This week’s guest columnist is Dr. Crystal Davis, a Family Practice resident at the University Hospital and Clinics here in Lafayette.
Mom’s in the yard when her 5 year-old son Logan runs over. “Something bit me,” he cries, “it hurts!” Blood drips down his arm. He’s rushed inside and while mom washes the arm in the kitchen sink, the story comes out. Logan was next door at his friend Tommy’s, when they saw some animals in the bushes. They went to get a closer look, and Logan got bitten. It was a small animal, that looked to Logan like a rat.
Just then Tommy’s mom calls to check on Logan, and that she saw ferrets in the bushes lately. ”It was a ferret!” chimes in Logan, “One of the teachers at school has one in her classroom!” A ferret and a bleeding bite wound, mom thinks, what do I do now? Go to the Emergency Room? Call Animal Control?
Both are good ideas. Any time an animal bites and breaks the skin, the child is at risk for infections. The bite can cause other problems too- disfiguring scars, tendon and nerve damage, and pain. Your first step is doing just what Logan’s mom did- wash the wound. This rinses out harmful bacteria and viruses that might cause infection. Some bleeding is good- blood washes bacteria out too. After a good washing, stop the bleeding with direct pressure.
Call Animal Control. The animal should be captured and quarantined to see if it has rabies. This goes for pets, stray animals, and wild animals- any mammal can carry rabies, and rabies is deadly!
Then at the Emergency Room, the team can further clean the wound, assess for infection and damage, prescribe an antibiotic, and consider if rabies vaccine is necessary. Though deep lacerations are usually stitched, this isn’t always the case with bites. While face bites are often sutured to minimize scarring, wounds on hands, arms, legs, and feet are commonly left open to continue to drain. Stitching those increases the risk of infection by trapping bacteria inside. Finally, the child’s tetanus vaccine status is assessed. Tetanus is another deadly infection, and kids who aren’t up to date need a booster.
Preventing animal bites is the best way to avoid complications like above. Consider what your child watches on TV and in movies concerning animals. Most animals in kid shows talk, are friendly, and are really cute. These shows inadvertently teach your kids that animals are pretty much all great. So, they might think, why not play with every real animal they see?
Well, in real life wild animals are more like people in a big city- some are mean, some have nasty infections, some bite. You wouldn’t want your kid going up to every stranger and touching them, would you? Thus you need to teach them to be wary of animals too. Even a neighbor’s dog that you don’t know well may be skittish with strangers, and bite when confronted.
Caution with animals is particularly important given the nastiness of animal bite infections. The scariest of these is rabies. Rabies is a fatal viral infection. It infects the brains of animals, causing them to be very aggressive, and attack other animals and humans. Rabies is passed along in the biting animal’s saliva, and all infected animals eventually die. Likewise with humans, rabies just about always kills. There have only been 13 known survivors in history, compared to 65,000 deaths worldwide per year.
So which kid needs rabies prophylaxis? Factors include prevalence of rabies in your region, if the child’s skin was broken by a bite (bad) or paw scratch (less bad), and of course- could the offending animal be carrying rabies?
Domestic animals can have rabies- not all have had rabies vaccines. Wild animals are at high risk of carrying rabies, particularly bats, raccoons, skunks, foxes, and coyotes. And these wild animals can bite and transmit the virus to pets.
So as we said above, if your child is bitten, call Animal Control. They can help you and the doctor decide the risk of rabies. In the best case, they can capture the animal, take it into quarantine, to see if it develops rabies. If the animal turns rabid, your child can start the vaccines. If the animal turns out to be safe, so is your child.