Incidence Of Dog Bites Research Articles

A study on dog bite incidence in Union Territory of Dadra & Nagar Haveli, India

The injuries caused by dog bites have grown to such epidemic proportions that they are now considered a major public health concern. The epidemiology of dog bites in the UT of Dadra & Nagar Haveli has been evaluated, for the year 2012. This assessment included victims age, sex, biting site and season of the year. During the study, a total of 938 dog bites, were reported from aforesaid place. Of all the dog bites reported, 39.6% victim belonged to age group upto 0-15 year (children) and 60.4% were more than 15 years old (adults). The majority of the incidents 40.8% occurred during the pre monsoon period (1-20 weeks). There was no case of rabies. There is a need to educate the public about the magnitude of dog-bite problems, enforce leash laws and impound stray dogs as an integral part of prevention programs.

Retrospective analysis of facial dog bite injuries at a Level I trauma center in the Denver metro area.

Facial dog bite injuries pose a significant public health problem. Seventy-five consecutive patients (45 males, 30 females) treated solely by plastic surgery service for facial dog bite injuries at a Level I trauma center in the Denver Metro area between 2006 and 2012 were retrospectively reviewed. The following information were recorded: breed, relationship of patient to dog, location and number of wounds, the duration between injury and surgical repair and dog bite incident, type of repair, and antibiotic prophylaxis. Primary end points measured were wound infection, the need for revision surgery, and patient satisfaction. Ninety-eight wounds in the head and neck region were repaired (46 children; mean age, 6.8 years) and (29 adults; mean age, 47.3 years). Twelve different breeds were identified. There was no significant association between the type of dog breed and the number of bite injuries. The duration between injury and repair ranged from 4 hours to 72 hours (mean [SD], 13.7 [10.9] hours). The majority of bite wounds (76 of 98) involved the cheek, lip, nose, and chin region. Direct repair was the most common surgical approach (60 of 98 wounds) (p < 0.05). There was no statistically significant association between wounds needing reconstruction versus direct repair according to dog breed (p = 0.25). Ten wounds required grafting. Twenty-five wounds were managed by one-stage or two-stage flaps. Only three patients (3.06 %) underwent replantation/revascularization of amputated partial lip (n = 2) and of cheek (n = 1). There was one postoperative infection. Data from five-point Likert scale were available for fifty-two patients. Forty patients were satisfied (5) with the outcome, while five patients were somewhat satisfied (4), and seven were neutral. Availability of the plastic surgery service at a Level I trauma center is vital for the optimal treatment of facial dog bite injuries. Direct repair and reconstruction of facial dog bite injuries at the earliest opportunity resulted in good outcomes as evidenced by the satisfaction survey data and low complication rate. Therapeutic study, level V. Epidemiologic study, level III.

An Evaluation of Rabies Vaccination Rates among Canines and Felines Involved in Biting Incidents within the Wellington–Dufferin–Guelph Public Health Department

The objectives of this study were to determine the rate of animal bite incidents occurring in the human population of a local health department, and to determine the proportion of these canines and felines that were not up to date on their rabies vaccination at the time the incident occurred. Data were obtained from animal bite incidents reported to Wellington-Dufferin-Guelph Public Health during 2010 and 2011. Descriptive statistics of 718 eligible reports revealed the average rate of animal biting was 1.55 bites per 1000 residents per year. Approximately 54% of these animals were vaccinated against rabies, 32% were not up to date with their rabies vaccination, and the remaining 14.5% were of unknown status. The unit of analysis was the municipality, and the four outcomes of interest were: (i) number of animal bite incidents per 1000 residents, (ii) number of dog bite incidents per 1000 residents, (iii) proportion of animals involved in bite incidents that were not up to date with their rabies vaccination, and (iv) proportion of dogs that were not up to date. Associations between the outcomes and selected demographic variables were investigated using regression analysis. The number of veterinary clinics per 10,000 residents, and whether the municipality was urban or rural were identified as significant predictors for the number of animal bites per 1000 residents, and the number of dog bites. There were no significant predictors for the proportion of unvaccinated animals or dogs. Spatial clustering and the location of spatial clusters were assessed using the empirical Bayes index and spatial scan test. This analysis identified five municipalities within the health department that have a high rate of biting incidents and a high proportion of animals that were not up to date on their rabies vaccination. Such municipalities are ideal for targeted educational campaigns regarding the importance of vaccination in pets.

