite, individual susceptibility, age, weight, kind of bite, secondary infection, and the management. All patients bitten by an adder should be admitted to the hospital for observations. In cases of mild poisoning treatment procedure is limited to symptomatic treatment in the form of administration of analgesics and antiemetic drugs. Some bites are called as "dry bites" where no venom is injected into the body. It is advisable to follow the directions for use of antitoxin by reason of the risk of anaphylactic shock and serum sickness. It should be administered against general poisoning or in the case of massive or rapidly spreading oedema.