From Guide to YKHC Medical Practices

With a preponderance of dogs on the Delta, you may be faced with many bites. The important issues concern the fear of rabies and the risk of infection. Any unprovoked attack, or an attack by an unknown animal or unimmunized animal, should be considered for treatment for rabies. All bites should be reported to OEH. (543-6420)

There are “Rabies Investigation Report Forms” that should be filled out – (all the health aides and ER have) and there is always an OEH person on call if you have questions. (The operator keeps the list.) If the bite is severe it may need to come to Bethel. The rabies vaccine series may need to be given. The animal often needs to be caught and the brain sent for studies. The animal is usually quarantined for 10 days for observation before the decision to send the brain for rabies is made.

  • Local care of any dog bite includes washing with soap and water.
  • Fox bites are especially rabies prone.
  • The patient should receive a tetanus shot if they haven’t had one within 5 years.
  • wounds probably require prophylaxis, but this is controversial. Oral flora usually complicate the wound and treatment should be considered for:
    • any wound showing signs of infection
    • any wound that is difficult to clean
    • any wound in a critical area (face, hand, etc.).
  • Organisms usually include
    • Streptococci
    • Eikenella Corrodens*
    • S. Aureus
    • Bacteroids
    • Peptococcus
    • Petostreptococci
    • Pasteurella (14-50% dogs, 50-75% cats)

Penicillin resistant gram-negative rods are infrequent pathogens. *Eikenella is unusual in that it is often sensitive to PCN and Ampicillin, but not to oxacillin/methecillin/nafcillin/clindamicin.

Amoxicillin/clavulanate would be the best choice for prophylaxis if it were needed.


YKHC Clinical Guidelines
Common/Unique Medical Diagnoses