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Human bite by a dog

Medical expert of the article

Internist infectious disease
, medical expert
Last reviewed: 04.09.2021

Currently, there is a large number of infectious diseases (zoonoses) that are transmitted from person to animal. These diseases include, for example, rabies, leptospirosis, leishmaniasis, various psittacosis, tetanus. For example, a common human dog bite can lead to various pathologies. One of the most dangerous consequences is infection of a person with rabies (if the dog has been infected). [1]

Why is a dog bite dangerous for humans?

The consequences of a dog biting a person can be unpredictable. The bite of a wild dog is especially dangerous for humans. The stronger the bite, the more likely the dog will transmit an infection. Usually, the saliva of a domestic dog is bactericidal, and has a disinfecting and wound healing effect. But a wild or stray dog can be infected with many infectious diseases, pathogenic for humans as well. Most often, rabies is transmitted from the dog  . [2]

Symptoms of the dog bite

It is usually impossible not to notice a dog's bite, since it is quite noticeable. One can feel both the pressing of the jaws and the direct damage to the skin caused by the teeth and canines. Particularly noticeable is the rupture of the skin surface, or the development of hematoma, subcutaneous bleeding. Almost always, bites are accompanied by pain, burning, the affected area and the skin around it bake, itch. Redness, swelling, swelling of the surrounding soft tissues may develop around. It is almost impossible not to feel the dog's bite.

Rabies in humans after a dog bite

A dog bite (if infected) can lead to the development of rabies in humans. In humans, rabies is severe and often fatal. Symptoms develop in the same way as in animals.

It is transmitted from the dog through saliva. The most severe and final manifestation of rabies is the stage at which photophobia, hydrophobia, develops. Movements become uncontrollable, aggressive. As a rule, this indicates the onset of a difficult stage, after which death occurs, and nothing can be done. [3]

The causative agent is a  virus belonging to the Lisavirus family. From the focus of infection, the virus spreads along neurogenic pathways: there is a gradual spread of the virus towards the brain. The peculiarity of this disease is that a dominant is formed in the brain of the affected person and animal, which is represented by the hypothalamus, medulla oblongata and subcortical structures. They are characterized by increased excitability, and are characterized by the fact that they block impulses from all other areas. Accordingly, whatever signal arrives at the brain, only the acting dominant reacts to it.

It is from this dominant that a response signal comes in the future, which manifests itself in the form of motor hyperactivity, uncontrolled movements, convulsions, and excessive aggressiveness. The reactivity and susceptibility of the whole organism gradually increases, at the same time, its endurance and resistance decrease, a decrease in the immune system develops, and the hormonal background is disturbed.

It was also found that there are a number of other manifestations of the disease that are in no way associated with any specific site of localization of the virus. [4]

When analyzing the pathological picture of the pathology of rabies, a peculiar picture appears. It is worth noting that there are individual cases in which no pathology is noted at the autopsy. As strange as it sounds, the absence of any changes during autopsy is also an important diagnostic sign of rabies. Additionally, you need to take into account clinical data, anamnesis.

An external examination of an infected patient indicates that all visible mucous membranes are blue. This is especially pronounced in the area of the eyes, lips, mouth and nasal cavity. The skin becomes dry enough and is highly sensitive. One of the main signs of rabies is emaciation, dry mouth, and increased weakness. It should be noted that bites, scratches, and other injuries are often found on the surface of the skin. Many wounds, scratches, abrasions are found on the body.

The virus can be found in fairly large quantities in the salivary glands, as well as in the discharge of the eyes, mouth and nasal cavity. The virus is often found in lung tissue, mucous membranes, liver, kidneys, uterus, heart and skeletal muscles. The virus is found in large quantities in the salivary glands, where not only its accumulation, but also reproduction takes place. This is what determines the infectivity of saliva in patients with rabies. A large number of viruses accumulate in the nerve elements, in connection with which neuro-inflammatory, degenerative processes often develop. [5]

The clinical picture is presented mainly by an increase in body temperature. The separation of mucus and saliva is significantly increased, there is increased sweating, heart palpitations, and the level of glucose in the blood rises. The disease is often fatal as a result of progressive paralysis of the respiratory muscles.

Symptoms of rabies in humans after being bitten by a dog

Rabies symptoms are very specific and easy to distinguish. In addition, they appear in humans some time after a dog bite. The disease proceeds in several stages. At first, the incubation period lasts for 3-4 weeks. The virus has entered the body, but it remains either directly at the site of the bite, or accumulates in the nearest lymph nodes and blood vessels, or slowly moves towards the brain. The main manifestations of the disease begin when the virus entered the brain and began to multiply intensively there.

The main reproduction of the virus occurs in the brain and spinal cord, and its accumulation also occurs there. Numerous attempts have been made to identify the relationship between the morphological changes that the virus undergoes and the clinical manifestations of the disease. For example, disorders of the somatic nervous system, such as paralysis, paresis, hemiparesis, are often associated with damage to the brain and spinal cord by the virus.

