Published: Saturday, March 30, 2013

Animal Bites

Taking notice of a neglected problem

 Taking notice of a neglected problem

Animal bites are a significant cause of morbidity and mortality globally. Worldwide, up to 5 million people are bitten by snakes in a year resulting in around half a million severe health consequences including deaths; the majority in Africa and South-East Asia that includes Bangladesh. Tens of millions suffer injuries from dog bites, with the highest risk among children. Awareness and prompt medical attention are crucial to reduce those unnecessary and preventable deaths and disability.
Snake bites
Poisonous (envenoming) snake bites are a cause for serious concern. It leads to death and other severe health consequences, such as infection, tetanus, scarring, contractures, and psychological sequelae. Poor access to health care and scarcity of antivenom increases the severity of the injuries and their outcomes.
At the time of a bite, the cornerstone of care is complete immobilisation of the affected body part and prompt transfer to a medical facility. Tourniquets and cutting wounds can worsen the effects of the venom and should not be used as first aid. Frequently, victims of snake bites will require treatment with antivenom.
Additional measures include wound cleansing to decrease infection risk, supportive therapy such as airway support, and administration of tetanus vaccine upon discharge if the person has been inadequately vaccinated against tetanus.
To prevent or limit the serious health consequences of snake bites, health-care providers should be educated on snake-bite management, including the proper use and administration of antivenom.
Dog bites
Dog bite fatality rates are higher in low- and middle-income countries than in high-income countries as rabies is a problem in many of these countries, and there may be a lack of post-exposure treatment and appropriate access to health care. Bites from rabid dogs account for the vast majority of these deaths.
Children make up the largest percentage of people bitten by dogs, with the highest incidence in mid-to-late childhood.
Treatment of dog bites depends on the location of the bite, the overall health condition of the bitten person and whether or not the dog is vaccinated against rabies. The main principles of care include:
•    Early medical management;
•    Irrigation and cleansing of the wound;
•    Primary closure if the wound is low-risk for developing infection;
•    Prophylactic antibiotics for high-risk wounds or people with immune deficiency;
•    Rabies post-exposure treatment depending on the dog vaccination status;
•    Administration of tetanus vaccine if the person has not been adequately vaccinated.
Cat bites
Worldwide, cat bites account for 2–50% of injuries related to animal-bites. Female adults have the highest rate of cat bites. Treatment depends on the location of the bite and the rabies vaccination status of animal species inflicting the bite. The main principles of care is almost same as dog bites.

Source: World Health Organisation