Domestic animal bites in infants: Potential risk of fatal maltreatment

Kobayashi, Tetsuo; Tsurukiri, Junya; Hoshiai, Akira; Konishi, Hiroyuki; Arai, Takao

doi:10.1111/ped.13974

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…3 Among these, animal bites, including canine bites, are recognized as potential sources of tetanus infection. 4 Clostridium tetani spores that enter the wound germinate and multiply in the anaerobic environment of the wound. 5 Tetanus toxin spreads through hematogenous and lymphatic routes, resulting in peripheral motor, cranial, and sympathetic nerve depression and tetanus symptoms, 5 of which muscle spasms and rigidity are the main symptoms.…”

Section: Introductionmentioning

confidence: 99%

Tetanus Following Canine Bite in Japan: A Case Report and Literature Review

Hirai,

Mori,

Shibata

et al. 2023

IDR

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The incidence of tetanus has significantly declined in developed countries owing to widespread vaccination efforts. However, it remains a threat worldwide, including in Japan, because of the sharp decline in antibody titers against tetanus in adults. Animal bites, including canine bites, are potential sources of tetanus infection. This case highlights the rarity of tetanus caused by canine bites and the need for continued vigilance for tetanus prevention. This case report and literature review aimed to shed light on the clinical course and outcomes of tetanus following a canine bite. Case Presentation: A 46-year-old Japanese man with no medical history presented with symptoms of tetanus, such as difficulty in opening his mouth, 19 days after a canine bite on his right hand. He was born and brought up in Japan. He had never been vaccinated against tetanus. Despite washing the wound and receiving human tetanus immunoglobulin (HTIG) and a tetanus toxoid vaccine, the patient developed tetanus. After intravenous metronidazole and HTIG were administered, the symptoms improved gradually. The patient was discharged after a 12-day hospital stay. Discussion: This is the first reported case of canine bite-induced tetanus in Japan, where tetanus toxoid vaccination is provided routinely. This case highlights the waning immunity in adults and the critical need for education on tetanus immunization, including catch-up immunization, particularly for adults and individuals in high-risk occupations. A review of the existing literature revealed only four cases of tetanus following canine bites between 1889 and 2018. All patients experienced symptom onset between 3 and 19 days post injury. Treatment typically involved HTIG, metronidazole, and toxoid administration. A higher risk of mortality is seen in unvaccinated individuals than in vaccinated individuals, highlighting the critical role of tetanus vaccination. Conclusion: Physicians should consider canine bite-induced tetanus in the differential diagnosis when patients exhibit relevant symptoms.

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Section: Introductionmentioning

confidence: 99%

Tetanus Following Canine Bite in Japan: A Case Report and Literature Review

Hirai,

Mori,

Shibata

et al. 2023

IDR

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“…Previous studies reported the incidence of bite injuries [7][8][9][10] and the risk factors for animal bites [11,12]. However, few studies concentrated on the severity of bite wounds.…”

Section: Introductionmentioning

confidence: 99%

The wound severity of animal bite victims visiting rabies prevention clinics and the influencing factors in Central China: a cross-sectional investigation

Liao

Fan

et al. 2021

BMC Public Health

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Background Animal bites are a major public health problem. The more serious the bite wound is, the higher the risk of developing rabies is. This study aimed to investigate the severity of wounds among animal bite victims and identify the influencing factors in Wuhan, China. Methods A cross-sectional study was conducted among 1015 animal bite victims visiting rabies prevention clinics. We performed a face-to-face interview to collect information on the exposure category of the bite wound, the type of the offending animal, exposure-to-risk situations, etc. Factors associated with exposure categories were identified by multivariate logistic regression analysis. Results Five hundred and sixty-four (55.57%) cases were category III exposures, 418 (41.18%) were category II exposures, and 33 (3.25%) were category I exposures. People who were hurt by their own domestic animals (odds ratio [OR] = 1.55, 95% confidence interval [CI]: 1.14–2.10), and those exposed to animals unvaccinated against rabies (OR = 1.45, 95% CI: 1.08–1.95) had a higher risk for category III exposures. Respondents who did not know the fatality of rabies were more likely to be injured seriously compared to those who knew that rabies is fatal, and the OR was 1.40 (95% CI, 1.05–1.86). Conclusions This study showed that factors associated with the severity of bite wounds mainly included types of the offending animal, vaccination status of the animal, and knowledge of rabies fatality. Educational programs and awareness-raising campaigns should be provided to decrease severe animal bites, especially targeting pet owners and those with limited rabies knowledge.

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Domestic animal bites in infants: Potential risk of fatal maltreatment

Cited by 2 publications

References 3 publications

Tetanus Following Canine Bite in Japan: A Case Report and Literature Review

Tetanus Following Canine Bite in Japan: A Case Report and Literature Review

The wound severity of animal bite victims visiting rabies prevention clinics and the influencing factors in Central China: a cross-sectional investigation

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