Dog or Other Domestic Animal Bites: Any animal bite that breaks the skin requires three types of management. The first is local wound care. If the wound is minor and only consists of a minor abrasion, it should be thoroughly cleansed with soap and water, and then Neosporin ointment applied. The wound should be carefully watched for signs of secondary infection (pain, swelling, redness, red streaks, fever, discharge). If these symptoms should occur, an appointment should be made. If the wound is more extensive involving more than just a minor abrasion, then you should call the doctor. Antibiotics are advised for some animal bites.
The second part of management of animal bites involves the prevention of rabies from the bite exposure. If the animal is well known and has been vaccinated against rabies, there is little chance that your child will catch this disease. The offending animal should be confined for ten days and observed. If the animal is healthy at the end of ten days, the child has no need for rabies prevention. If, however, your child is bitten by a stray or wild animal, an animal which cannot be found or an animal that subsequently dies, it is very important to bring this to our attention immediately. Rabies immunization may be needed. The Arkansas State Health Department can help with the decision on whether Rabies prevention is needed. Sick or dead wild animals should be strictly avoided because of the risk of rabies. Bats are also particularly prone to carrying rabies. They should be avoided. If your child should be bitten by a bat, you should bring this to our attention.
Lastly, as with any other wound, it is important that the child be up-to-date with her immunization to tetanus. After an animal bite or other dirty wound, a tetanus immunization is required if the child has not had one in the past five years. If your child is not up-to-date and she does suffer a wound, you should bring her to the office during regular office hours.
Human Bites: Human bites should be treated like domestic animal bites with evaluation by the physician if a significant break in the skin occurs. Of course, the offending biter should not be kept up for ten days. He should just be appropriately punished.
Insect Bites and Stings: Most insect bites and stings are not dangerous unless the child is severely allergic to a particular bite or sting. These bites however can be quite painful. Please know that wasp and hornet stings can create a large circular area of redness around the site of the sting. Only if these become large (bigger than 4 or 5 inches), do we become concerned.
Treatment:
- If the stinger is present, remove it with a horizontal scraping motion.
- Place a cold compress on the bite for several minutes to reduce swelling and resulting redness of the bite or sting. You should expect some redness and swelling to occur. You should call the office if this becomes severe (redness and swelling 4 or 5 inches in diameter).
- Treat with Benadryl elixir (see Dosing Guide) to help relieve the symptoms.
- Apply 0.5% Hydrocortisone ointment or cream to the area to help with further itching. This is available without a prescription.
- Go to the nearest emergency room if your child develops difficulty in breathing and or becomes very pale and begins to feel faint.
- Use acetaminophen (Tylenol) for pain (see Dosing Guide)
Snake Bites: Nonpoisonous snake bites are treated the same as bites from a dog or other domestic animal. Reptile bites do not cause rabies. If your child has been bitten by a poisonous snake, he should be taken immediately to the nearest hospital. You should make no effort to treat this yourself. Cutting the wound, oral suction, suction from snake bite kits, ice compresses, etc., are no longer recommended for poisonous snake bites.
Tick Bites: A lot of attention has been focused on the diseases which can be transmitted by tick bites. The four most notable of these are Lyme disease, Erlichiosis, Rocky Mountain Spotted Fever and Tularemia. Lyme disease usually begins with a rash, usually in the form of a ring which slowly enlarges around the site of the tick bite. The rash develops over a period of several days to weeks after an infected bite. Associated symptoms may include fever, enlarged lymph glands, headache, fatigue and swollen, sore joints. This disease generally takes several days up to a few weeks to fully develop. Thankfully, the ticks that carry Lyme disease are not endemic in Arkansas. Therefore, if you are bitten by a tick from Arkansas, you can rest 99.9% assured that you do not have Lyme disease. People bitten by deer ticks from the northeast section of the US, do have cause for concern when a rash develops as described above. A US map showing where Lyme disease occurs can be viewed at http://www.cdc.gov/lyme/stats/maps.html.
The symptoms of Rocky Mountain Spotted Fever are high fever, headache and rash in association with a recent tick bite. This disease in contrast to Lyme disease has a much more rapid course. Erlichiosis is very similar to Rocky Mountain Spotted Fever, except that it rarely causes a rash. All three diseases are treatable with antibiotics. If your child has a history of a recent tick bite and high fever and a headache, you should be seen by the physician within 24 hours.
The best treatment for all of the tick-borne diseases mentioned above is prevention. A simple measure taken every day can prevent these diseases. If your child has been playing in an area which might be infested with ticks, you should inspect the entire area of your child’s skin each evening. If a tick is found, remove it with forceps (tweezers), grasping the tick nearest the mouth and pulling it straight out. Tick-borne diseases such as Lyme disease, Erlichiosis, Tularemia and Rocky Mountain Spotted Fever can be prevented by removing an infected tick before 12 to 24 hours have elapsed from the attachment of the tick.
Wild Animal Bites: The physician should be called immediately with any wild animal bite.