Dog Bite Prevention and Zoonotic Diseases
Pets are wonderful additions to our families. They provide many benefits for both children and adults. Before getting a pet or once your children reach the age of 3-4 you should start to teach your child about pets, taking care of their pets, and how to treat pets and other animals. It’s a great chance to educate your child, increase their compassion and sense of responsibility.
Despite being part of our family, we have to be cautious around our pets. We need to be wary of dog bites and zoonotic diseases. Today, we will learn about dog bites, dog body language, as well as zoonotic diseases.
There are over 4.5 million bites attributed to dogs every year. Of those 4.5 million bites, 77% of them are from a familiar or well-known dog. Kids are much more likely to be injured and make up over half of the 800,000 people who seek medical attention due to dog bites each year. The most common area to be bit is the head and neck, especially around the eye.
DOG BITE CARE
If your child is bit by a dog, assess the bite. If it is bleeding, apply firm pressure to the wound. A wound that won’t stop bleeding will need immediate medical attention. Also, any severe attack may require 911 or immediate medical attention.
If the wound is small and stops bleeding, make sure to wash the bite with soap and water. You will also need to call your child’s pediatrician. Your child may need antibiotics and potentially a tetanus shot if not up to date with their vaccinations or it has been over 3 years since their last tetanus booster.
It is also important to get the name of the dog owner, their contact information, the dog’s rabies vaccination status, and the information for their dog’s veterinarian to confirm the vaccination status. If it is a stray dog or the dog is not vaccinated against rabies, your child will need to start rabies post-exposure prophylaxis. More information can be found below when we will discuss zoonotic disease.
DOG BITE PREVENTION
How can we prevent dog bites? We need to do two things. First, we need to keep our babies and newly mobile children and dogs separate as discussed in the previous blog. Dogs can be scared of small children with their noises and erratic, impulsive movements. Smaller children can make threatening eye contact, reach out and unexpectedly grab a dog’s face, ears, or fur. By providing your dog a safe space and by placing a physical barrier or your body between your dog and child, you are setting your dog up for success and improving their relationship. You are also lessening the chance of any accidents. We all love our dogs but even the “best” dogs have their limits. Unfortunately, due to their lack of language, the only way they can enforce those limits is through warning signs including snarls, growls, nips, or bites.
As your child gets older, it is important to teach your child about dog’s body language. Knowing how to read your dog’s body language can be a huge help in knowing when to give your dog space or knowing when your dog is enjoying an interaction.
The challenging part about dogs is that they are such people lovers and attached to their adults, they often do not remove themselves from stressful situations. They may feel too stressed to be far from the adult who is their safe person, they may wonder if they are allowed to leave, or they may physically be cornered. It is our job as dog parents to help remove them or a child from a situation that is stressful to your dog.
DOG BODY LANGUAGE
Dog body language can be tricky. There are behaviors that look very similar and can make it hard to tell if they are stressed or relaxed. Also, a dog that has been punished for certain body language or reactions in the past may not show early signs of stress. We need to learn to read their body language but also be willing to step in during an unsafe interaction before any signs are shown.
A relaxed dog will have their ears forward and loose. They will have a relaxed face with a smooth forehead. Their mouth may be open and relaxed and their tongue will be long and relaxed. Their body will look relaxed, they may be lying on their hip. A relaxed dog who is enjoying an interaction may approach that person, may lean into a person and will follow or nudge that person to get more attention.
Ladder of Aggression
Dogs can show many signs of stress, some subtle and some obvious. Dominika Knossalla-Pado, a certified dog trainer who owns and runs Dog Meets Baby (@dogmeets_baby), can help dog parents learn to recognize the ladder of aggression. Dogs will start with small signs of stress and may start to try calming behaviors to indicate to your child that they are not a threat, they don’t want to be hurt, and they are stressed and need to get out of the situation. If they don’t get space or their signals respected, they may move up the ladder of aggression. Not all dogs will show every sign, they can skip levels or quickly escalate to the red zone. It is important to intervene as low on the ladder as possible. The ladder starts with blinks, yawns, and licking and ends with snapping and biting.
Other signs of stress include:
• Shaking when not wet (this is to relieve stress)
• Zoomies (when they run around really fast, back and forth)
• Sniffing at nothing on the floor
• Licking lips
• Panting when they are not hot, or they were not just playing or running
• Whale eyes (opening eyes wide, seeing a lot of the white of the eyes)
• Licking your child continuously (“drive by” licks as they walk by are ok)
• Obsessive licking of their lips or paws, or objects nearby such as the floor
Dogs can also do play signals, such as a play bow or pinning a small child to the ground. These will look like they want to play but is actually a sign of stress or a sign that they are confused or conflicted to how to behave. If this occurs stop the interaction between your child and the dog.