The duration is primarily determined by how far the bite is from the brain. The closer to the brain, the faster the main symptoms of rabies appear. Also, a lot depends on the severity of the bites inflicted, the amount of the virus that entered the body, on its activity, virulence, as well as on individual resistance, the state of the immune system, the general resistance and endurance of the body of a bitten person or animal.

The disease proceeds quickly, develops rapidly. The clinical picture is similar in all animal species. Rabies usually proceeds relatively quietly, in a paralytic form. The violent form is extremely rare. In a quiet form, after the incubation period, the main course of the disease immediately begins. This stage usually manifests itself as paralysis and ends in death. Most often, they die from paralysis of the respiratory muscles. [6]

In a violent form, several stages are observed. So, after the incubation period, which can be much longer, the prodromal stage begins, which is the initial stage of pathology. The duration of this stage ranges from 12 hours to 3-4 days. First of all, the state of a person, his behavior, appearance changes dramatically. The person usually looks sad, depressed. Due to photophobia, he begins to hide in dark places, to hide in corners.

Gradually, as the virus multiplies, the disease progresses, anxiety and fear build up. She may have increased excitability, motor activity increases. The person behaves inappropriately. For example, he often catches air with his mouth, as if he is trying to catch a fly, flinches from light touches, and becomes overly sensitive. The voice often becomes hoarse, fearfulness gradually builds up, and at the same time aggressiveness. The first signs of paralysis of the respiratory and chewing muscles appear, which manifests itself as cough, spasm in the throat, hoarseness and congestion of the throat, difficulty swallowing. The impression often arises that a person is suffocating. Drooling begins. The appearance of these signs indicates the transition of the disease to the next stage.

The next stage is the stage of arousal, which lasts 3-4 days on average. At this stage, a sharp feeling of fear is noted, the person becomes aggressive, fearful. A characteristic feature is the desire to run away, to move a lot and randomly, the desire to hide, to retire. Strabismus is clearly expressed. The jaw drops downward, making it difficult to eat and eat.

Attacks of rage, violence are noted, which alternate with stages of an oppressed, depressed state. Usually, a depressed state occurs when a person, exhausted, lies motionless on the floor. At this time, he can no longer eat or drink. Convulsions are noted. Paralysis of muscles, including smooth muscles, may develop. Each seizure is often accompanied by seizures, paralysis, and loss of voice. The lower jaw drops more and more. This stage lasts 1-4 days and is fatal. Death often occurs from paralysis of the respiratory center. The limbs and trunk are also paralyzed. The most dangerous condition is paralysis of the smooth muscles that form the internal organs. On average, the illness is thought to last from 8 to 11 days. But in fact, death usually occurs as early as 3-4 days. [7]

Symptoms of tetanus in humans after a dog bite

Tetanus  after a dog bite is rare. More precisely, it is not a direct consequence of a bite, but occurs when an infection enters the body. As a rule, the infection enters the body through damage to the skin, wound surface, micro- and macro-damage, any violation of the integrity of the skin and mucous membranes. In order to prevent the development of tetanus symptoms, immediately after a dog bite, you need to treat the damaged area.

In humans, tetanus usually develops when a bacterial infection penetrates, which is common in the environment, especially in the soil. Signs are redness, swelling in the area of the bite, and irritation. Sometimes the bite site swells, an inflammatory, purulent-septic process develops.

Complications and consequences

One of the most dangerous consequences of a dog bite is the transmission of an infectious disease to a person. Most often, you can get rabies from a dog. There is also a great risk of developing a bacterial infection if any contamination gets into the wound. Often, when an infection enters, an inflammatory process develops, a purulent-septic inflammation with further necrosis and death of the affected areas. Also, bacteremia, sepsis often develop, with further infection entering the bloodstream, the formation of new foci of infection. [8]

Who to contact?

Treatment of the dog bite

Dog bites are treated with a special anti-rabies serum, which is injected into the victim's body. What exactly to treat will be told by the doctor (traumatologist, infectious disease specialist). Usually, at first, the bite site is treated independently with the help of various antiseptics, then a special anti-rabies serum is injected in a medical institution. Then, further restorative treatment is carried out at home, aimed at healing the damage, eliminating the scar. In this case, various agents prescribed by a doctor are used: ointments, lotions, balms. Homeopathic remedies, ointments prepared according to alternative recipes are used. 

First aid for domestic and wild dog bites

If a dog is bitten, regardless of whether it is domestic or wild, a person needs first aid, and the sooner it is provided, the more favorable the consequences will be. The first thing to do is to sanitize the bite site by treating it with an antiseptic (alcohol, hydrogen peroxide). Then it should be smeared with brilliant green or iodine, or sprinkled on top with crushed streptocide (an antiseptic that prevents the risk of infection and inflammation). After that, a bandage is applied to the bite site. Or they glue it with adhesive tape in order to avoid the risk of infection. After that, it is imperative to consult a doctor (to the nearest trauma center, or to an infectious disease specialist).

