• MeSH
• Antidotes classification   therapeutic use   MeSH
• Benzodiazepines poisoning   MeSH
• Alcoholic Intoxication diagnosis   drug therapy   classification   MeSH
• Mushroom Poisoning diagnosis   drug therapy   classification   MeSH
• Poisoning * diagnosis   etiology   drug therapy   classification   nursing   MeSH
• Acetaminophen poisoning   MeSH
• Snake Bites drug therapy   classification   MeSH
• Publication type
• Review MeSH

• MeSH
• Humans MeSH
• Primary Prevention methods   MeSH
• First Aid MeSH
• Snake Bites * diagnosis   prevention & control   therapy   MeSH
• Vipera MeSH
• Check Tag
• Humans MeSH
• Publication type
• Newspaper Article MeSH

INTRODUCTION: Snakebite incidence varies across Europe. However, there is limited research from Central and Southeastern Europe. These regions are notable for the presence of the common European adder (Vipera berus) and the more venomous nose-horned viper (Vipera ammodytes). No standard European antivenom protocol exists. The aim was to assess the epidemiology and treatment of viper bites in this region, focusing on a comparison of bites from Vipera berus and Vipera ammodytes. METHODS: We conducted a prospective multicenter study in Central and Southeastern Europe from 2018 to 2020. This study included poison centres and toxicology-associated hospital wards in Poland, the Czech Republic, Slovakia, Hungary, Slovenia, Croatia, Serbia, and Bulgaria. The following data were collected: age, gender, Vipera species, snakebite site, clinical picture, laboratory results, Audebert's clinical severity grading score, and antivenom therapy. RESULTS: The annual incidence of viper bites in Central and Southeast Europe was estimated at 2.55 bites per million population. Within their respective geographical distribution areas, the incidence of Vipera ammodytes bites (1.61 bites per million population) was higher than Vipera berus bites (1.00 bites per million population). Patients bitten by Vipera ammodytes more frequently reported local pain and developed thrombocytopenia. Antivenom treatment was more commonly administered in Vipera ammodytes bites (72%) compared to Vipera berus bites (39%). The incidence of Vipera ammodytes bites treated with antivenom within its geographical distribution area was three times higher than Vipera berus bites treated with antivenom (1.16 bites per million population versus 0.39 bites per million population). No deaths were reported. CONCLUSIONS: The estimated incidence of viper bites in Central and Southeastern Europe is at least 2.55 per million population. Vipera ammodytes bites are more common and severe, characterized by higher frequencies of pain and thrombocytopenia. Antivenom is needed more often for Vipera ammodytes bites. It is vital that enough European Medicines Agency-approved Vipera ammodytes antivenom is produced and offered affordably.

• MeSH
• Antivenins therapeutic use   MeSH
• Pain MeSH
• Humans MeSH
• Prospective Studies MeSH
• Thrombocytopenia * MeSH
• Snake Bites * epidemiology   therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Geographicals
• Europe MeSH

• MeSH
• Foreign Bodies diagnostic imaging   MeSH
• Dermatitis etiology   drug therapy   pathology   therapy   MeSH
• Child MeSH
• Edema etiology   therapy   MeSH
• Hematoma etiology   therapy   MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Plant Poisoning etiology   drug therapy   pathology   therapy   MeSH
• Poisoning * etiology   pathology   therapy   MeSH
• Wounds and Injuries * diagnostic imaging   etiology   pathology   therapy   MeSH
• Snake Bites epidemiology   pathology   therapy   MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

BACKGROUND: Snakebite envenoming is a neglected tropical disease that kills an estimated 81,000 to 138,000 people and disables another 400,000 globally every year. The World Health Organization aims to halve this burden by 2030. To achieve this ambitious goal, we need to close the data gap in snake ecology and snakebite epidemiology and give healthcare providers up-to-date knowledge and access to better diagnostic tools. An essential first step is to improve the capacity to identify biting snakes taxonomically. The existence of AI-based identification tools for other animals offers an innovative opportunity to apply machine learning to snake identification and snakebite envenoming, a life-threatening situation. METHODOLOGY: We developed an AI model based on Vision Transformer, a recent neural network architecture, and a comprehensive snake photo dataset of 386,006 training photos covering 198 venomous and 574 non-venomous snake species from 188 countries. We gathered photos from online biodiversity platforms (iNaturalist and HerpMapper) and a photo-sharing site (Flickr). PRINCIPAL FINDINGS: The model macro-averaged F1 score, which reflects the species-wise performance as averaging performance for each species, is 92.2%. The accuracy on a species and genus level is 96.0% and 99.0%, respectively. The average accuracy per country is 94.2%. The model accurately classifies selected venomous and non-venomous lookalike species from Southeast Asia and sub-Saharan Africa. CONCLUSIONS: To our knowledge, this model's taxonomic and geographic coverage and performance are unprecedented. This model could provide high-speed and low-cost snake identification to support snakebite victims and healthcare providers in low-resource settings, as well as zoologists, conservationists, and nature lovers from across the world.

