HEALTH INSIGHTS

Animal Bites and Rabies

February 21, 2019

Animal Bites and Rabies

What are the dangers of animal bites?

Animal bites and scratches, even when they are minor, can become infected and spread bacteria to other parts of the body. Whether the bite is from a family pet or an animal in the wild, scratches and bites can carry disease. Cat scratches, even from a kitten, can carry "cat scratch disease," a bacterial infection. Other animals can transmit rabies and tetanus. Bites that break the skin are even more likely to become infected.

What is the care for animal bites?

For shallow bites from a household pet that is immunized and in good health:

  • Wash the wound with soap and water under pressure from a faucet for at least 5 minutes. Do not scrub. This may bruise the area. Apply an antiseptic lotion or cream.

  • Watch for signs of infection at the site. Check for increased redness or pain, swelling, fluid leaking, or fever. Call your healthcare provider right away if any of these symptoms happen.

For deeper bites or puncture wounds from any animal, or for any bite from an unknown animal:

  • If the bite or scratch is bleeding, apply pressure to it with a clean bandage or towel to stop the bleeding.

  • Wash the wound with soap and water under pressure from a faucet for at least 5 minutes. Do not scrub. This may bruise the area.

  • Dry the wound. Cover it with a sterile dressing. Do not use tape or butterfly bandages to close the wound. These could trap harmful bacteria in the wound.

  • Call your healthcare provider for guidance. Ask if you should report the attack. Ask if more treatment is needed. This may include antibiotics, a tetanus booster, or rabies vaccine. This is most important for bites on the face, hands, or feet, or for bites that cause deeper puncture wounds of the skin. It is also important for all cat bites that have a high risk of infection. 

  • If possible, find the animal that bit you. Some animals need to be captured, confined, and watched for rabies. Do not try to capture the animal yourself. Contact the nearest animal warden or animal control office.

  • You may need a series of rabies shots and a dose of rabies immunoglobulin. This may be the case if the animal can't be found or is a high-risk species such as a raccoon, skunk, or bat. This may also be needed if the animal attack was unprovoked.

Call your healthcare provider for any flu-like symptoms. These include a fever, headache, malaise, loss of appetite, or swollen glands.

What is rabies?

Rabies is a viral infection of some warm-blooded animals and is caused by a virus in the Rhabdoviridae family. It attacks the nervous system. Once symptoms start, is 100% fatal in animals. It is almost 100% fatal in humans as well. There has been only 1 report of an unvaccinated person surviving. But getting the vaccine for rabies soon after a possible rabies exposure will protect you from ever getting rabies.

In North America, rabies can occur in skunks, raccoons, foxes, coyotes, and bats. In some areas, these wild animals infect domestic cats, dogs, and livestock. In the U.S., cats are more likely than dogs to be rabid.

Each state keeps information about animals that may carry rabies. It is best to check for your state's information if you have been bitten are unsure if that type of animal in your state is likely to have rabies.

Talk with your healthcare provider about the rabies vaccine before travel to developing countries. In some of these places, vaccination of domestic animals for rabies is not routine. 

How does rabies happen?

The rabies virus enters the body through a cut or scratch, or through mucous membranes (such as the lining of the mouth and eyes), and travels to the central nervous system. Once the infection is established in the brain, the virus travels down the nerves from the brain and multiplies in different organs.

The salivary glands are most important in the spread of rabies from one animal to another. When an infected animal bites another animal, the rabies virus is transmitted through the infected animal's saliva. Scratches by claws of rabid animals are also dangerous because these animals lick their claws.

What are the symptoms of rabies?

The incubation period in humans from the time of exposure to the start of illness can range anywhere from 5 days to more than 1 year. The average period is about 2 months. The most common symptoms of rabies include:

Rabies: Stage 1

Rabies: Stage 2

  • Initial period of vague symptoms, lasting 2 to 10 days

  • Vague symptoms may include, fever, headache, ill feeling, less appetite, or vomiting

  • Pain, itching, or numbness and tingling at the site of the wound

  • People often have trouble swallowing, including saliva. This can look like s "foaming at the mouth." Even the sight of water may terrify the person.

  • Some people become agitated and disoriented, while others become paralyzed.

  • Immediate death, or coma resulting in death from other complications, may result.

The symptoms of rabies may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

How is rabies diagnosed?

In animals, the direct fluorescent antibody test (dFA) done on brain tissue is most often used to detect rabies. Within a few hours, the lab test can show if an animal is rabid. These results may save a person from having treatment if the animal is not rabid.

In humans, a number of tests are needed to confirm or rule out rabies. No single test can be used to rule out the disease for sure. Tests are done on samples of serum, saliva, and spinal fluid. Skin biopsies may also be taken from the nape of the neck.

What is the treatment for rabies?

There is no known, effective treatment for rabies once symptoms of the disease appear. But there are vaccines that give immunity to rabies when given soon after contact with the virus. It may also be used for protection before contact with the virus, for people such as veterinarians and animal handlers.

How can animal bites and rabies be prevented?

Being safe around animals, even your own pets, can help reduce the risk of animal bites. Some general guidelines for avoiding animal bites and rabies include the following:

  • Do not try to separate fighting animals.

  • Avoid unknown and sick animals.

  • Leave animals alone when they are eating.

  • Keep pets on a leash when out in public.

  • Select family pets carefully.

  • Never leave a young child alone with a pet.

  • Make sure your pets all have rabies shots on schedule.

  • Do not go near or play with wild animals of any kind. Be aware that domestic animals may also be infected with the rabies virus.

  • Watch pets so they do not come into contact with wild animals. Call your local animal control agency to remove any stray animals.

What would my healthcare provider need to know about an animal bite?

If you or someone you know is bitten by an animal, report these facts to your healthcare provider:

  • Location of the incident

  • Type of animal ( pet or wild animal)

  • Type of exposure (cut, scratch, licking of open wound)

  • Part of the body bitten

  • Number of exposures

  • If the animal has been immunized against rabies

  • If the animal appears to be sick, and what symptoms it has

  • If the animal is available for testing or quarantine

Updated:  

February 21, 2019

Sources:  

Compendium of Animal Rabies Prevention and Control. Brown C. Morbidity and Mortality Weekly Report. 2011;60(6):s1-14., Use of a Reduced (4-Dose) Vaccine Schedule for Postexposure Prophylaxis to Prevent Human Rabies. Rupprecht C. Morbidity and Mortality Weekly Report. 2010;59(2):s1-10.

Reviewed By:  

Eric Perez MD,Lu Cunningham,Lu Cunningham