Animal Bites, Infection Risk, and Rabies Exposure: What Infection Preventionists Need to Know During High-Risk Seasons

Any celebrations in the home often bring families together, introduce new pets into households, and fill living spaces with visitors. Although holidays and birthdays are associated with celebration, they also create environmental and behavioral stressors for animals, particularly dogs and cats, who may become overwhelmed by unfamiliar faces, increased noise, and disruptions to their normal routines.

This year, during the winter holiday season, I observed a noticeable rise in animal‑bite–related emergency department (ED) visits in my community. Nationally, animal bites account for approximately 1% of all ED visits each year, representing an estimated 2 to 5 million incidents.¹ Dogs are responsible for the majority of these injuries, contributing to roughly 337,000 ED visits annually, followed by cats.¹ Epidemiologically, children are at heightened risk, often sustaining bites to the head and neck due to their smaller stature, while adults more commonly experience injuries to the hands and arms.

Animal bites occur year-round; incidence typically peaks during the summer months, when people spend more time outdoors and interact more frequently with animals. Interestingly, during the COVID-19 pandemic, several emergency departments reported a surge in animal bites, likely attributable to pet owners spending more time at home with their pets under restrictions.²

When an animal bite occurs, immediate wound care is a key determinant of infection risk. The wound should be washed thoroughly with soap and warm water, then covered with a clean bandage. Prompt medical evaluation is recommended, particularly for deep wounds. Identifying the animal involved is essential, as vaccination history and ownership guide clinical decision‑making. Many counties or states require that animal bites be reported to the local health department, especially when rabies exposure is a concern. According to the World Health Organization, dog bites and scratches cause 99% of human rabies cases.³

Infection risk is a major concern with all bite wounds, as bacteria or viruses can be introduced. The oral cavities of animals contain complex polymicrobial ecosystems. Cat bites, in particular, pose a high risk because their sharp, narrow teeth create deep puncture wounds that inoculate bacteria into subcutaneous tissues. These infections often progress more rapidly than those caused by dog bites.² Dog and cat bites commonly transmit mixed aerobic and anaerobic organisms, including Pasteurella, Staphylococcus, Streptococcus, Fusobacterium, and Bacteroides species.² Rodent bites, by contrast, are more strongly associated with Streptobacillus moniliformis or Spirillum minus, the causative agents of rat‑bite fever.²

In the ED, clinicians conduct a comprehensive assessment of the wound, evaluating its depth, anatomical location, and potential involvement of nerves, tendons, or bone. Wounds are irrigated to reduce bacterial load, and devitalized tissue may be debrided. Antibiotic prophylaxis is often initiated, and tetanus immunization is updated when indicated.

In addition, rabies post‑exposure prophylaxis is commonly administered and consists of 4 doses on days 0, 3, 7, and 14. For more complex injuries, imaging studies may be ordered when there is concern for foreign bodies, fractures, or joint involvement, and surgical specialists may be consulted. The majority of animal bites I have observed in the ED are minor and include prophylactic antibiotics and administration of the rabies vaccine series. They are often caused by approaching a dog or attempting to deescalate aggression between 2 dogs.

For infection preventionists, animal bites represent more than isolated clinical events; they are indicators of broader community health trends. Monitoring seasonal patterns, such as increases during holidays or summer months, helps identify periods of elevated risk and can be used to prepare the ED. These epidemiological insights highlight the importance of ongoing surveillance and targeted prevention efforts.

References:

1. StatPearls Publishing. Rabies. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; updated 2024. Accessed January 27, 2026. https://www.ncbi.nlm.nih.gov/books/NBK430852/
2. Rupprecht CE, Briggs D, Brown CM, et al. Rabies. Medscape. Updated 2024. Accessed January 27, 2026. https://emedicine.medscape.com/article/768875-overview#a8?form=fpf
3. Rabies. Fact sheet. World Health Organization. Updated September 2023. Accessed January 27, 2026. https://www.who.int/news-room/fact-sheets/detail/rabies