• MeSH
• Antivenins therapeutic use   MeSH
• Global Health MeSH
• Snakes MeSH
• Humans MeSH
• Neglected Diseases diagnosis   epidemiology   MeSH
• Artificial Intelligence MeSH
• Snake Bites * diagnosis   epidemiology   therapy   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Africa South of the Sahara MeSH

Envenomations that are caused by Viperidae snakebites are mostly accompanied by venom-induced consumption coagulopathy (VICC) with defibrination. The clinical course of VICC is well described; however, reports about its detailed effects in the hemocoagulation systems of patients are sparse. In this pilot study, we prospectively analyzed the changes in plasma fibrinogen that were caused by the envenomation of six patients by five non-European Viperidae snakes. Western blot analysis was employed and fibrinogen fragments were visualized with the use of specific anti-human fibrinogen antibodies. All of the studied subjects experienced hypo- or afibrinogenemia. The western blot analysis demonstrated fibrinogenolysis of the fibrinogen chains in all of the cases. Fibrinogenolysis was considered to be a predominant cause of defibrination in Crotalus, Echis, and Macrovipera envenomation; while, in the cases of VICC that were caused by Atheris and Calloselasma envenomation, the splitting of the fibrinogen chains was present less significantly.

• MeSH
• Antivenins MeSH
• Disseminated Intravascular Coagulation * MeSH
• Fibrinogen MeSH
• Humans MeSH
• Pilot Projects MeSH
• Snake Bites * complications   MeSH
• Viperidae * MeSH
• Venoms MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Child MeSH
• Humans MeSH
• Snake Bites * diagnosis   physiopathology   therapy   MeSH
• Check Tag
• Child MeSH
• Humans MeSH

Coagulopathy with defibrination is one of symptoms accompanying snakebite envenoming, where life-threatening complications such as massive bleeding and organ hematomas formation can occur. Here, we report a case of hemocoagulation failure due to bite by African Great Lakes bush viper Atheris nitschei with impossibility of specific treatment for absence of antivenom and its life-threatening complication: very rare and unexpected atraumatic splenic rupture with massive hemoperitoneum and necessity of urgent splenectomy.

• MeSH
• Antivenins therapeutic use   MeSH
• Hemoperitoneum etiology   MeSH
• Humans MeSH
• Splenic Rupture * diagnosis   etiology   surgery   MeSH
• Snake Bites * complications   MeSH
• Viperidae * MeSH
• Viper Venoms MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

BACKGROUND: Fear acquisition of certain stimuli, such as snakes, is thought to be rapid, resistant to extinction, and easily transferable onto other similar objects. It has been hypothesized that due to increased survival chances, preparedness to instantly acquire fear towards evolutionary threats has been hardwired into neural pathways of the primate brain. Here, we compare participants' fear of snakes according to experience; from those who often deal with snakes and even suffer snakebites to those unfamiliar with snakes. METHODS: The Snake Questionnaire-12 (SNAQ-12) and Specific Phobia Questionnaire (SPQ) were administered to three groups of participants with a different level of experience with snakes and snakebites: 1) snake experts, 2) firefighters, and 3) college students. RESULTS: This study shows that individuals more experienced with snakes demonstrate lower fear. Moreover, participants who have suffered a snakebite (either venomous or not) score lower on fear of snakes (SNAQ-12), but not of all other potentially phobic stimuli (SPQ). CONCLUSIONS: Our results suggest that a harmless benign exposure might immunize people to highly biologically prepared fears of evolutionary threats, such as snakes.

• MeSH
• Phobic Disorders * MeSH
• Snakes MeSH
• Humans MeSH
• Fear MeSH
• Snake Bites * MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

V kazuistice je prezentován případ 66leté ženy se šokovým stavem, těžkými celkovými a závažnými lokálními příznaky po uštknutí hadem do levé dolní končetiny. Druh útočícího hada nebyl jasně specifikován, nebyl zcela jasně spatřen, ale pravděpodobně se jednalo o zmiji obecnou, hada z čeledi zmijovitých, který se běžně vyskytuje v našich zeměpisných šířkách. Z důvodu nejasného původce uštknutí nebylo přistoupeno k podání specifického antiséra a léčba probíhala symptomaticky.

The case report presents the case od 66-year-old woman with schock, severe general and grave local symptoms after a snake bite into the left limb. The species of attacking snake was not clearly specific, it should not have been clearly seen, but it was propably a common viper, a snake of viper family, which commonly occurs in our latitude. Due to the unclear origin of the bite, no specific antiserum and symptomatic treatment were given.

• MeSH
• Anaphylaxis diagnosis   therapy   MeSH
• Immune Sera administration & dosage   MeSH
• Glucocorticoids administration & dosage   therapeutic use   MeSH
• Humans MeSH
• Aged MeSH
• Shock diagnosis   etiology   therapy   MeSH
• Snake Bites * diagnosis   complications   therapy   MeSH
• Viperidae MeSH
• Treatment Outcome MeSH
• Viper Venoms * adverse effects   MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Case Reports MeSH