Costs Analysis of a Population Level Rabies Control Programme in Tamil Nadu, India

The study aimed to determine costs to the state government of implementing different interventions for controlling rabies among the entire human and animal populations of Tamil Nadu. This built upon an earlier assessment of Tamil Nadu's efforts to control rabies. Anti-rabies vaccines were made available at all health facilities. Costs were estimated for five different combinations of animal and human interventions using an activity-based costing approach from the provider perspective. Disease and population data were sourced from the state surveillance data, human census and livestock census. Program costs were extrapolated from official documents. All capital costs were depreciated to estimate annualized costs. All costs were inflated to 2012 Rupees. Sensitivity analysis was conducted across all major cost centres to assess their relative impact on program costs. It was found that the annual costs of providing Anti-rabies vaccine alone and in combination with Immunoglobulins was $0.7 million (Rs 36 million) and $2.2 million (Rs 119 million), respectively. For animal sector interventions, the annualised costs of rolling out surgical sterilisation-immunization, injectable immunization and oral immunizations were estimated to be $ 44 million (Rs 2,350 million), $23 million (Rs 1,230 million) and $ 11 million (Rs 590 million), respectively. Dog bite incidence, health systems coverage and cost of rabies biologicals were found to be important drivers of costs for human interventions. For the animal sector interventions, the size of dog catching team, dog population and vaccine costs were found to be driving the costs. Rabies control in Tamil Nadu seems a costly proposition the way it is currently structured. Policy makers in Tamil Nadu and other similar settings should consider the long-term financial sustainability before embarking upon a state or nation-wide rabies control programme.

Knowledge and practices towards rabies and determinants of dog rabies vaccination in households: a cross sectional study in an area with high dog bite incidents in Kakamega County, Kenya, 2013

IntroductionAn estimated 55,000 people die from rabies annually. Factors promoting dog vaccination, estimates of vaccination coverage and knowledge on rabies are important for effective rabies control. We sought to establish these estimates at household (HH) level and whether rabies knowledge is associated with proper control practices.MethodsCross-sectional cluster survey with two-stage sampling was employed in Kakamega County to enroll HH members above 18 years. A set of questions related to rabies knowledge and practice were used to score participant response. Score above the sample mean was equated to adequate knowledge and proper practices respectively. Independent t-test was used to evaluate the differences of sample mean scores based on dog vaccination status. Bivariate analysis was used to associate knowledge to practices.ResultsThree hundred and ninety HHs enrolled and had a population of 754 dogs with 35% (n = 119) HH having vaccinated dogs within past 12 months. Overall mean score for knowledge was 7.0 (±2.8) with range (0-11) and 6.3 (±1.2) for practice with range (0-8). There was a statistically significant difference in mean knowledge (DF = 288, p < 0.01) and practice (DF = 283, p = 0.001) of HH with vaccinated dogs compared to ones with unvaccinated dogs. Participants with adequate rabies knowledge were more likely to have proper health seeking practices 139 (80%) (OR = 3.0, 95% CI = 1.4-6.8) and proper handling practices of suspected rabid dog 327 (88%) (OR = 5.4, 95% CI = 2.7-10.6).ConclusionRabies vaccination below the 80% recommended for herd immunity. Mass vaccination campaign needed. More innovative ways of translating knowledge into proper rabies control practice are warranted.

