Encounters with animals can result in medical problems which, though uncommon, may cause mechanical injury, infection, infestation, envenomation and death. Travellers need to be made aware of the risks and of the precautions they can take to protect themselves. 

1. Animal Contact and Risk to the Traveller 

1.1 Rabies

Human and animal rabies is present throughout most parts of the world. Rabies is transmitted to humans when the skin is broken by an infected animal's bite or scratch, and saliva containing the rabies virus contaminates the wound. Virtually all those who develop symptoms will die. Those considered at increased risk are people who work with animals, people who may be exposed to bats in caves (spelunkers), people who work in the streets of big-city slums where stray dogs roam, those planning extensive and unprotected exposure in rural areas (bicycling, camping) and, according to some experts,  children, when travelling to an endemic country for one month or more. (for more info see outline #34)

1.2 Snakes Bites

The risk of snakebite is greatest where dense human and venomous snake populations are present: South East Asia, sub-Saharan Africa, and the tropical parts of the Americas. It is most frequently the indigenous population who are affected and this usually is related to walking barefoot in the jungle or paddy fields. For the average traveler the risk is negligible. For the traveler working on agricultural or other field projects, the risk is higher, though still small. Not all snakes are venomous and venomous snakebites often do not transfer venom. Spitting cobras can induce eye damage.(for more info see outline #34) 

1.3 Scorpion and Spider Stings

Venomous scorpions are dangerous and are found in tropic, sub tropic and desert areas. The sting from a scorpion can result in death, mainly from lack of availability of specialized medical care and support. Children are most at risk. Dangerous spiders are found in the Mediterranean and Africa (tarantula), North America (black widow and brown recluse), and Australia (red-back and Sidney funnel web). Only the former are known to be aggressive and this, in addition to their  potent venom, makes them the most dangerous. Depending on the species, spider venom may cause severe pain, muscle spasm with nerve dysfunction or haemolysis and cell necrosis.  Scorpions and spiders are usually nocturnal creatures and they are more active during the warmer season. They hide under rocks, leaves, clothing and in holes, corners, shoes etc,. (for more info see # outline34)

1.4 Injuries / Attacks from Large Animals

It is estimated that mammalian bites are the cause of several thousand deaths annually. The danger often arises from unnecessary intrusion into their territory or perceived threat to their young, as most wild animals will avoid confrontation with humans.  Crocodiles continue to take a small toll of human life in, notably, the Sudan, Central Africa and South East Asia (the estuarine crocodiles of Indonesia and Sarawak) .  Injuries inflicted by the claws, teeth, tusks, or horns of wild animals can inflict tearing, cutting and crushing injuries and cause internal organ damage or deep arterial or nerve damage or multiple fractures or even death. Injuries may become infected.

2. Precautions and Risk Avoidance

2.1 Rabies

1) Avoid direct contact with domestic animals as well as wild and captive animals where rabies occurs; avoid startling, frightening or threatening an animal

2) Avoid eye contact with dogs, as it will be interpreted as a threat or challenge. Running away often provokes a chase. When threatened with an attack, the best is to freeze, turning sideways away from the dog .

3) If taking animals along, have them immunized against rabies

4) If traveling to rabies-endemic countries consider pre-exposure vaccine if at increased risk or if post-exposure prophylaxis not easily accessible.

5) An animal bite or saliva contact must be considered potential exposure and requires immediate vigorous wound cleansing with copious amounts of soap and water, immune globulin (with wound injection) and vaccine treatment. Those who have received pre-exposure vaccination must receive at least two additional doses of vaccine.    

2.2 Snakes, Scorpions and Spiders.

1) Avoid snakes and snake charmers

2) If you see a snake to not disturb it; if you are cornered, stay absolutely still until it slithers away: snakes strike only moving objects.

3) Wear boots, socks and long trousers to walk in undergrowth: at night always carry a light.

4) Use a mosquito bed net

5) Carefully check clothing, shoes, and camping gear before wearing.

6) Living quarters should be frequently cleaned and debris removed from around housing and camping areas. 

7) Never use your bare hands to collect wood or to move sticks in burrows, holes and crevices or to  climb trees and rocks with thick foliage or, moving sticks

8) Snake or spider venom poisoning is a medical emergency. Antivenom treatment should only be administered in a professional setting. To delay the venom's spread, first aid consists of immobilization, pressure bandage or tourniquet (not so tight as to obliterate pulse) on the affected limb. For scorpion stings treatment is supportive: ice and oral analgesics for local pain until victim is moved to a medical facility.

2.3 Large animals

1) Treat large animals with respect and avoid unnecessary close contact with them in the wild, in safari parks or zoos

2) Seek local advice about the local fauna, the dangers, and where and when it is safe to venture out  

3) Be aware that strolls between dusk and dawn without a light attract large carnivores  

4) Be cautious when viewing elephants or rhinoceroses from a hardtop vehicle as this may be  unsafe under some circumstances.

5) Local treatment of wounds should be instituted immediately (see under rabies) and victim removed to a hospital.

References

Martinez, L. (Executive Editor). International Travel and Health. Published by the World Health Organization (WHO). 2002.

DuPont, H.L. and Steffen R. (Editors). Textbook of Travel Medicine and Health. 2^nd Edition. Hamilton, Ontario, Canada: B.C. Decker, Inc., 2000.

Steffen R., DuPont H.L. (Editors). Manual of Travel Medicine and Health, 1st Edition. Hamilton, Ontario, Canada: B.C. Decker, Inc., Revised reprint 2002.

Health Information for International Travel 2001-2002. Published by the Centers for Disease Control and Prevention (CDC). Atlanta, Georgia: U.S. Department of Health and Human Services, Public Health Service, 2001.

Keystone, J.S. (Editor) Don't drink the water.....The complete traveller's guide to staying healthy in warm climates. 5^th Edition.  Co-published by the Canadian Public Health Association and the Canadian Society for International Health. 2000

Dawood, R. Traveller's Health. Oxford, Great Britain: Oxford University Press.1986

Submitted by:

Pauline Delorme RN

Tel: 613 236-6163. Fax: 613 238-7230.

pdelorme@idrc.ca