Animal Bites 

  • Author: Suzanne K Doud Galli, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Sep 23, 2011
 

Background

Animal bites are not uncommon occurrences. However, victims who are treated in emergency centers represent only a small percentage of all bite victims. Although notification is mandatory in many states, an estimated 50% of all dog bites are not reported.

Most animal bites are dog bites (80-90%). Cat bites make up approximately 10%, and bites from miscellaneous animals and rodents also contribute to these figures.

Most animal bites occur on the extremities, but the head and neck region is also often affected. Animal bites to the face are most commonly made by dogs or cats. Of all dog bites, 9-36% occur to the head and neck region. The head and neck region is injured in 6-20% of persons who sustain cat bites. Children are injured more frequently in the head and neck region than adults.

Most bites occur in the summer months in the late afternoon. Additionally, most bites occur in the victim's home or in the home of a friend or relative. Often, the animal is known to the victim (eg, a pet).

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Pathophysiology

Although the risk of infection exists in any bite situation and proper wound management is required, animal bites to the head and neck require special considerations. The intimate juxtaposition of vital structures and the cosmetic issues of the head and neck region warrant special care for animal bite wounds to these areas.

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Epidemiology

Frequency

United States

Animal bites account for 1% of the emergency department visits in the United States. Up to 4.5 million people are treated for animal bites each year.

International

In studies from England and Scotland, animal bite injuries account for 3% of emergency department visits. In Switzerland, up to 23,000 people are treated for animal bites and scratches annually.

Mortality/Morbidity

Animal bites can lead to infection, and, if treated appropriately, patients can avoid this risk. Other complications include sepsis, osteomyelitis, septic arthritis, and even death. Fatalities are uncommon, but an average of 10-15 deaths occur following dog bites each year in the United States. Most of these fatalities are children who sustain bites to the head and neck region. Even a minor bite to a major vessel can lead to hemorrhage in a small child. Skull fractures resulting from dog bites have been reported.

Race

Epidemiologic data have failed to demonstrate an association between race and bites.

Sex

In general, animal bites occur with equal incidence in men and women. However, dog bites occur more frequently in men and boys, while cat bites occur more frequently in women and girls.

Age

Animal bites occur more frequently in adults. However, children have a higher percentage of head and neck bites. Additionally, bites in children are more likely to warrant medical attention.

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Breed

The breed of the dog has been reported for some bites. Most bites (>50%) are inflicted by working dogs, which includes German shepherds, Doberman pinschers, collies, Great Danes, huskies, and mixed shepherd-type dogs. Sporting dogs, such as spaniels, retrievers, pointers, and setters, are implicated less frequently. Cats are not typically identified by breed.

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Contributor Information and Disclosures
Author

Suzanne K Doud Galli, MD  PhD, FACS, Consulting Staff, Cosmetic Facial Surgery, Private Practice

Suzanne K Doud Galli, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Rhinologic Society, and Triological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Philip J Miller, MD, FACS  Assistant Professor, Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, New York University School of Medicine

Philip J Miller, MD, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngic Allergy, American College of Surgeons, American Medical Association, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Clark A Rosen, MD  Director, University of Pittsburgh Voice Center; Professor, Department of Otolaryngology and Communication Science and Disorders, University of Pittsburgh School of Medicine

Clark A Rosen, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Pennsylvania Medical Society

Disclosure: Bioform Medical Consulting fee Consulting; Bioform Medical Consulting fee Speaking and teaching

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Dominique Dorion, MD, MSc, FRCSC, FACS  Vice Dean and Associate Dean of Resources, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Sherbrooke Faculty of Medicine, Canada

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

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