Damages in a Dog Bite Case

Animal law as a discipline continues to evolve. This evolution touches everything from our beliefs regarding animals' proper place in society and what bundle of rights should accompany this property, both from possessors' and animals' perspectives, to more every-day matters such as animal trusts, veterinary-care issues, and dog bite cases. Damages in a dog bite case can be more encompassing than damages in any personal injury matter. As our understanding grows of animals and thus also the reasons behind certain animal interactions with humans, our ability to more accurately categorize and quantify the spectrum of damages in a dog bite case also grows.In this paper Michael Kaiser provides the foundation for his recent presentation on damages in dog bite cases. The presentation was given during the October, 2013, national Continuing Legal Education (CLE) videocast Plaintiff's Guide to Dog Bite Litigation. In this paper he presents a platform for a much more encompassing approach to quantifying damages in these type of cases. His paper parses damage issues concerning pain and suffering, scarring and disfigurement, post traumatic stress disorder, lost income, punitive damages, loss of quality of life, and loss of consortium. His paper also addresses pet victims in dog bite cases as well as police dog bite incidents.

Increased incidence of dog-bite injuries after the Fukushima nuclear accident

ObjectiveThe objective of this study is to assess the localized incidence of dog bites following the nuclear accident related to the Great East Japan Earthquake in March 2011. MethodsWe identified the patients with dog bites in our hospital in Minamisoma City, Fukushima, during the period from 1year prior to the earthquake to 3.5months following it, and calculated the monthly and weekly incidence proportions by dividing the patient number by the total emergency room visits. We also analyzed the data by the characteristics of the patients. ResultsWe identified 27 dog-bite cases during the post-disaster period. The median monthly incidence proportion during the pre-disaster period and the highest monthly incidence proportion during the post-disaster period were 0.21 and 6.50 per 100 visits, respectively. The weekly incidence proportion peaked at 3weeks after the earthquake and thereafter decreased to the baseline level. ConclusionThe Fukushima nuclear accident may be associated with an increased incidence of dog bites, and the prolonged evacuation in response to the radiation contamination may have prolonged the increased incidence after the disaster. Physicians and local residents should recognize this potential hazard. Countermeasures to contend with this risk should be a mandatory aspect of disaster preparedness, including for nuclear accidents.

Dog bite histories and response to incidents in canine rabies-enzootic KwaZulu-Natal, South Africa.

The objective of this paper is to report evaluated observations from survey records captured through a cross-sectional observational study regarding canine populations and dog owners in rabies enzootic KwaZulu-Natal province, South Africa. Our aim was to evaluate respondent knowledge of canine rabies and response to dog bite incidents towards improved rabies control. Six communities consisting of three land use types were randomly sampled from September 2009 to January 2011, using a cluster design. A total of 1992 household records were analyzed using descriptive statistics and regression modeling to evaluate source of rabies knowledge, experiences with dog bites, and factors affecting treatment received within respective households that occurred within the 365 day period prior to the surveys. 86% of the population surveyed had heard of rabies. Non-dog owners were 1.6 times more likely to have heard of rabies than dog owners; however, fear of rabies was not a reason for not owning a dog. Government veterinary services were reported most frequently as respondent source of rabies knowledge. Nearly 13% of households had a member bitten by a dog within the year prior to the surveys with 82% of the victims visiting a clinic as a response to the bite. 35% of these clinic visitors received at least one rabies vaccination. Regression modeling determined that the only response variable that significantly reflected the likelihood of a patient receiving rabies vaccination or not was the term for the area surveyed. Overall the survey showed that most respondents have heard of dog associated rabies and seek medical assistance at a clinic in response to a dog bite regardless of offending dog identification. An in-depth study involving factors associated within area clinics may highlight the area dependency for patients receiving rabies post exposure prophylaxis shown by this model.

Response to a rabies epidemic, Bali, Indonesia, 2008-2011.

