By Meredith Cohn, The Baltimore Sun
March 24, 2011
Animal bites can be serious. They can injure the skin and bones and joints, and the damage could have lasting impacts. Dr. Tanveer Giaibi, chief of emergency medicine at Northwest Hospitals, answers questions about the dangers of and treatments for all kinds of bites.
Question: How common are animal bites and scratches, and who is most likely to get them?
Answer: Animal bites are common, with 2 [million] to 5 million occurring each year. Children are bitten more often than adults. Children are typically bitten on the face and neck since they are closer in height to animals. Older children and adults are typically bitten on their arms. The majority of animal bites are caused by dogs (85 to 90 percent), followed by cats (5 to 10 percent) and rodents (2 to 3 percent).
Q: What are the dangers associated with animal bites?
A: Some of the dangers associated are rabies, although skin infection is the most common complication. Some bites can cause serious injury and permanent disability, such as bites to the hand. These are at higher risk for serious complications because the skin's surface is so close to the underlying bones and joints.
Q: Is it ever safe to treat yourself after being bitten, and if so, what should you do?
A: People should watch for signs of infection. These include worsening pain, redness, fever or puslike discharge. If the bite is near a joint, the person should monitor for pain, swelling and joint movement. Anyone whose wound appears to be worsening rather than improving should seek medical care.
Q: How do you know if you need to go to a doctor, and how will he treat bites?
A: You should seek medical attention if an animal bite has broken through the skin. Other reasons for visiting the doctor should include if a bone may be broken, or if there is other serious injury. Finally, victims who have a weak immune system due to underlying medical conditions such as diabetes, liver disease, cancer, HIV, or takes medications that could weaken the immune system.
The most common complication of an animal bite is infection. Antibiotics may be indicated to prevent infection in people with high-risk wounds, or for people with weakened immune system. Generally there is a higher risk of infection with cat bites, and many of these patients will need antibiotics.
Other treatments which may be necessary include a tetanus immunization, as these bites can be very dirty. Typically if it has been greater than five years since receiving your tetanus immunization, a booster will be necessary.
Finally, if the animal is at risk for carrying rabies, a series of rabies vaccine may be necessary.
Q: Are some places on the body worse to be bitten than others?
A: Bites to the hand can be especially problematic as they are at higher risk for serious complications because the skin's surface is so close to the underlying bones and joints.
Q: Do your risk infection more if you are bitten by a dog or a cat?
A: Generally cat bites and scratches are at more risk for causing infection.
Q: What is cat scratch fever, also called cat scratch disease?
A: It is usually a self-limiting infectious disease classically characterized by painful regional swelling of lymph nodes following the scratch of a cat. However, 10 percent of victims can go on to develop more serious complications such as altered mental status, vision loss, prolonged fever, joint pain and abdominal pain.
Q: When should someone get vaccinated for rabies?
A: It is dependent on the type of animal involved, and whether the animal exposure was provoked or unprovoked. Infected animals are more likely to attack even when unprovoked. Other useful information includes the vaccination history of the animal for rabies and the availability of the animal for testing or observation.
Q: What pre-existing conditions can make animal bites more dangerous and necessary to call a doctor immediately?
A: People who have a weak immune system due to underlying medical conditions such as diabetes, liver disease, cancer, HIV, or takes medications that could weaken the immune system.
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