Animal Bites and Rabies

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 superficial bites from a familiar 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, but do not scrub, as this may bruise the tissue. Apply an antiseptic lotion or cream.
• Watch for signs of infection at the site, such as increased redness or pain, swelling, drainage, or if the person develops a 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 a strange 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 as this may bruise the tissue.
• Dry the wound and cover it with a sterile dressing. Do not use tape or butterfly bandages to close the wound as this could trap harmful bacteria in the wound.
• Call your healthcare provider for guidance in reporting the attack and to determine whether additional treatment, such as antibiotics, a tetanus booster, or rabies vaccine is needed. This is especially 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 incidence of infection.
• If possible, locate the animal that inflicted the wound. Some animals need to be captured, confined, and observed for rabies. Do not try to capture the animal yourself. Contact the nearest animal warden or animal control office in your area.
• If the animal cannot be found or is a high-risk species (raccoon, skunk, or bat), or the animal attack was unprovoked, the victim may need a series of rabies shots and a dose of rabies immunoglobulin.

Call your healthcare provider for any flu-like symptoms, such as a fever, headache, malaise, decreased appetite, or swollen glands following an animal bite.

What is rabies?

Rabies is a viral infection of certain warm-blooded animals and is caused by a virus in the Rhabdoviridae family. It attacks the nervous system and, once symptoms develop, is 100% fatal in animals, if left untreated.

In North America, rabies happens primarily 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.

Individual states maintain information about animals that may carry rabies. It is best to check for region-specific information if you are unsure about a specific animal and have been bitten.

Travelers to developing countries, where vaccination of domestic animals is not routine, should talk with their healthcare provider about getting the rabies vaccine before traveling.

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 onset of illness can range anywhere from 5 days to more than a year, although the average incubation period is about 2 months. The following are the most common symptoms of rabies. Symptoms may include:

• Initial period of vague symptoms, lasting 2 to 10 days
• Vague symptoms may include, fever, headache, malaise, decreased appetite, or vomiting
• Pain, itching, or numbness and tingling at the site of the wound

• People often develop difficulty in swallowing (sometimes referred to as "foaming at the mouth") due to the inability to swallow saliva. 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, diagnostic labs can determine whether an animal is rabid and provide this information to medical professionals. These results may save a person from undergoing treatment if the animal is not rabid.

In humans, a number of tests are necessary to confirm or rule out rabies, as no single test can be used to rule out the disease with certainty. 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?

Unfortunately, there is no known, effective treatment for rabies once symptoms of the disease appear. However, there are effective vaccines that provide immunity to rabies when administered soon after an exposure. It may also be used for protection before an exposure happens, 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 strange 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.
• All domestic dogs and cats should be immunized against rabies and shots kept current.
• Do not approach or play with wild animals of any kind, and be aware that domestic animals may also be infected with the rabies virus.
• Supervise 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, remember these facts to report to your healthcare provider:

• Location of the incident
• Type of animal involved (domestic pet or wild animal)
• Type of exposure (cut, scratch, licking of open wound)
• Part of the body involved
• Number of exposures
• Whether or not the animal has been immunized against rabies
• Whether or not the animal is sick or well; if "sick," what symptoms were present in the animal
• Whether or not the animal is available for testing or quarantine