First Aid for Dog Bites - WHO Guidelines

Objectives

By the end of this session you will be equipped not only with knowledge but also with practical skills to protect yourself, your family, and your community from the dangers associated with dog bites.
The session covers: the types of dog bites and how they affect the body; the correct immediate first aid response to reduce complications; infection risks and the role of tetanus protection; the importance of rabies prevention and vaccination; observation guidelines for suspected rabid animals; safety considerations regarding anti-rabies vaccination.

Rabies is a viral disease affecting the brain and nervous system.
It is spread through the saliva of infected animals, with dogs being the primary source in most cases: 99\% of cases in dogs.
Once symptoms appear, rabies is almost always fatal.
Immediate first aid and post-exposure prophylaxis (PEP) can save lives.

Category I: touching/feeding, licks on intact skin → no treatment required.
Category II: minor scratches, nibbling without bleeding → wash the wound and vaccinate.
Category III: bites or scratches with bleeding, saliva on mucosa or broken skin, bat contact → wash, vaccinate, and administer Rabies Immunoglobulin (RIG).

Category I (No risk): No direct contact with animal saliva. Example: touching fur or saliva splash with no wound. Actions: no vaccine or extra action required; wash hands.
Category II (Low risk): Minor wounds; small scratches; Example: a cat or dog nibbled the skin causing a small wound. Actions: wash wound with soap and go to clinic for rabies vaccine.
Category III (High risk): Deep wounds or high-risk exposure (head/neck/mucosal contact); Example: dog bite deep into the skin or face area. Actions: wash wound, go to clinic for complete vaccination, may require ERIG.

Wash the wound with soap and running water for at least 15\ \text{minutes}.
Apply iodine or alcohol to the wound.
Keep the wound open to the air (do not seal with a bandage that discourages drying).
Avoid irritants (Chili, Garlic, Vinegar) on the wound.
Note: First aid alone is not enough; proceed to vaccination and clinical care as indicated.

Observe the biting dog for 10\ \text{days} if the animal is healthy and available for observation.
A rabid dog will typically show symptoms or die within this 10-day window.
Do not delay PEP while waiting for observation results or the animal's status.

Dog bites carry risks of bacterial infection in addition to rabies; wash and seek care to prevent secondary infection.
Tetanus risk should be assessed; ensure tetanus immunization is up to date as part of wound management and vaccination planning.
Public health guidance emphasizes clean wound care, timely vaccination, and consideration of tetanus prophylaxis as appropriate.

Modern vaccines are very safe.
Very rare deaths are associated with severe allergic reaction or unmanaged pre-existing illness.
The benefits of vaccination (preventing a deadly disease) far outweigh the risks.

Mass dog vaccination achieving at least 70\% coverage to interrupt transmission.
Immediate access to PEP for exposed individuals.
Public awareness campaigns on rabies prevention and bite management.
Goal: Zero human rabies deaths by 2030.

Rabies is deadly but preventable.
Follow the WHO exposure categories (Categories I–III) for management.
Use a simple, critical sequence: Wash – antiseptic – health facility for immediate steps.
Never delay or skip PEP if exposure risk exists.
Educate and empower the community to prevent infections and rabies.

Public health impact: Rabies prevention relies on vaccination campaigns, rapid wound care, timely PEP, and education.
Community action: Encourage reporting of animal bites, vaccination drives, and access to PEP centers.
Ethical considerations: Balancing vaccine safety with the need to prevent a fatal disease; ensuring equitable access to PEP and vaccines.
Connection to foundational principles: Zoonotic disease control, infection prevention, and immunology concepts (immunoglobulin, vaccines, herd protection).

Rabies risk after a dog bite is real but manageable with proper steps: immediate wound care, exposure-category-based actions, observation where applicable, and vaccination strategies to protect individuals and communities.