The doctor will assess the risk of developing rabies, other infectious diseases, the risk of complications, and take the necessary preventive measures. If there is a risk of developing rabies, special anti-rabies serums are used to prevent the development of the disease. But they can be effective only if the virus did not have time to penetrate the brain and spinal cord, did not invade the nerve ganglia. If this happened, nothing can be done, rabies will progress and subsequently end in death for a person. Therefore, in this case, the speed of reaction is important - the faster measures are taken to provide emergency care, the more likely it is to develop rabies.[9]

An injection after a dog bite to a person

One of the main and most reliable and effective methods of treatment and prevention of rabies is immunoprophylaxis, vaccination, administration of rabies serums, which is based on the formation of stable immunity in response to the introduction of viral material into the body. Therefore, after being bitten by a dog, a person is usually given injections (a special rabies vaccine is administered). The nature of rabies immunity is not fully understood, although since the vaccine was discovered by L. Pasteur, practically nothing has changed. So, the virus enters the body along with the infected saliva, then begins its movement through the body, meets with immune cells.

The virus acts as an antigen, in response to it, antibodies are formed, which provide protection for the body. As a result of the reaction between them, immune complexes are formed, which underlie immunity and further resistance to the disease. The main immunity is formed due to the activation of T-lymphocytes, enhanced synthesis of interferons. The humoral link (B-lymphocytes) is gradually activated.

If a person is vaccinated, the process is much easier. After the organism re-meets the infection, recognition occurs much faster, since there is a primary cellular memory. The disease proceeds faster and easier. Recovery is possible, the risk of death is significantly reduced. [10]

How to treat a dog bite in humans?

The main agents that are used to treat the site of a dog's bite are antiseptics: hydrogen peroxide, alcohol, chlorhexidine, and other skin antiseptics. Local antibiotics and ointments are used. The better to process, the doctor will tell you. A person often has itching, so it is additionally recommended to use anti-itching agents. Alternative and homeopathic remedies prepared at home have proven themselves well. Consider the most commonly used recipes.

  • Recipe number 1.

To prepare the ointment, fish oil, eucalyptus oil, resin of fruit trees in a ratio of 2: 2: 1 are taken as a base, melted in a water bath, or over low heat until dissolved, with constant stirring. Add 2 tablespoons of lemon peel infusion with sugar, cucumber flowers, fresh apples to the resulting mass. All this is mixed until a homogeneous consistency is formed. They remove the fire, give the opportunity to freeze. Apply a thin layer to the bite site, rub in until completely absorbed.

  • Recipe number 2.

As a basis for the ointment, take about 100 grams of interior fat and 50 grams of lard. All this is melted to form butter. A mixture of the following herbal components is prepared in advance in a refractory dish: decoction of wild rose, blue cornflower, wormwood, tincture of sunflower stems (at the rate of about 2 tablespoons of each herb per 150 grams of fat). The oil is heated over low heat (not boiling). As soon as the oil has warmed up strongly enough, but has not boiled yet, remove it from the heat and fill in the herbs prepared in advance. Add dark chocolate grated on a fine grater. Stir, cover with a lid on top, insist in a dark place for a day (at room temperature). The oil is then ready for use. Apply to the bite site and the area around the bite with a thin layer.

  • Recipe number 3.

As a basis, take a mixture of massage base oils (shea butter and shea butter), add 3 egg yolks, 5 ml of castor oil. Stir. Add 2 drops of the following essential oils to the resulting mixture: chamomile, fir, sage. Mix thoroughly.

  • Recipe number 4.

Take any body cream. Add a tablespoon of bitter almond, chamomile and myrtle oils to it. All this is mixed until smooth. Lubricate the bites with a thin layer.

  • Recipe number 5.

To prepare the ointment, lamb fat, wax and bee honey are taken as a base, melted in a water bath, or over low heat until dissolved, with constant stirring. In the resulting mass add 2 tablespoons of oils of rue, laurel, castor oil, as well as the oil of the orchard and dill. All this is mixed until a homogeneous consistency is formed. They remove the fire, give the opportunity to freeze. Apply in a thin layer, rub in until completely absorbed. Apply to the bite site.

Punishment and responsibility when a dog bites a person

The animal owners are obliged to annually vaccinate animals against rabies (in accordance with the law of the Russian Federation "On Veterinary Medicine", veterinary legislation). The state is charged with the responsibility of controlling stray and wild dogs, and other animals that may be a source of infection. When determining the degree of responsibility and punishment, they are guided by veterinary legislation, sanitary and hygienic standards and requirements. When a person is bitten by a dog, the animal that has bitten is taken under control at a veterinary facility. An administrative fine (administrative offense) is attributed to the owner for the violation.

If no signs of rabies appear within 10 days, the animal is returned to the owner. Also, constant work is carried out with wild and homeless animals, if necessary, quarantine is observed, sanitary and hygienic, anti-epidemic measures are organized. This is especially true for sanitary disadvantaged areas. Compulsory vaccination and immunization are carried out.

It should be borne in mind that in all cases all dogs, cats, and other pets that are carriers of rabies must be vaccinated (within the prescribed time frame, in the established order). Special  anti-rabies vaccines  and serums are used that are approved for use on the territory of the state. [11] The documents are marked with vaccinations. Also, vaccinations are given to people in the event that a person has been bitten by a dog.

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