Emergency vaccinations and culling failed to contain an outbreak of rabies in Bali, Indonesia, during 2008–2009. Subsequent island-wide mass vaccination (reaching 70% coverage, >200,000 dogs) led to substantial declines in rabies incidence and spread. However, the incidence of dog bites remains high, and repeat campaigns are necessary to eliminate rabies in Bali.

Incidence and Risk Factors associated with Rabies and Dog Bites among Dogs Involved in Bites in Plateau State, Nigera between 2011 and 2012

This study investigated the incidence of rabies among dogs involved in bites and the risk factors associated with rabies infections and dog bites in Plateau State, Nigeria, between January 2011 and December, 2012 using the fluorescent antibody test, the mouse inoculation test and questionnaire analysis. The overall incidence observed was 46.7% (150/321), with males and females representing 27.7% (89/321) and 19.0% (61/321) of the overall incidence respectively. This was statistically insignificant (P> 0.05). In relation to dog breeds, incidence rates observed were 45.8% (147/321), 0.3% (1/321), 0.6% (2/321) and 0.0% (0/321) for Local, Alsatian, Rottweiler and Caucasian respectively which was statistically insignificant. Based on rabies vaccination status, vaccinated and unvaccinated dogs had incidence rates of 1.2% (4/321) and 45.5% (146/321) which was statistically significant (P 36 months 19.0% (61/321), followed by dogs within the age group 0-6 months 11.8% (38/321), while the lowest was among those within the age bracket >30-36 months 1.6% (5/321). This was was highly statistically significant (P60 years of age 2.2% (13/321). In relation to sex, incidence of dog bite was higher among males 57.6% (185/321) than females 42.4% (136/321). Risk factors analysis indicated that level of awareness of rabies, lack of vaccination of dogs against rabies, the bitten of pet dogs by stray dogs and the capture of trade dogs from the wild are associated with the incidence of rabies in the study area. This study observed a high incidence of rabies among dogs involved in bites and a higher incidence of dog bites among children between the age brackets 0-10 and 11-20. It is recommended that there should be increased veterinary education on the public health risk of rabies in the study area and the necessity of prevention through animal intervention.

Incidence of dog bites and public attitudes towards dog care and management in Samoa

AbstractIn many developing nations, dogs (Canis familiaris) present a significant issue in terms of human health, safety and animal welfare. We assessed attitudes towards dogs and their management in Samoa, a developing South Pacific island nation, using a questionnaire. It demonstrated that Samoa has one of the world's highest recorded levels of household dog ownership (88%) but a comparatively low rate of vaccination (12%) and sterilisation (19%). Those interviewed believe dogs were important and should be considered part of the family; however most households reported that their dogs were kept for protection (79%). There was a clear skew in the sex distribution. The dog population showed a strong male bias (71%) suggesting females are removed from the population. Of those surveyed only 16% had received any education about dogs and their management and overall the respondents showed a clear disparity between attitudes and behaviour (eg the majority believe dogs should be vaccinated [81%] yet most dogs in this sample [72%] had never been to a veterinarian). Overall, there was a willingness to manage the free-roaming dog population which was considered by many to be a nuisance, however there were few enforceable mechanisms by which this could occur and most dogs were not confined. Harm or killing of dogs was relatively commonplace with 30% of households reporting they knew someone who had harmed or killed a dog and 26% of respondents indicating they believed harming or killing dogs was good for Samoan society, presumably by reducing problems associated with the free-roaming population. Dog bites were relatively frequent in Samoa and reports from two hospitals indicated a frequency of 37 new bites per annum requiring hospitalisation per 10,000 head of population. Furthermore, this paper outlines strategies and further research that could be considered to improve dog welfare and reduce the need to harm or kill dogs, namely improvements in veterinary provision and dog-focused education. It also considers the need for legislative controls and more research and funding to be made available for small developing nations to explore their animal welfare obligations.

