Dogs are often referred to as ‘man’s best friend’, however they can be extremely dangerous both due to risk of bite injuries and the fact that they are major carriers of the deadly rabies virus. This December, which is Prevention of Injuries Month, is the ideal time to teach children about safety around dogs.
“Children under the age of 15 are unfortunately particularly at risk of being bitten by dogs. Often children may be too trusting of unfamiliar dogs, may not understand dogs’ behaviour or how to interact safely with them, which can lead to sudden serious injury,” says Rene Grobler, Netcare’s national quality and systems manager for trauma and emergency.
Netcare’s trauma injury prevention (NTIP) programme is calling on parents to inform themselves and their children about dog safety ahead of the holidays, as children may well come into contact with strange dogs at their holiday destination. The NTIP programme aims to reduce the risks of healthy people experiencing traumatic injuries through educational initiatives and sharing practical advice to promote safer behaviours.
“It is important to remember that dogs are the main carriers of the rabies virus, which is of particular concern in some parts of our country. According to the National Institute for Communicable Diseases (NICD), in the last 20 years more than 40% of human rabies cases in South Africa have been recorded in KwaZulu-Natal, with 24% in the Eastern Cape and 21% in Limpopo province,” she says.
“Educating children on behaviours that can help reduce the chances of them being bitten is a vital step in preventing injury due to dog attacks and the spread of the rabies virus.”
Teach children the following to help prevent them being bitten by a dog:
- Never wake a sleeping dog, even a family pet
- Never interfere with a dog while it is eating or feeding its puppies
- Do not hurt, pester or tease dogs
- If an unfamiliar dog runs towards you, it is best to stand still and remain quiet “like a tree” with your hands at your sides and not make eye contact. Usually, the dog will soon lose interest.
If a dog does attack:
- Try to keep still and do not pull away from the dog
- If you fall, roll into a ball, protecting your face and head, tucking your arms and legs in
While prevention is always better than cure, unfortunately dog attacks do still occur. Rabies is a concern for any animal bite that does not have a confirmed record of up-to-date rabies immunisation, according to Dr Dudu Ndlovu of North Coast Emergency Group, operating the emergency departments at Netcare Alberlito Hospital in Ballito and Netcare The Bay Hospital in Richards Bay.
“Rabies is rare, but it is a deadly disease and therefore all animal bites are taken seriously and scrutinized to determine if post-exposure prophylaxis is needed. In the case of a person being bitten by a dog, it is most helpful for the treating doctor to know whether there is proof that the dog’s rabies vaccination is up to date,” Dr Ndlovu says.
What to do if your child is attacked or bitten by a dog
- Get out of danger – Move the child somewhere where the dog cannot attack either of you or lock the dog away.
- Assess the child – Check to see if they are alert, breathing well and not bleeding excessively.
- If the wound is bleeding, apply direct pressure on the site. Keep the child warm and comfortable.
- Contact an emergency medical services provider, such as Netcare 911 on 082 911, and describe the child’s injuries in as much detail as possible, or take the child to an emergency department.
In cases where the child has been bitten with massive bleeding and extensive wounds, an emergency medical services provider should be contacted immediately.
First aid for dog bites
If paramedic assistance is required, you can do the following while waiting for the emergency services to arrive:
- Start cleaning the child’s wound by rinsing it thoroughly with clean water.
- If the child is in pain, consider administering over-the-counter pain medication in an appropriate dose for the child’s age.
- Gather information that can assist the treating doctor with the correct management when you arrive at hospital:
- The dog owner’s name and contact details
- The dog’s vaccination status with documented proof
- The details about how the incident unfolded.
“This information is clinically relevant because if there is proof that the dog’s rabies vaccination is up to date, the treating doctor can avoid administering multiple anti-rabies injections. The treating doctor at the emergency department will assess and clean the wound or wounds, ensure adequate pain control, and decide on the correct management based on the patient’s condition,” Dr Ndlovu says.
The partners of the North Coast Emergency Group, now running the emergency departments at Netcare Alberlito and Netcare the Bay hospitals, have almost two decades of emergency medicine experience between them, and all doctors at the practice have additional emergency training and are hand-picked for their experience and bedside manner.
Does a minor dog bite really require medical attention?
“If a child or any person is bitten by a dog, even if the wound is not bleeding badly it is important to seek emergency medical care for an assessment of the wound, tetanus immunisation and a rabies risk assessment,” Grobler adds.
According to David Stanton, head of clinical and education at Netcare 911, if you are ever unsure of the level of medical care your child needs, the Netcare 911 national emergency operation centre is ready to provide expert assistance in determining what steps are necessary.
“Netcare 911’s national emergency operation centre has trained emergency medical personnel available to support callers in a medical emergency by explaining to them how to assist the patient until paramedics arrive on scene,” Stanton says.
“We are now also able to include a visual element to telehealth consultations via secure video link, to assist with a more detailed immediate assessment of the patient remotely. In an emergency situation, this can be most significant for clinical decision making and help in the co-ordination of highly specialised resources, such as deploying helicopter emergency medical services to airlift a patient to hospital.”
“Remember it is imperative that for any potential risk of rabies, the first dose of rabies post-exposure prophylaxis must be administered as soon as possible after the bite occurred as time is of the essence when it comes to preventing the virus from attacking the nervous system,” Grobler says.
In association with the Global Alliance for Rabies Control [GARC], Netcare’s TIP programme developed a fun and informative booklet, which is supported by the World Health Organization, dealing with safety around animals.
“The booklet places particular emphasis on teaching children about responsible pet ownership, understanding dogs’ body language, and the behaviours people should avoid in their interactions with dogs that could provoke aggression, Grobler says.
The booklet, ‘Want a friend? Be a friend’, is available for free as a service to the public. You can download it at https://www.netcare911.co.za/Helping-Hand under the heading ‘Animal safety’.
NICD reference and further reading: https://www.nicd.ac.za/wp-content/uploads/2020/07/An-update-on-rabies-in-South-Africa.pdf
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