Abstract
EPIDEMIOLOGY AND BURDEN OF PROBLEM Dogs and cats are very important to millions of Canadians. In 1995, more than 100 million cats and dogs were owned as pets in Canada and the United States. Bites from these animals are very common, with between one million and two million dog bites reported annually in both countries (1). According to the Canadian Hospitals Injury Reporting and Prevention Program web site , injuries related to dog bites account for 1% of all visits to hospital emergency departments, and dogs are responsible for 85% of all bite wounds. Fiveto nine-year-old males sustain dog bites most frequently. Dog and cat bites occur most often in the summer, and between 16:00 and 20:00. Up to 85% of dog and cat bites are caused by the victims’ family pet or by a neighbour’s pet. About half of these bites are considered to have been provoked. In a survey of 455 families with 960 children who sustained injuries related to dog bites (2), 20% of the children were bitten at least once, and the majority of the children received bites before they were five years of age. Dog and cat bites are particularly more serious in children than in adults because children are more likely to be bitten on the face, neck and head in up to 70% of cases (1). Children account for the majority of the 10 to 20 deaths from animal bites that occur annually in the United States (3). As a result, physicians need to diagnose appropriately and treat bite-related injuries that are potentially life-threatening.
Highlights
MICROBIOLOGY Dog bites typically cause puncture wounds, lacerations and crush injuries
TREATMENT AND PROPHYLAXIS The appropriate treatment for dog and cat bites consists of the following: inquiring about the status of tetanus immunization and providing booster doses, as needed; inquiring about the risk of rabies and arranging appropriate immunoprophylaxis; cleansing and debridement of the wound, and an assessment of the appropriateness of wound closure; an evaluation of the need for prophylactic antibiotics; and management of emotional trauma, which may occur as a result of the bite
Tetanus immunization guidelines should be administered according to the Canadian Immunization Guide, 5th Edition (Table 1) [14]
Summary
H Dele Davies MD MSc FRCPC, Division of Infectious Diseases, Alberta Children Hospital, Calgary, Alberta. In 1995, more than 100 million cats and dogs were owned as pets in Canada and the United States Bites from these animals are very common, with between one million and two million dog bites reported annually in both countries [1]. Cat bites typically cause puncture wounds and contain Pasteurella multocida in about 50% to 75% of cases, as well as other aerobes and anaerobes, including S aureus [4]. TREATMENT AND PROPHYLAXIS The appropriate treatment for dog and cat bites consists of the following: inquiring about the status of tetanus immunization and providing booster doses, as needed; inquiring about the risk of rabies (see below) and arranging appropriate immunoprophylaxis; cleansing and debridement of the wound, and an assessment of the appropriateness of wound closure; an evaluation of the need for prophylactic antibiotics; and management of emotional trauma, which may occur as a result of the bite. Telephone 613-526-9397, fax 613-526-3332, web site http://www.cps.ca
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