Post-war Demographic and Ecological Survey of Dog Populations and Their Human Relationships in Sierra Leone. (A Case Study of Urban Freetown)

This research conducted on 900 dog-owning households randomly selected in urban Freetown investigated dog population and ecology, and how they relate with human populations, with regards to rabies. Pre-tested questionnaires designed according to World Health Organization standards were administered from Allen town in the east to Juba hills in the west. Area measurements using prescribed methods were done in the east, central and west of Freetown. Dog population was obtained by counting the number of dogs in the three clusters. Results obtained revealed an estimated total dog population of 13,246 with a ratio of 1:14 dogs to humans respectively., Life expectancy of dogs was 3-4 years, although some lived up to 7 years and above. More males were involved in dog rearing than females. Although 72% of dog owners are skilled income earners, however, 81% do not feed their dogs with canned food; hence 88% don't know the cost of feeding their dogs. Approximately, 44% of households allow their dogs to scavenge garbage dumps and to mix with other dogs. Most dogs (77%) are owned by parents, mainly for security purposes, but 59% do not monitor or register their dogs with veterinary clinics and the Ministry of Health and Sanitation. Lack of care and attention accounted for 78% of dog mortality; hence dog owners need to pay closer attention in the management of their dogs to reduce the incidence of dog bites and rabies for a healthy co-existence with them.

Dog Bites in Humans and Estimating Human Rabies Mortality in Rabies Endemic Areas of Bhutan

BackgroundDog bites in humans are a public health problem worldwide. The issues of increasing stray dog populations, rabies outbreaks, and the risk of dogs biting humans have been frequently reported by the media in Bhutan. This study aimed to estimate the bite incidence and identify the risk factors for dog bites in humans, and to estimate human deaths from rabies in rabies endemic south Bhutan.MethodsA hospital-based questionnaire survey was conducted during 2009–2010 among dog bites victims who visited three hospitals in Bhutan for anti-rabies vaccine injection. Decision tree modeling was used to estimate human deaths from rabies following dog bite injuries in two rabies endemic areas of south Bhutan.ResultsThree hundred and twenty four dog bite victims were interviewed. The annual incidence of dog bites differed between the hospital catchment areas: 869.8 (95% CI: 722.8–1022.5), 293.8 (240–358.2) and 284.8 (251.2–323) per 100,000 people in Gelephu, Phuentsholing and Thimphu, respectively. Males (62%) were more at risk than females (P<0.001). Children aged 5–9 years were bitten more than other age groups. The majority of victims (71%) were bitten by stray dogs. No direct fatal injury was reported. In two hospital areas (Gelephu and Phuentsholing) in south Bhutan the annual incidence of death from rabies was 3.14 (95% CI: 1.57–6.29) per 100,000 population. The decision tree model predicted an equivalent annual incidence of 4.67 (95% CI: 2.53–7.53) deaths/100,000 population at risk. In the absence of post exposure prophylaxis, the model predicted 19.24 (95% CI: 13.69–25.14) deaths/year in these two areas.ConclusionsIncreased educational awareness of people about the risk of dog bites and rabies is necessary, particularly for children in rabies endemic areas of Bhutan.

Assessing human–dog conflicts in Todos Santos, Guatemala: Bite incidences and public perception

