page_title: List of dangerous snakes
section_title: Puff adder
hierarchical_section_title: List of dangerous snakes / Considerably dangerous / African vipers / Puff adder
caption_attribution_description: Bitis arietans Deutsch: Puffotter (Bitis arietans), Darmstadt Vivarium, Darmstadt, Deutschland English: Puff adder (Bitis arietans) head, Darmstadt Vivarium, Darmstadt, Germany Français&#160;: Tête de Vipère heurtante (Bitis arietans) Polski: Głowa Żmiji sykliwej (Bitis arietans)
context_page_description: Of the 3,500 snake species, there are around 600 venomous snake species in the world. This is an overview of the snakes that pose a significant health risk to humans, through snakebites or other physical trauma.
  The varieties of snakes that most often cause serious snakebites depend on the region of the world. In Africa, the most dangerous species include black mambas, puff adders, and carpet vipers. In the Middle East the species of greatest concern are carpet vipers and elapids; in Central and South America, Bothrops and Crotalus are of greatest concern. In South Asia, it has historically been believed that Indian cobras, common kraits, Russell's viper and carpet vipers were the most dangerous species; however other snakes may also cause significant problems in this area of the world. While several species of snakes may cause more bodily destruction than others, any of these venomous snakes are still very capable of causing human fatalities should a bite go untreated, regardless of their venom capabilities or behavioral tendencies.
context_section_description: The Puff adder (Bitis arietans) is responsible for more fatalities than any other African snake. This is due to a combination of factors, including its wide distribution, common occurrence, large size, potent venom that is produced in large amounts, long fangs, their habit of basking by footpaths and sitting quietly when approached. The venom has cytotoxic effects and is one of the most toxic of any vipers based on LD50 studies. The LD₅₀ values in mice vary: 0.4–2.0 mg/kg IV, 0.9–3.7 mg/kg IP, 4.4–7.7 mg/kg SC. Mallow et al. (2003) gives a LD₅₀ range of 1.0–7.75 mg/kg SC. Venom yield is typically between 100–350 mg, with a maximum of 750 mg. Brown (1973) mentions a venom yield of 180–750 mg. About 100 mg is thought to be enough to kill a healthy adult human male, with death occurring after 25 hours. In humans, bites from this species can produce severe local and systemic symptoms. Based on the degree and type of local effect, bites can be divided into two symptomatic categories: those with little or no surface extravasation, and those with hemorrhages evident as ecchymosis, bleeding and swelling. In both cases there is severe pain and tenderness, but in the latter there is widespread superficial or deep necrosis and compartment syndrome.
  Serious bites cause limbs to become immovably flexed as a result of significant hemorrhage or coagulation in the affected muscles. Residual induration, however, is rare and usually these areas completely resolve. The fatality rate depends on the severity of the bites and some other factors. Deaths are rare and occur in less than 10% of all untreated cases (usually in 2–4 days from complications following blood volume deficit and a disseminated intravascular coagulopathy), although some reports show that very severe envenomations have a 52% mortality rate. Most fatalities are associated with bad clinical management and neglect.
caption: Puff adder (Bitis arietans)
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