A Guide to the Clinical Management of <i>Vipera</i> Snakebite in Italy
Matteo Riccardo Di Nicola,
Marta Crevani,
Ignazio Avella,
Anna Cerullo,
Jean-Lou C. M. Dorne,
Giovanni Paolino,
Caterina Zattera
Affiliations
Matteo Riccardo Di Nicola
Unit of Dermatology and Cosmetology, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy
Marta Crevani
Poison Control Centre, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
Ignazio Avella
Landes-Offensive zur Entwicklung Wissenschaftlich-ökonomischer Exzellenz-Centre for Translational Biodiversity Genomics, Senckenberganlage 25, 60325 Frankfurt Am Main, Germany
Anna Cerullo
Department of Veterinary Sciences, University of Turin, L.go Braccini 2, 10095 Grugliasco, Italy
Jean-Lou C. M. Dorne
Methodological and Scientific Support Unit, European Food Safety Authority, Via Carlo Magno 1A, 43100 Parma, Italy
Giovanni Paolino
Unit of Dermatology and Cosmetology, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy
Caterina Zattera
Unit of Emergency Medicine, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo University Hospital, University of Pavia, P.Le Golgi, 19, 27100 Pavia, Italy
The genus Vipera encompasses most species of medically significant venomous snakes of Europe, with Italy harbouring four of them. Envenomation by European vipers can result in severe consequences, but underreporting and the absence of standardised clinical protocols hinder effective snakebite management. This study provides an updated, detailed set of guidelines for the management and treatment of Vipera snakebite tailored for Italian clinicians. It includes taxonomic keys for snake identification, insights into viper venom composition, and recommendations for clinical management. Emphasis is placed on quick and reliable identification of medically relevant snake species, along with appropriate first aid measures. Criteria for antivenom administration are outlined, as well as indications on managing potential side effects. While the protocol is specific to Italy, its methodology can potentially be adapted for other European countries, depending on local resources. The promotion of comprehensive data collection and collaboration among Poison Control Centres is advocated to optimise envenomation management protocols and improve the reporting of epidemiological data concerning snakebite at the country level.