The issues surrounding dog bites are a major public health concern, particularly in areas of low income where accessibility to adequate health care, veterinary medicine and sufficient management of canine population control is low. An understanding of the risk factors associated with human–dog conflicts may be important when establishing dog bite and disease prevention strategies. In May 2008, a census of 12 consociated neighbourhoods in Todos Santos, Guatemala was conducted to investigate dog bite incidences and the public perception of free-roaming dog populations. Approximately 16.5% (78/472) of households reported at least one dog bite between May 2006 and May 2008. In total, 85 incidents occurred: 49.4% (42/85) with adults (≥18 years) and 50.6% (43/85) children (<18 years). However, there was no significant difference in cumulative incidence of dog bites by victim gender or among age categories, there was a non-significant trend of higher cumulative incidence of dog bites in children aged six to 17 years compared to other age categories. The anatomical location of the bite varied, but bites to the legs were the most common (73/85; 85.9%). Of the 85 reported dog bites, 5.9% (5/85) were from dogs from the victims’ own households, 48.2% (41/85) were from a neighbour's dog, 9.4% (8/85) were from dogs regularly seen in the community, and 15.3% (13/85) were from dogs not regularly seen in the community; the ownership status of the latter two categories of dogs could not be determined. Approximately 21% (18/85) of respondents did not know the type of dog that bit. Residents were asked for their opinions on potential problems associated with dogs in the community. The majority of respondents strongly agreed that dogs posed physical risks (78.8%; 372/472), could transmit infections to people (88.6%; 418/472), scared the family (82.4%; 389/472) and were too high in number (82.6%; 390/472). There were significant but weak correlations between owning a dog and expressing negative perceptions of community dogs (Spearman rho < 0.13). Reporting of a dog bite was not significantly correlated to expressing fear or negative perceptions towards community dogs. A further understanding of current programs directed at the prevention of dog bites and means of dog population control may help determine appropriate future steps for canine management. Conflicts between free roaming dogs and people are a pressing issue worldwide, and a focus on prevention strategies through education, rather than rapid extermination, would be of benefit.

Human rabies post exposure prophylaxis in Bhutan, 2005–2008: Trends and risk factors

The aim of this study was to understand the use and distribution of human rabies post exposure prophylaxis (PEP) vaccine in Bhutan and to identify risk factors for receiving an incomplete course of the vaccine. We analyzed post exposure treatment records from 28 medical hospitals from 2005 to 2008. Males (59%) accounted for significantly more PEP events than females (41%) across all age groups ( P < 0.001). Children – particularly 5–9 years of age – received more rabies PEP than other age groups. Animal bite and non-bite accounted for 27% ( n = 2239) and 16% ( n = 1303) of rabies PEP, respectively, whilst 57% ( n = 4773) of the PEP events had no recorded information about the reasons for post exposure treatment. Post exposure treatment was provided throughout the year with a higher number during the winter and spring months. The number of PEP events significantly ( P < 0.001) increased between 2005 and 2008, from <1000 to >2800 events, respectively. Significantly ( P < 0.001) more PEP events were reported from the southern parts of Bhutan that are endemic for rabies or those areas in eastern Bhutan that have reported rabies outbreaks than other parts of Bhutan. Forty percent ( n = 3360) of the patients received an incomplete course of vaccine (<5-doses of vaccine intramuscular). Results suggest that patients with animal bite injury were less likely to receive an incomplete vaccine course than non-bite recipients, and patients presented to hospitals in rabies endemic or outbreak areas were less likely to receive an incomplete course than in non-rabies areas or rabies free areas. Similarly, patients presenting to hospitals for PEP during spring and summers months were less likely to receive an incomplete vaccine course than those during other seasons. Public education campaigns need to be conducted in Bhutan to reduce dog bite incidents and also to prevent mass exposures to rabies. A thorough assessment of each individual case based on the WHO guidelines would reduce unnecessary PEP (and therefore costs) in Bhutan.

How to prevent dog bite injuries? Children misinterpret dogs facial expressions

Almost half of school children reported that they were bitten (Beck & Jones,1985; Spiegel, 2000) and in other research, 20% of dog-owning parents reported their child bitten (Wilson, Dwyer and...

How to prevent dog bite injuries? The blue dog

We carried out an empirical assessment of children's learning success using the interactive dog bite prevention CD ‘the blue dog’. In a cross-sectional experimental design, ninety-six 3-, 4-, 5- and...

