General News of Saturday, 2 February 2013

Source: Daily Graphic

Dog, man bites among 10 top OPD cases at Korle Bu

Dog and human bites are among the top 10 outpatient department (OPD) attendance at the Korle Bu Teaching Hospital for three consecutive years.

According to the 2011 Annual Report of the Hospital, while dog bites ranked third after road accidents and assaults, human bites are fourth on the list from 2009 to 2011.

While in 2009, 100 dog bites were recorded, the figure jumped to 255 before dropping to 217 in 2011.

For human bites, the data was 17 in 2009, rose to 102 in 2010 and went up again to 108 in 2011.

In the period under review, statistics from the Ghana Veterinary Medical Association (GVMA), also showed that 25 people died from bites from rabies-infested dog deaths between January 2009 and July 2011.

A danger associated with dog bite is rabies, which could kill untreated victims between a day and three months.

Ghana recorded 144 deaths nationwide between 1986 and 2003 due to dog bites, Greater Accra region alone recorded 2,620 dog bites between 2003 and 2008, the GMA figures showed.

GVMA data also indicated that 30 to 60 percent of dog bite victims in dog-endemic areas are children less than 15 years of age but unfortunately, the majority of these cases go unreported to health authorities.

In a country where stray unvaccinated dogs are common, Dr Samuel Hanson, a former Director of the Veterinary Services, said an easy way to avoid the death and complications that came with dog bites was to vaccinate all dogs.

“when you vaccinate dogs against rabies, the primary concern is to prevent humans from getting rabies,” he said.

“Dog vaccines are ten times cheaper than human vaccines. It therefore makes sense to vaccinate your dog to prevent somebody from being bitten by a rabies infected dog.”

The anti-rabies vaccine is available in most veterinary clinics, and costs five to GH¢10.00 per shot.

In the past, there was a free vaccination programme for dogs but the initiative was suspended after 1998 because of funding challenges.

He said while dog bites generally may not cause death, rabies-infected dogs could be lethal, if medical attention was not received quickly, adding that a quick first aid before rushing the victim of a dog bite to the hospital was to wash the spot with soapy water.

“Don’t leave it there, you’ll have to ensure that the dog is sent to the nearest veterinary centre as dogs bite under different conditions and this could help determine what is wrong with the dog. ”

Unlike dog bites, the reasons for which a person may bite another is difficult to guess but could be explained as a form of self defence or increased stress level, the Chief Psychiatrist, Dr Akwesi Osei told Graphic Online.

“People may fall on their teeth because they feel disadvantaged in terms of physique or strength. They, therefore, use that to express self defence. It ,thereore, becomes a natural way of dealing with the aggressor when the person is no match for his or her opponent,” he said.

Dr Osei said if human bites were on the increase, then there was the need to find out why people were fighting and biting as it could be a possible indicator of increased stress levels.

“It could mean that a lot of people are getting stressed up and getting easily irritated with others,” the Chief Psychiatrist added.

According to medical experts, human bites can be as dangerous as or even more dangerous than animal bites because of the types of bacteria and viruses contained in the human mouth.

High levels of bacteria and different types of virus are contained in human mouths that can turn a minor wound to a severe infection that can be hard to treat and move quickly to cause major complications.

Human bites have been shown to transmit hepatitis B, hepatitis C, herpes simplex virus (HSV), syphilis, tuberculosis, actinomycosis, and tetanus. Evidence suggests that it is biologically possible to transmit the human immunodeficiency virus (HIV) through human bites, although this is quite unlikely.

Rabies is a zoonotic disease (a disease that is transmitted to humans from animals) that is caused by a virus. The disease infects domestic and wild animals, and is spread to people through close contact with infected saliva through bites or scratches.

According to the World Health Organisation (WHO), the incubation period for rabies is typically one to three months, but may vary from less than a week to more than a year. The initial symptoms of rabies are fever and often pain or an unusual or unexplained tingling, pricking or burning sensation (paraesthesia) at the wound site.

As the virus spreads through the central nervous system, progressive, fatal inflammation of the brain and spinal cord develops.

Two forms of the disease can follow---furious and paralytic rabies. People with furious rabies exhibit signs of hyperactivity, excited behaviour, hydrophobia and sometimes aerophobia. After a few days, death occurs by cardio-respiratory arrest.

Paralytic rabies accounts for about 30 per cent of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. The muscles gradually become paralysed, starting at the site of the bite or scratch. A coma slowly develops, and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease, the WHO said.

Other rabies symptoms and signs occur after exposure and may include delirium, combativeness, loss of muscle function, muscle spasms, drooling, convulsions and pain.