Animal bites should be treated “like a car accident,” says Ministry of Health

An animal bite can be dangerous. The Buncombe County Health Department receives over 1,000 reports of bites each year, according to a Buncombe Public Health Department nurse. Susan Creede.

Since the beginning of 2024, she says, 930 bite reports have been received. The county sheriff's office's health department and animal control are investigating each and every case. And so far this year, there have been so many concerns about possible rabies exposure that the health department recommended that people take post-exposure prophylaxis (PEP) in 178 of those cases.

Creede and Jessica SilverHead of the county’s environmental health program, spoke with Xpress how to administer PEP treatment after an animal bite, signs that an animal may have rabies, and what you should know about bats in your home.

This interview has been condensed for length and edited for clarity.

What should someone do if they have been bitten by an animal?

Susan Creede: The best thing to do is to treat a bite like a car accident. If you are bitten by a dog, write down the dog's name, owner's name, phone number, address, and veterinarian. Animal control will contact the veterinarian to check the status of the animal's rabies vaccination. If we know [the owner’s] Phone number and place of residence, that makes the process smooth. … Every bite, every injury to the skin, we need to be informed about it.

Explain to me what happens – to the person and the animal – when someone is bitten.

SC: Let's say you're hiking in Bent Creek and a strange dog bites your leg. [That would require filing a] Bite reporting. The doctor's office, the hospital, the emergency room – they are all required by law to report a bite to us and to animal control. Then we at the health department take care of the human side of the matter, and animal control takes care of the animal side.

Animal control will try to find the dog and quarantine it. If we can quarantine the dog, there is a 10-day quarantine that takes place in the house. The dog will not be euthanized, the dog will not be taken away. The quarantine has some guidelines – simple things like: do not let your dog out in the front yard unsupervised, and in order for him to pee and poop, he must be on a leash, and [keep the dog away from] other dogs or other people. So if you are hosting a dinner party, consider locking the dog in a room.

At the end of the 10 days, animal control either comes to the home or makes a FaceTime call with the family and observes the dog. If the dog is alive, we are done. We know that rabies affects a pet within 10 days, and that is the [reason for] the quarantine. So if we can just keep the dog away from others and quarantine it at home, then we know [it doesn’t have rabies].

Tell me about post-exposure prophylaxis for rabies. When would the health department recommend that a bitten person start taking PEP?

SC: [If an animal is quarantined and it is alive after 10 days]we do not recommend PEP. If the animal were to die on the seventh day, we could send it for testing and check whether it died of rabies or not. If the lab/animal tests positive for rabies, we recommend starting PEP immediately.

[If we can’t locate the animal]which does happen from time to time, we must recommend that you start PEP. … Each bite represents a potential rabies infection until you carry out your examination.

How does PEP treatment work? The patient has to receive many injections over several weeks, right?

SC: That's a lot of vaccinations. If you're recommended to have PEP, it will have to start in hospital because you'll have to get an immunoglobulin shot. It's known as HRIG (human rabies immunoglobulin). That gives you immediate protection; it's like a jump start for your immune system. While you're in hospital, you'll probably get an antibiotic for the bite and you should get a booster shot for tetanus. There are a lot of vaccinations given on day zero.

The remaining recordings are planned. Day zero [requires going to the] Hospital; then on the third day you come back for injections, [and then you return again on] Day seven and day 14. … This schedule is designed [for shots to be administered] from 10 a.m. to 2 p.m. is perfect. We can never give a shot too early. If something happens, we could do it a little later, but for full protection you should stick to this schedule as best as possible.

Which animal bites are most common?

SC: It is a variety. Every bite is reportable by law – a raccoon bite, a squirrel bite, a bear bite, a dog, a cat, a groundhog. Most of them are [from a] Dog. The animals we are most concerned about are bats, raccoons, foxes, coyotes and skunks. These are our most common vectors – they can transmit rabies more often than other animals.

How do people come into contact with some of these animals?

Jessica Silver: Most of the wild animals I know of that have bitten people have been due to excessive kindness from people saying, “Oh, that's a raccoon, let me touch it, let me play with it, let me feed it.” [With] Wild animals, no matter how cute they look, [you] should stay away and not try to pet or pick them up.

SC: It's all about feeding – people feed a deer or a raccoon. The animal comes closer and closer, but it's still a wild animal and will bite if frightened.

[We have] our Good Samaritans who try to save an animal that has been hit by a car or is injured on the side of the road. They pick up the animal and bring it to safety. Often an injured animal [may] bite. This applies to both wild and domestic animals.

If you're a Good Samaritan in this regard, make sure you have good gloves and a thick towel. We don't recommend doing it at all – but if you want to be that person, you need the appropriate equipment.

Can you tell if an animal has rabies just by looking at it?

SC: Animals behave strangely, as if a raccoon should not be outside during the day. They are usually aggressive and fearless. They might stagger. They might have a seizure. Often they drool. That is where rabies lives, in the saliva. …

You will [pets] Stay away from an animal that appears different or sick. You certainly won't let your children or loved ones near the animal. Again, if the animal has rabies, it won't survive more than 10 days. It will crawl into the woods and die pretty quickly. Probably even sooner than 10 days. You should never try to feed it or help it. Just let nature take its course.

Is there anything else you would like to tell people about animal bites and rabies?

JC: Bats are unique creatures whose teeth are so sharp that you may not necessarily realize you've been bitten. Let's say you're taking a nap on your couch, wake up, and see a bat in the house – you should definitely call animal control, and animal control workers can come over and help capture the bat and send it for examination. … A bat should never be released back into the wild.