As you can see from the above ladder and signs of stress, some of the signs are very subtle. Some signs many adults read as a sign your dog wants to be pat or play such as lying down with a leg up. The key is to look at the dog as a whole. A dog on their side, leg up, showing their belly, may not want a belly rub but may be showing that they aren’t a threat and want to end an interaction. If that is the case, their front paws will be tightly curled up, their body and face will be tense and straight. They will probably look away and their tail may be tucked. A dog who wants a belly rub will be on their back (not their side), exposing their belly. They will have an open mouth, relaxed paws, and a floppy body. They may even look like they are smiling! Dominika Knossalla-Pado has great videos on her Instagram page that help you see and identify different signs of stress while a dog is interacting with a child. This can be helpful to practice identifying these subtle signals.
With any of signs of aggression or stress, get your body in between your child and the dog immediately, separate them and make sure your dog can be in a safe space. If you do not act, your dog may progress up the ladder of aggression, may give your child warning signs or may bite.
Dog Meet Baby, either on their website or Instagram provides free resources and information about dog behavior and body language including video examples of dogs and children interacting. She walks you through the interactions pointing out subtle signs of aggression, signs of a relaxed dog, and she teaches you how to recognize both.
This American Human Organization PDF has a great guide to introducing a pet but also has great graphics showing dog and cat body language.
Some dogs will show predatory behavior to a child, usually a newborn or small infant. They will treat the baby like they would a new bone or new chew toy. Predatory behaviors are often seen in ‘cute pet videos” where the pet behavior is interpreted of a “good dog sibling” taking care of the baby. These are NOT safe behaviors. These behaviors include:
• Playfully nuzzling the baby
• Rubbing their face on the baby
• Pushily licking the baby
• Covering the baby with a blanket
• The dog may or may not have a stiff body during the interaction.
• The dog may act serious during the interaction
• They may lunge towards or “stalk” the baby
• They may try to grab the baby (particularly dangling feet)
If your dog has any of the above behaviors with or without signs of stress, DO NOT IGNORE THIS BEHAVIOR. This is NOT your dog being cute. This is a very unsafe situation. Stop the interaction immediately and separate your dog and child. Dogs showing predatory behavior towards a baby and treating the baby like a treat, toy or bone may escalate their behaviors very quicky in reaction to baby movement or noises.
Pets are part of our families, but they can also bring diseases into your house. Diseases from animals or pets are called zoonotic diseases. These diseases are more likely to affect children under the age of five, pregnant women, or children and adults with a weakened immune system. Here are a few you need to be aware of if you own pets or interact with animals.
Rabies is a deadly viral infection spread when an infected animal bites or scratches you. Rabies virus affects the brain and nervous system that results in death. Only two people have ever survived rabies without post-exposure prophylaxis. Wild animals such as bats, skunks, raccoons, foxes, and coyotes can carry rabies even if they appear to have no symptoms and can transmit rabies to humans. Other wild animals such as chipmunks, prairie dogs, squirrels, rabbits, mice, rats, moles, and gophers do not carry rabies but can become infected themselves. They very rarely transmit rabies to humans.
Most dogs in the United States are vaccinated against rabies but any dog and animal should be considered to have rabies until proven otherwise. If you or your child is bit by a dog that is not your own make sure you get their rabies vaccination information, as well as the owners name, contact info, and their veterinarian’s information to confirm the dog has up to date rabies vaccination. If you have contact with a bat or find a bat in your room if you were sleeping or suffer a bite or scratch from a stray animal or a dog that is not vaccinated against rabies, you will need to complete a rabies postexposure prophylaxis. This involves a dose of immune globulin and four doses of rabies vaccines over a 14-day period. You should start treatment as quickly as you can after a bite. And of course, after any bite or scratch wash immediately with soap and warm water.
CAT SCRATCH DISEASE
Cat Scratch Disease or Cat Scratch fever is caused by Bartonella henselae entering your body from either a cat bite or a scratch. This bacterium is found in kittens and some cats and is transmitted to the cat via fleas. The cat may appear healthy. The infection is more common in children and people less than 20 years old. Symptoms include swollen lymph nodes especially in armpit, neck, or groin. The lymph node will be warm, hard to the touch, and tender. A week or two before the lymph node enlarges you may have sores or a lump under the skin where the bite or scratch occurred, When the lymph node is enlarged, you often have a headache, fever, and fatigue. If your immune system is weakened, your liver and spleen may become enlarged or it may cause inflammation of the brain or retina, pneumonia, a bone infection, or a rash called erythema nodosum. If you are bit or scratched by a cat, make sure you wash it with soap and warm water immediately and apply antibiotic ointment. If your child develops symptoms of cat scratch fever, please make an appointment with your provider so they can order laboratory studies to confirm the diagnosis and start antibiotic treatment.
