Abstract
The treatment of viper bite envenomations in France has been simplified during these last ten years for three reasons. First, toxicokinetics of Vipera aspis venom reveals that severity of envenomation is related to plasma concentration and that more venom is neutralised by intravenous immunoglobulins than by intramuscular route. Secondly, early clinical and biological prognosis factors have permitted to assess the severity of envenomations. Finally, new purified F(ab’) 2 antibodies counteracting strongly the venom of three different European vipers have improved the prognosis of envenomations. Early prescription of F(ab’) 2 antibodies, as soon as grade II or grade III signs appear, reduces morbidity, sequelae and total hospital stay and is safe. In Martinique, specific F(ab’) 2 fragments against Bothrop lanceolatus venom have significantly reduced thrombotic complications, coagulopathy and mortality. Exotic snake importation causes new snakebite envenomations and thus specific antibodies have to become available in France.
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