Treatment of bites by adders and exotic venomous snakes.

Every year, hundreds of people and unknown numbers of dogs and other domestic animals in England, Wales, and Scotland are bitten by our only indigenous venomous snake, the adder (Vipera berus) (fig 1). UK poisons centres are consulted about an average of 100 human and a dozen veterinary cases each year. In about 70% of patients, envenoming is negligible or purely local, causing pain, swelling, and inflammation of the bitten digit. Only 14 fatalities have been reported since 1876, the last in a 5 year old child in 1975, but adder bites should not be underestimated. On rare occasions, envenoming can be life threatening, especially in children, and many adults experience prolonged discomfort and disability after the bite. Apart from the exotic venomous snakes held legally by zoos, research establishments, and licensed private individuals, large numbers of dangerous snakes are kept surreptitiously as macho pets in the United Kingdom, Ireland, and other countries. 3 w2-w8 This “underground zoo” reveals itself on average only five or six times each year in the UK when bitten owners are forced to seek medical help.