Chatper 1 : Animal Bites

Abstract:

Virtually any wild or domestic vertebrate animal can inflict bite, scratch, or other wounds to humans. Main considerations from animal-related injuries are rabies, wound infection, and systemic bacterial infections. The main injured body parts were arm and hand, leg and foot, and head and neck. Most mammals are susceptible to rabies virus, including domestic mammals, bats, and terrestric wildlife. Any terrestrial mammal that is not validly vaccinated or any bat species can be a source of human rabies. Most reported human deaths from rabies are due to dogs: ≥95% in China and India and >90% worldwide. Vaccination has significantly reduced the importance of dogs as rabies vectors in high-income countries. Nonvaccinated dogs, including puppies, illegally imported into high-income countries from enzootic areas are an emerging source of rabies. Worldwide, ~1% of reported human rabies deaths are due to cats. A municipality in Bahia state, Brazil, with ~16,000 inhabitants recorded 308 vampire bat attacks and three rabies deaths in 1992, and another municipality of similar size recorded five attacks and two deaths. Itching at an injured site or neurological manifestations points to rabies virus or Clostridium tetani as causative agents. Wounds should be promptly cleaned with water and soap and evaluated for rabies, tetanus, need for débridement, and wound infection. Infections are typically polymicrobial and grow three to five bacterial species per culture.