Differential Hematotoxic Activity of Southeast Asian Pit Viper Venoms: The Cross-Neutralizing Effect of Available Antivenoms

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  Image Credit: Creative Commons (some rights reserved) CC BY-NC Photo 111998430, (c) Nicholas Hess Differential Hematotoxic Activity of Southeast Asian Pit Viper Venoms: The Cross-Neutralizing Effect of Available Antivenoms Abstract Background/Objectives : Pit vipers (subfamily Crotalinae) are responsible for a large proportion of snakebite envenoming cases in Southeast Asia. Envenomation by these snakes commonly causes hematotoxic effects, including platelet dysfunction and coagulation disturbances. Although antivenom remains the mainstay of treatment, species-specific antivenoms are not available for several regional pit viper species. This study evaluated the hematotoxic activities of selected Southeast Asian pit viper venoms and the cross-neutralizing capacity of commercially available antivenoms.  Methods : Venoms from five medically important pit viper species— Calloselasma rhodostoma ,  Trimeresurus albolabris ,  T. hageni ,  T. purpureomaculatus , ...

First Clinical Report on Efficacy of Alternative European Viper Antivenoms in Treatment of Vipera ammodytes Envenomation in Croatia

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Image Credit: By Holger Krisp - Own work, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=15435685

First Clinical Report on Efficacy of Alternative European Viper Antivenoms in Treatment of Vipera ammodytes Envenomation in Croatia

Abstract

In Croatia, the European Viper Venom Antiserum®, produced by the Institute of Immunology Zagreb, was the only antiserum used to treat Vipera ammodytes envenomation. When production of the Zagreb antivenom ceased, three other antivenoms, Viperfav®, BulBio®, and Viekvin®, replaced it in clinical practice at the Department of Infectious Diseases, University Hospital Split. This study includes 34 patients envenomed by Vipera ammodytes during the period between 2020 and 2025: 24 (71%) suffered grade 2a envenomation, nine (26%) grade 2b, and one grade 3 (severe envenomation). None were admitted to the Intensive Care Unit. All patients received antivenom: 16 received Viperfav®, 17 BulBio®, and one Viekvin®. All grade 2a patients were treated with a single dose of antivenom. Among grade 2b patients, four received one dose and two received two doses of Viperfav®, while one received one dose and two received two doses of BulBio®. The grade 3 patient received two doses of BulBio®. In all cases, treatment was successful and patients were discharged from hospital after an average of 3.97 days. Patients with pronounced neurotoxic signs did not require treatment with multiple doses of antivenom. All antivenoms proved effective. No adverse reactions or fatalities were observed.

Šimunković, M. Č., Leonardi, A., Križaj, I., & Karabuva, S. (2026). First Clinical Report on Efficacy of Alternative European Viper Antivenoms in Treatment of Vipera ammodytes Envenomation in Croatia. Toxins, 18(4). https://doi.org/10.3390/toxins18040178