Infection is the main complication that arises from animal bites and bites from humans. Infected bites rarely cause serious problems, as long as they are promptly treated using antibiotics.
However, infected animal bites can lead to more serious secondary infections, including:
Signs of a serious secondary infection include having a high temperature (fever) of or above 38C (100.4F) or feeling unwell.
Immediately contact your GP if you think that you may be developing a more serious secondary infection. If this is not possible, telephone NHS Direct (0845 46 47) or your local out-of-hours service for advice.
Post-traumatic stress disorder (PTSD)
It is estimated that around one-in-four children who require hospital treatment for a severe dog bite (and one-in-10 who require treatment for a moderate dog bite) will develop post-traumatic stress disorder (PTSD).
PTSD is a psychological condition where a person relives a past traumatic event. In children, this usually takes the form of repeated nightmares and becoming very nervous and frightened around dogs.
Other symptoms of PTSD in children may include:
- refusing to go outside unless accompanied
- becoming unusually shy with friends and family or becoming unusually aggressive
- a lack of interest in games or school activities
- fear of the dark
- fear of being left alone
PTSD may resolve within a couple of months. However, if the symptoms persist or worsen, your child may require treatment.
Treatment options for PTSD in children include cognitive behavioural therapy (CBT), a type of talking therapy that aims to change patterns of negative thinking or behaviours.
CBT for PTSD often focuses on helping the child realise that while fear and distress are very real and upsetting emotions, it is possible to take control of fear and distress.
Never force your child to be in close contact with a dog in an attempt to overcome their fears if they are in obvious distress. This could make their symptoms worse and prolong treatment.
Read more about the treatment of post-traumatic stress disorder.
Tetanus
It is possible to catch tetanus from an animal or human bite. Tetanus is a potentially fatal infection of the muscles and nervous system.
The bite itself does not cause tetanus but it allows a break into the skin that can provide the tetanus bacteria ("Clostridium tetani") with a way to enter the body.
The most common symptom of tetanus is stiffness in your jaw muscles. This is sometimes known as lockjaw. It can make it difficult for you to open your mouth. Muscle stiffness and spasms can then spread to other parts of your body.
The symptoms of tetanus can develop from four to 21 days after the infection has taken place.
If you do have a bite that has a risk of being infected by tetanus then you can be given tetanus immunoglobulin (TIG).
TIG is a medication that contains antibodies that kill the tetanus bacteria. Antibodies are infection-fighting cells. TIG is given as an injection into a muscle and gives immediate, short-term protection against tetanus.
Read more about treating tetanus.
Immunisation is the best way to prevent tetanus. The complete course of the tetanus vaccination consists of five doses. In the UK, all children are routinely offered the tetanus vaccination as part of the NHS childhood immunisation programme.
As an adult, if you are unsure about whether or not you have been fully immunised against tetanus, speak to your GP or practice nurse. They will be able to advise you about having a booster injection.
Rabies
Rabies is a potentially fatal infection of the nervous system. It is possible to catch rabies from an animal bite and, in rare cases, the disease can be caught if you have a scratch or an abrasion, or from licking open wounds.
Most cases of rabies occur in Africa, Asia (particularly India) and central and southern America. Some cases have been reported in Europe – mostly in Eastern Europe.
You may need immunisation for rabies if you are visiting these areas or you have a job that involves coming into contact with animals that have been imported from abroad.
See preventing rabies for more details on the rabies vaccinations and who should have it.
It was thought that rabies had been wiped out in all animals in the UK. However, some bats have been found to carry the disease. If you are bitten by a bat in the UK, your bite should be immediately assessed and, as a matter of urgency, you should be given the rabies treatment to prevent rabies developing. The same advice applies if you have received a bite from an animal while you are abroad in a country where rabies is widespread.
Treatment to prevent rabies developing is known as post-exposure prophylaxis. You will be given one dose of rabies immunoglobulin (a blood product that contains antibodies against rabies) and five doses of the rabies vaccine. If exposure to rabies is uncertain, the vaccination on its own may be considered.
Read more about preventing bites.
