A Study of 136 Cases of Adder Bite Treated in Swedish Hospitals during One Year

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Abstract
The adder (V. berus) is the only naturally occurring poisonous snake in Sweden. During 1 yr, 136 patients were hospitalized due to adder bites in a population of 5.3 million (63% of the total population). These patients were traced through the central register on diagnosis codes and studied retrospectively. The main purpose was to study the epidemiology and estimate the degree of poisoning, thereby getting an idea of the frequency of severe cases. Minor local symptoms occurred in 27% of patients, and 46% suffered mild, 15% moderate and 12% severe poisonings. The average duration of hospitalization was 1.6, 3.8, 5.5 and 7.6 days, respectively. Shock, CNS disturbances, anaphylactic reactions, extensive edemas renal dysfunction and severe anemia were typical findings in the group with severe reactions. Although no deaths occurred, the proportion of severe cases contrasted with the current conception that severe envenomation after adder bites was rare. The mortality due to adder bit has been low during the last decades. During 1911-1978, 44 deaths due to adder bite were registered in Sweden.

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