This document summarizes information about animal and insect bites, including rabies, snake bites, and arthropod bites. It describes the epidemiology, transmission, clinical manifestations, diagnosis, and management of rabies. It also discusses the toxicology, clinical manifestations, laboratory examination, and hospital and field management of snake bites. Finally, it provides information on hymenoptera (bee) bites, black widow spider bites, including their venom effects, manifestations, and treatment approaches.

1. ANIMAL & INSECT BITES James Taclin C. Banez, MD, FPCS, FPSGS, DPBS, DPSA

23. Management WHO GUIDE FOR POST-EXPOSURE TREATMENT: Assess Nature of Contact or Injury and the Biting Animals TYPE OF EXPOSURE TREATMENT HEALTHY SICK/RABID Category I: Touching or feeding, licking of healthy skin w/ no open wound, no documented contact of saliva w/ mucous membrane, reliable history No treatment No treatment Category II: Nibbling of uncovered skin, superficial scratch that doesn’t break skin, licking over broken skin or healing wounds. Category I w/ unrealiable history Vaccine + observe Vaccine (full course) Category III: Single or multiple transdermal bite or scratch which penetrates skin at any location; licking of mucous membrane Vaccine + RIG + observe Vaccine + RIG + (Full course)

26. SNAKE BITE

27. SNAKE BITES Characteristic Poisonous Nonpoisonous a. Shape of head triangular round b. Pit (+) (-) c. Pupils elliptical Round d. Bite marks Fang marks 2 rows of teeth e. Caudal plates Single row Double row f. Color body Red ring next to yellow (coral snakes) Alternating color

46. ARTHROPOD BITE

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