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Bite Wounds: What to Do

by Berkeley Wellness

Any bite wound is a cause for concern, since mouths harbor a multitude of microorganisms—and bite wounds that break the skin therefore carry a risk of infection (this includes tetanus, a disease of the central nervous system caused by infection of a wound with spores of the bacterium Clostridium tetani).

The most worrisome concern after an animal bite is rabies, a viral brain disease that is almost always fatal if not treated promptly. However, if the bite hasn’t come from a wild animal, infection from rabies is unlikely, since most rabies in the United States—over 90 percent—is carried by wild animals. In addition, depending on the depth and extent of the wound, there is a possibility of damage to bone, tendons, and other underlying tissues.

Dog and cat bites

The great majority of bites come from dogs and cats. Dog bites are a problem first and foremost for children, who are most vulnerable to serious injury from dogs. Dogs bite 4.5 million people in the U.S. each year, causing about 800,000 to visit the emergency room or otherwise seek medical attention. At least half of them are children, with the highest incident rate among children 5 to 9, according to data from the CDC.Young children in particular are also more likely than adults to get bitten in the head, neck, and face area.

Though they may seem less serious, cat bites are actually more likely to lead to infection than dog bites—30 to 50 percent of cat bites become infected compared with 5 to 10 percent of dog bites. This is because cats have sharp teeth that can penetrate deep into the skin and reach the muscle, tendons, and bone underneath; and they carry in their mouths the highly virulent bacteria Pasteurella multocida.

Immediate care for bites

Animal bites should always be treated promptly, no matter how minor they seem. But the treatment varies depending on how severe the bite is and whether or not the animal is a household pet or an unfamiliar or wild animal, as explained below.

  • For a superficial bite or nip from a household pet that has been vaccinated, wash the bite and any scratches thoroughly with plenty of soap and running water. This can help wash away infectious agents. You can also apply a small bandage.
  • Be sure that tetanus immunization for you, or for a child who has been bitten, is up to date. If you haven’t had a tetanus shot within 10 years, you may need one. If there are extensive wounds from bites, a booster will probably be needed after five years.
  • For a deeper bite, or a bite from a wild animal or an unfamiliar domestic animal, washing the bite area is the most valuable first step. After washing thoroughly, elevate the injury and apply ice. Then call your doctor or go to the emergency room of a hospital.

If a Human Bites You

Human bites are the most common mammalian bite after dog and cat bites, carrying a 10 to 15 percent chance of infection if they break the skin. There are two main types of human bites: "simple" and "clenched-fist injury."

Preventing bite wounds

The people most likely to suffer bite wounds are children. Moreover, most bites are caused by a person’s own pet or by an animal the person is familiar with. About 5 percent of bites come from rodents and other wild and domestic animals.

Bites from both domestic and wild animals are highly preventable.

  • Be a responsible dog owner. You can significantly reduce the chance that your dog will bite you or anyone else by properly training your pet.
  • Obey leash and licensing laws—they protect dogs as well as people. Keep vaccinations up to date, and provide good health care for your dog.
  • Don’t assume that even the gentlest dog will behave with children, unless the animal is accustomed to children’s ways and has been socialized. Infants and toddlers are the most frequent victims of dog attacks—and the attacker is most often a family pet. Even a small dog can severely injure or kill a small child. Provide supervision, and teach your children how to interact with dogs.
  • Approach a strange dog with caution, and tell children not to approach a dog on their own. When entering a house where there’s a dog, let the owner introduce you and any child in your care. Speak to the dog, and offer a hand (fist closed) to be sniffed. Let the dog warm up to you first. If it appears reluctant or uninterested, let it be.
  • Never beat, kick, jerk, tease, or torment a cat or dog. Gentleness is the watchword.
  • Never goad a dog to attack. Don’t play rough games with a dog, such as wrestling or tail pulling.
  • Don’t bother a dog that is eating, sleeping, or caring for puppies. To wake a dog, call it rather than touching it.
  • If you encounter a strange dog off the leash, stay still. Don’t run or scream. Dogs, like wolves, will instinctively chase and attack a fleeing target. If a dog growls, bristles, or stands stiff-legged, it may be about to attack.
  • If you are attacked by a dog, protect your face, arms, hands, and legs. Roll up on the ground with your back in the air.
  • Observe wild animals from a distance. In particular, don’t try to make a pet of a raccoon, squirrel, or other wild animal. Be particularly cautious about wild animals that appear tame or lethargic, or that are fearless or aggressive. Also beware of any ordinarily nocturnal animal that is out in daylight. Such odd behavior might be a sign of rabies.

Minimizing the risk of rabies

Rabies is a viral disease transmitted by the saliva of infected animals. Any warm-blooded animal can carry it, but it is mostly found in raccoons, foxes, skunks, and bats. (Being bitten by an infected animal is almost the only way that humans are exposed to the disease, though airborne transmission is possible in a heavily infested bat cave.)

Rabbits and small rodents like squirrels, hamsters, guinea pigs, and mice rarely carry rabies, according to the CDC. Nor is it transmitted by reptiles such as lizards and snakes.

Symptoms of rabies may include pain or tingling at the site of the bite, aggressive behavior, hallucinations, extreme weakness, throat spasms that prevent swallowing, and thirst. Rabies may occur months or even years after the animal bite (another reason why all bites require prompt medical attention).

If left untreated until symptoms appear, rabies is usually fatal, but it can be caught and stopped if treatment is begun within 10 days after exposure. A series of five injections—using a modern version of the rabies vaccination discovered a century ago by Louis Pasteur—is very effective in combating the virus.

The treatment is expensive but less painful and less drawn out than it was years ago. Every year about 20,000 Americans get these shots. Serious side effects from the vaccine are quite rare.

Raccoons, which thrive in great numbers as suburban scavengers, are now the chief source of rabies, and while rabid raccoons seldom attack people, they do attack dogs and cats. Vaccination of pets, practiced since the 1940s, has almost wiped out rabies in domestic animals. In the 1950s skunks and foxes became reservoirs of the disease in the wild, later to be outpaced by bats and then, in the 1970s, by raccoons, so that unvaccinated pets are now at greater risk of exposure.

To minimize the likelihood that you or your pet will be exposed to rabies, follow these steps:

  • Vaccinate your pets regularly, as recommended by your veterinarian.
  • Don’t let pets roam outdoors at night, when they are more likely to come into contact with wild animals.
  • Keep outdoor garbage cans tightly sealed to discourage animal scavengers.