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Many parents assume that children are most likely to be bitten by strange or wild animals, but in fact most bites are inflicted by animals the child knows, including the family pet. Although the injury often is minor, biting does at times cause serious wounds, facial damage, and emotional problems.
As many as 1 percent of all visits to pediatric emergency centers during the summer months are for human or animal bite wounds. An estimated 4.7 million dog bites, 400,000 cat bites, 45,000 snake bites, and 250,000 human bites occur annually in the United States. About 6 of 10 of those bitten by dogs are children. About 50 out of every 100 people bitten by a cat get an infection, compared to 15 to 20 of every 100 following dog or human bites.
If your child is bleeding from an animal bite, apply firm continuous pressure to the area for five minutes or until the bleeding stops. Then wash the wound gently with soap and water, and consult your pediatrician.
If the wound is very large, or if you cannot stop the bleeding, continue to apply pressure and call your pediatrician to find out where to take your child for treatment. If the wound is so large that the edges won’t come together, it probably will need to be sutured (stitched). Although this will help reduce scarring, in an animal bite, it increases the chance of infection, so your doctor may prescribe antibiotics.
Contact your pediatrician whenever your child receives an animal bite that breaks the skin, no matter how minor the injury appears. The doctor will need to check whether your child has been adequately immunized against tetanus or might require protection against rabies. Both of these diseases can be spread by animal bites.
Rabies is a viral infection that can be transmitted by an infected animal through bites or scratches. It causes a high fever, difficulty in swallowing, convulsions, and ultimately death. Fortunately, rabies in humans is so rare today that no more than five cases have been reported in the United States each year since 1960; the number of human deaths caused by rabies in this country has declined from one hundred or more each year early in the twentieth century to an average of one or two each year today. Nevertheless, because the disease is so serious and the incidence has been increasing in animals, your pediatrician will carefully evaluate any bite for the risk of contracting this disease. The risk probably depends a great deal on the animal and the circumstances surrounding the bite. Bites from wild animals, especially bats but also skunks, raccoons, coyotes, and foxes, are much more dangerous than those from tame, immunized (against rabies) dogs and cats. The health of the animal also is important, so if possible, the animal should be captured and confined for later examination by a veterinarian. For help capturing the animal you may want to contact the animal control in your area or contact your local public health department. Talk to your pediatrician about reporting the incident to your local health department. Do not destroy the animal. If it has been killed, however, the brain can be examined for rabies, so call your pediatrician immediately for advice on how to handle the situation.
If the risk of rabies is high as determined by your pediatrician, he immediately will give, or arrange to have given, injections of the rabies vaccine to prevent the disease. If the biting animal is a healthy dog or cat, he will recommend that it be observed for ten days, starting treatment for your child only if the animal shows signs of rabies. If the animal is a wild one, commonly identified as a rabies risk if captured, it usually is euthanized immediately so that its brain can be examined for signs of rabies infection.
As noted earlier, an animal bite (even when it doesn’t cause rabies) can become infected. Notify your pediatrician immediately if you see any of the following signs of infection.
- Pus or drainage coming from the bite
- The area immediately around the bite becoming swollen and tender (It normally will be red for two or three days, but this in itself is not cause for alarm.)
- Red streaks that appear to spread out from the bite
- Swollen glands above the bite
Your pediatrician may recommend antibiotic therapy for a child who has:
- Moderate or severe bite wounds
- Puncture wounds, especially if the bone, tendon, or joint has been penetrated
- Facial bites
- Hand and foot bites
- Genital area bites
Children who have a weakened immune system or have no spleen often receive antibiotic treatment.
Your pediatrician may recommend a follow-up visit to inspect any wound for signs of infection within forty-eight hours.
Many children who have been bitten by dogs may also show signs of mental trauma—so-called “post traumatic stress disorder (PTSD)”—in the weeks and months after the incident. Long after the physical wound has healed, these children may continue to have emotional difficulties associated with the bite. They may feel fear, including anxiety about being bitten again. They may withdraw, or cling to their parents. They may resist going outside to play, have trouble sleeping, have nightmares, and wet the bed.
To help the healing process, be attentive to what your child is saying and feeling. Give her extra attention, particularly when you sense that she needs it. Some children with
PTSD may require treatment by a mental health professional.