Dog Bite and Rabies: What to Do First

A dog bite is not just a wound to bandage. WHO reports that dogs are responsible for up to 99% of human rabies cases, and that once rabies symptoms begin the disease is fatal in every case. The reassuring part is that treatment given soon after a bite works extremely well.

What should you do in the first minutes?

Washing the wound is the single most important first step, and it has to be thorough.

1. Wash the wound with soap and running water for at least 15 minutes. WHO and CDC both give this exact instruction. Fifteen minutes feels long, so time it rather than guessing.
2. If it is bleeding heavily, press a dry dressing or clean cloth firmly onto the wound.
3. If the bleeding is light, the NHS advises gently squeezing the wound so it bleeds a little, which helps flush out dirt and germs.
4. Pat the area dry and cover it with a clean dressing.
5. Go to a clinic or hospital the same day. Do not wait to see whether the wound becomes infected.

Why is speed so important?

WHO explains that rabies spreads through saliva, usually through bites or scratches, or when saliva touches the lining of the eyes, nose or mouth. The incubation period is usually 2 to 3 months but can range from one week to a year, depending on where the virus entered the body. Early symptoms are fever and a tingling or unusual feeling at the wound site. Once the virus reaches the central nervous system and symptoms appear, rabies is fatal in 100% of cases.

That is why the treatment given after an exposure, called post-exposure prophylaxis, matters so much. CDC says it is highly effective when given as soon as possible after the exposure. WHO describes it as washing the wound, a course of rabies vaccine, and, where the contact was more serious, rabies immunoglobulin or monoclonal antibodies as well. Minor scratches usually need the vaccine; deep bites or contact with the eyes, nose or mouth also need immunoglobulin. A health worker decides which parts you need.

Rabies kills around 44,000 people a year worldwide, and about 40% of those deaths are in children under 15. Children are bitten more often and may not mention a small bite or scratch, so ask directly whether a child has been near a stray animal.

What should you tell the clinic?

• What kind of animal it was
• Whether it behaved strangely or aggressively, and whether it was a stray
• Whether it is someone's pet and has proof of rabies vaccination
• When your last tetanus injection was

The NHS notes that medical staff will check your risk of both tetanus and rabies and give preventive treatment if it is needed. If you are not sure whether you had direct contact with a possibly rabid animal, CDC advises asking a health professional rather than deciding for yourself.

When to see a doctor

See a health worker after any bite or scratch from a dog, cat, monkey, bat or other mammal, even if the wound looks small. Get help the same day if:

• Something may be left in the wound, such as a tooth, hair or dirt
• The bite is on the hand, foot, face or head
• The wound becomes hot, swollen or discoloured, or leaks fluid or smells bad
• You develop a fever or chills
• Your last tetanus injection was more than 10 years ago, or you are not sure
• The bite came from a human rather than an animal

For a large or deep wound, or bleeding you cannot stop, call Rescue 1122 where available, or go to the nearest hospital emergency department.