Rabies Situation in Cambodia

BackgroundRabies, a fatal but preventable zoonosis, is a major public health problem in developing countries. In Cambodia the disease burden is largely underestimated because patients with encephalitis following dog bites are rarely hospitalized and die at home. Since 1998 Institut Pasteur in Cambodia (IPC), Phnom Penh has been the only source of free post-exposure prophylaxis (PEP) and post-mortem diagnosis.MethodsThe 1998–2007 data compiled by IPC was analyzed to describe all treated patients for PEP, results of human testing and confirmed rabies cases, and results of animal testing. From dog bites' characteristics, we defined a suspected rabid dog bite injury (SRDBI) in humans as a bite that was unprovoked, from a dog that died spontaneously, or from a dog that was reported sick. We applied a deterministic probability model to estimate 2007 rabies human mortality nationwide from the estimated incidence of rabid dog bites, the body distribution of bite wounds, and the probability of PEP access.ResultsDuring 1998–2007, 124,749 patients received PEP at IPC (average 12,470; range 8,907–14,475), and 63 fatal human cases presenting with encephalitis following a dog bite were reported, in which 73% were confirmed positive for rabies by direct immunofluorescence assay or by reverse-transcriptase polymerase chain reaction. During 1998–2007, IPC tested 1,255 animal brain samples; 1,214 (97%) were from dogs including 610 (49%) positive samples. In 2007, 14,475 patients received PEP (100 PEP/100,000 people in Cambodia) including 95% who resided in Phnom Penh (615 PEP/100,000) or five neighboring provinces. The predictive model estimated 810 human rabies deaths would occur in 2007 (95%confidence interval [CI] 394–1,607), an incidence of 5.8/100,000 (95% CI 2.8–11.5).ConclusionsAccess to PEP is only sufficient for Phnom Penh residents. In 2007, the estimated rabies related mortality exceeded that of malaria and that of dengue. A national rabies control program is needed to improve surveillance and access to PEP, and to initiate vaccination campaigns in dogs.

Head and neck dog bites in children

1) Demonstrate patterns of dog bite injury to the head and neck in children. 2) Identify treatment outcomes of dog bite injuries to the head and neck. Case series with chart review. Children aged 0 to 19 years, treated for head and neck dog bites at our tertiary care children's hospital (1999-2007), were included. Demographics, dog breed and ownership, seasonal incidence, wound location, characteristics, management, and complications were recorded. Eighty-four children, aged 10 months to 19 years (mean, 6.19 years) underwent primary repair of head and neck dog bite injuries. The cheek (34%) and lips (21%) were involved most commonly. Average wound length was 7.15 cm. Dog bite incidence peaked during summer months. Infection occurred in 10.7 percent. Pulsed dye laser was used to improve cosmesis. Children are vulnerable to head and neck dog bite injuries. Wound healing is excellent despite a contaminated wound. Infections occur infrequently. Pulsed dye laser improves cosmesis.

Rabies as a Traveler-s Risk, Especially in High-endemicity Areas

Rabies is a viral zoonosis, an animal disease transmissible to humans, caused by rhabdoviruses of the genus Lyssavirus. It is almost invariably fatal in humans. Rabies is widely distributed throughout the world and present in all continents. More than 99.,9 % of human deaths from rabies reported worldwide result from the bite of a rabid dog. Prompt and thorough cleansing of the wound, together with administration of immunoglobulin in cases of severe exposure, and immunization with modern vaccines starting immediately after exposure, virtually guarantee complete protection. When assessing the risk of contracting the disease for a traveller visiting a rabies- affected area, to contract the disease one should consider the probability of: rabies exposure that which is directly related to the incidence of rabies in the area and the probability of contact with an infected rabies- susceptible animals, be it either wild or and domestic animals, especially dogs and cats; being provided with the best possible treatment, which depends upon the availability of modern safe and efficacious rabies vaccines and rabies immunoglobulin, and the rabies awareness of the health care providers in charge of rabies prophylaxis in the area where the exposure occurs. This article,paper using a number of examples and recent data on dog bite incidence and vaccine availability in various parts of the world, provides guidance on how to assess the risk and proposes means to avoid or mitigate this risk.