BITES

Introduction

Animal bites and scratches, even minor ones, can become infected and spread bacteria to other parts of the body. Whether the animal is a family pet or a creature from the "wild," scratches and bites can carry disease. For example, cat scratch fever, a bacterial infection, can be transmitted by a cat scratch (usually from a kitten) even if the site of the scratch doesn't look infected. In addition, certain animals can transmit rabies and tetanus. Human bites that break the skin are even more likely to become infected.

What to Do:

• If the bite or scratch wound is bleeding, apply pressure to the area with a clean bandage or towel until the bleeding stops. If available, use clean latex or rubber gloves to protect yourself from exposure to another person's blood.
• Clean the wound with soap and water, and hold it under running water for at least 5 minutes. Do not apply an antiseptic or anything else to the wound.
• Dry the wound and cover it with sterile gauze or a clean cloth.
• Phone your child's doctor. If you child was bitten by an animal, he or she may need antibiotics, a tetanus booster, or a rabies vaccination. A bite or scratch on a child's hand or face is particularly prone to infection and should be evaluated by your doctor.
• If your child was bitten or scratched by an animal, try to locate the animal. Some animals may have to be captured, confined, and observed for rabies. But do not try to capture the animal yourself. Look in your phone book for the number of an animal control office or animal warden in your area.
• Go to the nearest hospital emergency department if:
• the wound won't stop bleeding after 10 minutes of direct pressure
• the wound is more than half an inch long or appears to be deep
• the attacking animal was wild (not tame) or behaving strangely
• a body part is severed (wrap the severed part in sterile gauze or a clean cloth and take it with you to the emergency department)

If you own a pet, make sure it's properly immunized and licensed.

SPIDER BITES

What is a Brown Recluse Spider
The brown recluse spider is one of a few poisonous kinds of spiders in the United States. It is part of the arachnid family, which includes not just spiders, but ticks, mites, and scorpions too. It has long, skinny legs and is about one-half inch long overall. Its entire body is brown, except for a dark mark in the shape of a violin on its head. Its poisonous relatives may be gray, orange, reddish-brown, or pale brown.
Brown recluse spiders are most commonly found in Midwestern and Southern states of the United States, and they usually hang out in dark places. When they are outside, they like to spend time in piles of rocks, wood, or leaves. If they come inside, brown recluse spiders will go to dark closets, attics, or basements. They aren't aggressive, and they bite only when disturbed.
What a Brown Recluse Spider Bite Looks and Feels Like
A person who gets bitten by a brown recluse spider may not notice anything at first or only feel a little sting at first. After about four to eight hours, the sting will start to hurt a little more. It might look like a bruise or might form a blister surrounded by a bluish-purple area that turns black or brown and becomes crusty after a few days.
What You Should Do
If you ever think that you've been bitten by a brown recluse spider, tell an adult immediately. Brown recluse spider bites rarely kill people, but it's important to get medical attention as soon as you can because they can make you pretty sick. With an adult's help, wash the bite well with soap and water. You can also apply ice to the area, elevate it, and keep it still.
If it's possible, have an adult catch and bring the spider to the doctor's office with you - this is important because it can sometimes be hard to diagnose a spider bite correctly. The spider can be killed first before you bring it with you; just be sure not to squish it so much that no one can tell what it is.
What a Doctor Will Do
Doctors treat people who have been bitten by a brown recluse spider with different types of medications like antibiotics, antihistamines, and pain medicines. Rarely, a skin graft might be needed if the skin is really damaged at the area of the bite. (A skin graft is when a small amount of skin is removed from some part of the body and put in a place where skin is damaged to create new skin.)
How to Avoid Getting Bitten
The best way to avoid getting bitten by brown recluse spiders is to be careful in areas where they like to spend time. Don't play around in rock piles or wood piles. If you are working outside in the yard in big piles of logs or leaves, wear gloves. Be sure to shake out blankets and clothing that have been stored in the attic or the basement, or if they have been in a closet but not used for a long time. If you keep your shoes in a mudroom or garage, shake them out before putting them on.

The two greatest risks from most insect stings and bites are allergic reaction (which may occasionally be fatal) and infection (more likely and less serious).
What to Do:
Spider Bites
Most spiders found in the United States are harmless, with the exception of the black widow and the brown recluse (or violin) spider. Both of these are found in warm climates.

• Wash the area carefully with soap and water. Do this two to three times a day until skin is healed.
• Apply cool compresses.
• Give acetaminophen for pain.
• To protect against infection, apply an antibiotic ointment and keep the child's hands washed.
• If you have any reason to suspect your child has been bitten by a black widow or brown recluse spider, apply ice to the bite site and head for the emergency room. Symptoms include:
• a deep blue or purple area around the bite, surrounded by a whitish ring and a large outer red ring
• body rash
• muscle spasms, tightness, and stiffness
• abdominal pain
• headache or fever
• general feeling of sickness
• lack of appetite
• joint pain
• nausea or vomiting

In the southwest United States, an unidentified bite may be caused by a scorpion. Take your child to the emergency room immediately.
TICK BITES

Engorged Tick on Head

Lymes Rash

Introduction
Check your children and pets for ticks carefully after you've been in or around a wooded area. Common types of ticks include dog ticks and deer ticks (deer ticks may be carriers of Lyme disease).
If you find a tick on your child:

• Call your child's doctor. The doctor may want you to save the tick after removal (you can put it in a jar of alcohol to kill it).
• Use tweezers to grasp the tick firmly at its head or mouth, next to your child's skin.
• Pull firmly and steadily on the tick until it lets go, then swab the bite site with alcohol.
• Do not use petroleum jelly or a lit match to kill and remove a tick.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Updated and reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: July 2004, September 2004
Originally reviewed by: Steven Dowshen, MD