Treating animal bites in children

Animal bites that break the skin are cuts, puncture wounds, or scrapes and should be treated as such. But animal bites have other special characteristics: they are prone to infection because of bacteria in the animal’s mouth, and they may cause lockjaw (tetanus) or rabies.
Rabies is a fatal disease of the central nervous system to which all mammals are susceptible. It is caused by a virus that can be seen microscopically and identified within the brain of affected animals. Transmitted through the saliva of the sick animal, rabies is most commonly found in the United States among skunks, foxes, cattle, dogs, bats, cats, and raccoons. It is rare among squirrels, chipmunks, rats, and mice. There is no risk from caged, domestic pets such as gerbils, guinea pigs, hamsters, and white mice.

Diagnosis

Bites are usually obvious from their appearance and from the child’s telling of the tale. Claw wounds may be indistinguishable from bites but are treated in the same way because of possible contamination by the animal’s saliva. Bruises without a break in the skin are not a threat of rabies, and are handled like any other bruises.

Home Treatment

Wash the wound with soap and water and flush with water. Apply antiseptic to minor wounds. If a wild animal did the biting, catch and hold it if this can be done without endangering anyone else; otherwise, kill and preserve it for inspection of its brain for rabies. If it’s a domestic animal, catch and impound or kill and preserve it. Find out if the domestic animal was vaccinated against rabies and determine the child’s tetanus toxoid status. Report the wound to your doctor immediately for advice concerning rabies, tetanus, and repair of the wound. In some states animal bites must be reported to the police.

Precautions

• Keep children current on tetanus boosters.
• Always contact your doctor about treatment in the case of animal bites.

Doctor’s Treatment

Because of the high incidence of infection your doctor may elect not to suture wounds. If cosmetic consideration necessitates closure, treatment first includes removal of the injured tissue and a thorough cleansing. Oral antibiotics may be prescribed. Also, your doctor will give a tetanus booster or human antitoxin to the patient if needed.
The decision whether or not to give antirabies vaccine, with or without antiserum, is complex. There’s a good possibility of serious reactions. Your doctor will arrange for examination of the animal for the presence of rabies. A pet properly immunized against rabies can still transmit rabies, although this possibility is minimal. If the animal is not caught, the decision depends upon prevalence of rabies in your area, circumstances of the bite (provoked or unprovoked), and the species of the animal.

Tags: tetanus, Children's health, General injuries, animal bites in children, rabies