Animal Bites

It is difficult to accurately estimate the number of cases per year as many go unreported. Animal bites may be wild animals such as coyotes, bats or foxes; or domestic animals such as cats and dogs. Bites from domestic animals are by far much more commonly seen in healthcare settings.

Besides the cosmetic effect of wound itself, the other major concern with an animal bite is the risk of an invasive infection.  A variety of bacteria and viruses may cause infection involving the skin alone, or may spread to deeper tissues and then to the rest of the body. Two of the more worrisome infections are rabies and tetanus.

First Aid for Animal Bites

First aid measures in cases of animal bites involve washing the wound with plentiful soap under running water, even if it stings. This will help prevent further infection. This should be done for a few minutes making sure any foreign particles or dirt is thoroughly removed. Direct pressure with a clean towel should be applied to the area that was bitten. This will slow down the bleeding and eventually stop it. The wound should then be covered with a sterile bandage.

When should a Doctor/Nurse be seen?

• For domestic animals, superficial scratches, where the skin is not broken, may not require immediate medical assistance. However, a health professional should be seen if the pet’s vaccinations are not up to date.
• A cat or a person bit you and it broke the skin. (Cat bites often lead to infection. Experts usually recommend antibiotics for anyone bitten by a cat.)
• Bites from any wild animal such as a raccoon, skunk, woodchuck, fox, coyote, or bat. These animals can carry rabies. It is very important that you see a doctor or nurse as soon as possible, even if it does not look very deep.
• If the person bitten has underlying conditions that will reduce their ability to fight off infection such as diabetes, AIDS, liver disease or cancer.
• If there is excessive bleeding even after direct pressure of 15 minutes.
• If the bite occurred on a hand, foot, joint (difficulty bending) or head or if you think you may have broken a bone.
• If it has been more than 5 years since the person bitten last received a tetanus injection or cannot remember when they last had it.

If you do not fit into any of the groups listed above, you should see a doctor or nurse if you develop signs of infection, which include:

• Pain that gets worse
• Redness or warmth
• Fever
• Oozing pus from the wound

What will a Doctor do in these cases?

In general, a doctor will ask important questions such as the time and location of the incident, the type of animal involved, whether its vaccination status is known, the circumstances that may have provoked the bite, and what treatment was administered before coming to the hospital. They will then need to assess the risk of rabies and whether a tetanus shot will be required.

The wound will be carefully inspected for foreign material and dead tissue and then irrigated with a saline solution. Stitches may be required depending on the depth and size of the wound. Severe wounds involving muscle tears, fractures or joint spaces will need to be referred to the proper specialist fields. Imaging studies, blood tests and wound swabs may be required in severe wounds. Finally, appropriate medication may be prescribed in the form of painkillers and antibiotics.

Some people who are bitten need a "booster shot" of the tetanus vaccine. The tetanus booster is especially important for people who got their last booster more than 5 years ago.

What Is Rabies?

Rabies is a disease caused by the virus Lyssavirus. It is suspected in cases where the attack was unprovoked or the animal was behaving strangely prior to the bite. It attacks the central nervous system and can cause symptoms such as:

• Headaches
• Fever
• Nausea
• Agitation
• Hallucinations
• Coma

It can also affect other systems in the body. A period of time can pass between the time of the bite and the time that the symptoms start, so sometimes people can forget about the incident. This is why it is important to be seen immediately and be given the treatment of a series of shots to prevent rabies.

Rabies is more common in bats, coyotes, raccoons, skunks, and foxes. Bats are particularly notorious at spreading rabies and their wounds are hard to spot. This is why it is recommended to see a doctor if a person wakes up to find a bat in their bedroom even though they think they have not been bitten, or if a person works closely with bats. Rabies is less commonly found in cats and dogs. Fish and lizards and other animals without fur do not carry the disease.

What Is Tetanus?

Tetanus is a disease caused by bacteria in the soil known as Clostridium Tetani. These bacteria can infect any open wound and therefore may easily pass into the body from an animal bite. The person may experience:

• Muscle spasms, especially in the neck and jaw
• Difficulty breathing
• Difficulty swallowing

The World Health Organization and the Center of Disease Control recommend a tetanus injection every 10 years. In cases of animal bites, a booster may be needed if the patient’s last tetanus shot was more than 5 years ago.