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June 23/30, 2020

Dog Bites

Author Affiliations
  • 1Fishbein Fellow, JAMA
JAMA. 2020;323(24):2535. doi:10.1001/jama.2020.1993

Dog bites can cause severe injury and infection if not treated promptly.

Who Is at Risk of Dog Bites?

Although there are many animals that can bite humans, dogs are among the most common. Dog bites cause an estimated tens of millions of injuries every year around the world.

Children are at higher risk of animal bites, particularly by dogs. Children are also at greater risk of bites to the head and/or neck, which can cause more severe injury and sometimes death. Households with dogs and adults with 2 or more dogs are more likely to incur a bite compared with those without pets. Travelers may also be at greater risk of dog bites, depending on the geographical location and activities associated with travel.

Complications of Dog Bites

Infection, particularly after deep or severe wounds, is an important possible complication after a dog bite. Bleeding, pain, skin tearing, and potential muscle or bone injury can also occur. In rare cases, dog bites can lead to tetanus, a bacterial infection that can cause painful muscle contractions and occasionally difficulty breathing, as well as rabies, a viral infection that causes confusion and agitation and is nearly always fatal if not treated.

Treating Dog Bites

Treatment depends on the health of the person bitten, location of the bite, and risk of rabies transmission from the animal. Open wounds from an animal bite should be evaluated immediately by a health care professional because they are at risk of infection. The wound will be thoroughly cleaned. The patient may be given antibiotics if the bite wound is severe or if signs of infection occur, such as fever or redness/swelling that spreads rapidly around the bite. Bites on the hand are at especially high risk of infection. An x-ray scan may be performed. Surgery may be required depending on the severity and depth of the wound. A tetanus vaccination may also be given to prevent infection. Rabies vaccination occurs over a period of several days and might be also be administered, depending on where the bite occurred geographically and the circumstances of the bite.

What to Do if You Are Bitten

Clean the area with soap and water. A large volume of water is best; putting the wound under a faucet to wash with lots of water is an effective method. If the wound is deep and bleeding, apply pressure with a clean, dry cloth and seek medical care immediately. For other serious symptoms, including extreme pain, exposure of underlying muscle or bone, or difficulty moving the bitten limb, or if you do not know the rabies status of the dog or when you had your last tetanus vaccination, it is important to go to the nearest health care clinic or hospital as soon as possible for evaluation and treatment. Report the bite to a local animal control agency or police department, particularly if you do not know the dog or observed the dog acting strangely. Consider contacting the owner to verify rabies vaccination status.

Preventing Dog Bites

Avoid unfamiliar dogs. Do not disturb dogs that are sleeping or eating. Make sure small children are supervised if playing with a dog. If approached by a dog you do not know, do not run or make loud noises.

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Article Information

Conflict of Interest Disclosures: None reported.

Sources: Centers for Disease Control and Prevention. www.cdc.gov/features/dog-bite-prevention/index.html

Raff AB, Kroshinsky D. Cellulitis: a review. JAMA. 2016;316(3):325-337. doi:10.1001/jama.2016.8825

World Health Organization. www.who.int/news-room/fact-sheets/detail/animal-bites