Animal bites should be treated ‘like a car accident,’ says health department

An animal bite can be dangerous. The Buncombe County Public Health Department typically receives upward of 1,000 bite reports yearly, according to Buncombe public health nurse Susan Creede.

Since the beginning of 2024, there have been 930 bite reports filed, she says. The Public Health Department and the county Sheriff’s Office Animal Control Department investigate every one. And so far this year, there has been sufficient concern about potential exposure to rabies that Public Health recommended people begin to take postexposure prophylaxis (PEP) in 178 of those cases.

Creede and Jessica Silver, county environmental health program manager, spoke with Xpress about the procedure for getting PEP after an animal bite, indicators that an animal might have rabies and what to know about bats in your house.

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

What should someone do if bitten by an animal?

Susan Creede: The best thing that anybody can do is treat a bite like a car accident. If you get bit by a dog, get that dog’s name, the owner’s name, phone number, address and vet. Animal Control will follow up with the vet to verify the status of the animal’s rabies vaccine status. If we know [the owner’s] phone number and where they live, that makes the process seamless. … Any bite, any break in the skin, we need to know about it.

Walk me through what happens – to the human and to the animal – if someone is bitten. 

SC: Say you’re out hiking in Bent Creek and a random dog chomps your leg. [That would require filing a] bite report. The doctor’s office, the hospital, urgent care — they’re all obligated by law to report a bite to us and to Animal Control. Then we in Public Health deal with the human side of things, and Animal Control handles the animal portion.

Animal Control will attempt to locate and quarantine that dog. If we can quarantine the dog, there’s a 10-day quarantine that happens in the home. The dog is not euthanized, the dog is not taken away. Quarantine has some guidelines — simple things like don’t let your dog out in the front yard unattended, and for them to pee and poo, they need to be on a leash, and [keep the dog away from] other dogs or other humans. So if you were having a dinner party, you want to keep that dog locked up in a room.

At the end of the 10 days, Animal Control either stops by the house or does a FaceTime call with that family and observes the dog. If the dog is alive, we’re done. We know that rabies will take over a domesticated animal within 10 days, and that is the [reason for] the quarantine. So if we can just keep that dog away from others and quarantined in the home, then we know [it doesn’t have rabies].

Tell me about postexposure prophylaxis for rabies. When would the Public Health Department recommend a person who has been bitten start taking PEP?

SC: [If an animal is quarantined and it is alive after 10 days], we do not recommend PEP. Now, if that animal were to die on day seven, we could send it for testing and verify if it did or did not die from rabies. If the lab/animal resulted positive for rabies, we would recommend PEP to start immediately.

[If we can’t locate the animal], which happens now and again, we would have to recommend you start PEP. … Every bite, until you do your investigation is a potential exposure to rabies.

What’s the procedure like for PEP? The patient needs to have a lot of shots over a period of a few weeks, correct?

SC: It’s a lot of shots. If you are recommended to get PEP, it must start at the hospital because you have to get a shot of the immunoglobulin. It’s known as HRIG (human rabies immune globulin). That just gives you immediate protection; it’s like a jump start to your immune system. While you’re in the hospital, you’re probably going to get an antibiotic for that bite, and you should get an updated tetanus shot. There’s a bunch of shots that happen on day zero.

The rest of the shots are on a schedule. Day zero [requires going to the] hospital; then on day three, you return for shots, [and then you return again on] day seven and day 14. … That schedule is designed [for shots to be administered] at 10 a.m.-2 p.m. perfectly. We can never give a shot early. If something happened, we could give it a little bit late, but for full protection, you want to stick to that schedule to the best of your ability.

What animal bites are the most common?

SC: It’s a variety. Any bite is reportable by law — a raccoon bite, a squirrel bite, bear bite, dog, cat, groundhog. Most of them are [from a] dog. The animals that we’re most worried about are bats, raccoons, foxes, coyotes, skunks. Those are our highest vectors — they can transmit rabies more often than other animals.

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

Jessica Silver: The majority of the wild animals that I know that have bitten people have been from people being overly friendly — like “Oh, it’s a raccoon, let me touch it, let me play with it, let me feed it.” [With] wildlife, regardless of how cute it looks, [you] should stay away — not try to pet them or pick them up.

SC: It is primarily feeding – people feeding a deer or raccoon. The animal approaches and approaches, but it’s still a wild animal and it’s going to bite if it gets spooked.

[We have] our good Samaritans who try to rescue an animal who’s been hit by a car or injured on the side of the road. They pick the animal up and get it to safety. Oftentimes, an injured animal [may] bite. That includes wild or domestic animals.

If you’re a good Samaritan in that way, make sure you’ve got good gloves and a heavy towel. We don’t recommend doing it at all — but if you’re going to be that person, you need to have equipment.

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

SC: Animals will act strangely, like a raccoon shouldn’t be out during the daytime. They’re typically aggressive, fearless. They might be staggering. They could have a seizure. Lots of times they’re drooling. That’s where rabies lives, in the saliva. …

You’re going to want to keep your [pets] away from an animal that is presenting differently or poorly. You’re certainly not going to let your children or loved ones anywhere near it. Again, that animal is not going to survive greater than 10 days if it has rabies. It’s going to crawl off into the woods and die pretty quickly. Probably sooner than 10 days, really. You should never try to feed it or help it. Just let nature take its course.

Is there anything else you want people to know about animal bites and rabies?

JC: Bats are unique critters in that their teeth are so sharp that you don’t necessarily know you’ve been bitten. Let’s say you take a nap on your sofa, you wake up and you see a bat in the house — you’ll definitely want to call Animal Control, and Animal Control officers can come out and help capture the bat and send the bat for testing. … You never, ever want to let a bat go.