Toxoplasmosis is an infection from the Toxoplasma gondii parasite found in cat feces (and contaminated human food). Many people have a small amount of this parasite in their body, but our immune system fights it off. When a woman is infected with Toxoplasma right before becoming pregnant or during early pregnancy it can cause a miscarriage or still birth, congenital toxoplasmosis infection in the baby or cause nervous system and eye issues in the baby. Symptoms of toxoplasmosis include flu like symptoms, muscle aches, brain, or eye damage. Toxoplasmosis is diagnosed through laboratory studies. To prevent a pregnant woman or an immunocompromised person from becoming infected with toxoplasmosis, do not adopt a new cat or handle a stray cat, and avoid changing and cleaning cat litter boxes.
Psittacosis is a respiratory infection caused by the chlamydia psittaci organism. Birds such as parakeets, parrots, macaws, cockatiels, pigeons, and turkeys can carry this organism and transmit it to humans when we breath in dust. A bird does not need to be ill to transmit this organism. Symptoms of this respiratory infection include fever, cough, headaches, fatigue. It can lead to pneumonia, heart infections, liver infections, and infections of the brain. You can prevent transmission by cleaning the cage regularly, so the organism doesn’t have a chance to become airborne.
Lymphocytic Choriomeningitis virus can infect young children and pregnant women. The virus infects humans when they breath dried particles of urine, feces, and saliva from rodents including rats, hamsters, and mice. This virus causes fever, headache, cough, nausea, vomiting, muscle aches, joint pain, and chest pain. It can also result in infection in the brain or birth defects in developing babies. To prevent virus transmission, do not let children help clean cages and make sure the rodent’s cage is cleaned frequently.
Salmonella bacteria can be found in the intestinal track of reptiles (turtles, lizards, snakes), amphibians (frogs and toads), poultry (chickens, ducks, geese, and turkey), birds (parakeets, parrots, and wild birds), rodents (mice, rats, and hamster), small mammals (hedgehogs), farm animals, as well as dogs and cats. People contract salmonella though contact with the animal who may have shed the virus through stool where it then gets onto their body. The virus can also live on the surfaces of an aquarium or terrarium, a coop, pen, stall, or fence. Animals can carry salmonella and not appear ill. People who contract salmonella may have a fever, diarrhea that may be bloody, nausea, vomiting, and stomach pan. Most of the time your body will recover without treatment in 4-7 days though some people require hospitalization due to dehydration or an infection that enters the blood stream.
We recommend waiting until your child is over 5 years of age to add a reptile, amphibian, or backyard bird to your family because of the high risk of zoonotic illness. If this is not feasible, make sure you wash your hands with soap and water, use sanitizer, and sanitize surfaces.
Most transmission can be prevented with hand washing after handling pet or animal food, pet homes such as crates, stalls in a barn, or coops, equipment, or after cleaning up urine or stool, Wash or sanitize your hands after petting animals at a farm or a petting zoo. Handwashing with soap and water is the best method, but hand sanitizer is also acceptable.
A family pet will bring joy to your family. We can ensure positive experiences for our children and pets by learning how to respect dog’s body language and make sure our dogs are not put in stressful situations. We can also prevent zoonotic disease by taking care to wash our hands with soap and water after contact with animals and to make sure to frequently clean their homes or habitats to prevent the spread of bacteria, viruses, and parasites that may make us ill.
Children’s Health Care of Newburyport, Massachusetts and Haverhill, Massachusetts is a pediatric healthcare practice providing care for families across the North Shore, Merrimack Valley, southern New Hampshire, and the Seacoast regions. The Children’s Health Care team includes pediatricians and pediatric nurse practitioners who provide comprehensive pediatric health care for children, including newborns, toddlers, school aged children, adolescents, and young adults. Our child-centered and family-focused approach covers preventative and urgent care, immunizations, and specialist referrals. Our services include an on-site pediatric nutritionist, special needs care coordinator, and social workers. We also have walk-in appointments available at all of our locations for acute sick visits. Please visit chcmass.com where you will find information about our pediatric doctors, nurse practitioners, as well as our hours and services.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.