Kleber JJ & Zilker T
Adder bites in humans.

Tierarztl Prax Ausg K Kleintiere Heimtiere, 26(2): 95-100, 1998
ISSN: 1434-1239 Tierärztliche Praxis: Ausgabe K, Klein- und Heimtiere (PubMed)

Abstract
In Germany the common viper (Vipera berus) and very seldom Vipera aspis are the only in freedom normally existing snakes. In general, bites by the common viper cause slight local symptoms, sometimes strong swellings of the extremities, but only rarely severe perilous general symptoms such as shock and angioneurotic edema. Mortal progresses despite of medical treatment are the exceptions. The most important therapeutic measure is the immobilization of the bitten extremity and the transport in a recumbent position to the next surgeon or clinic. The perilous shock and the angioneurotic edema often react on the administration of antihistaminica and corticosteroids, whereas the increase of the swelling of the extremity cannot be influenced by this treatment. The corresponding antisera have an advantageous and fast effect on all general symptoms and seem to favourably influence the swelling of the extremities. Because of the allergic reactions against the sera from horses, which do not occur seldom, in severe cases only Beritab - which is not yet admitted in Germany - with purified Fab-fragment antibodies from sheep should be used.