Animal Bites & Stings (Zoonotic Exposures)

Human Interaction with Animals: A Risk Factor for Injury & Illness

Animals do not have to be sick to be a risk to humans. Animals such as poultry, reptiles, and goats, carry human pathogens as normal flora. Other animals, such as rodents, bats, and nonhuman primates, can be subclinical carriers of pathogens. Animals, even those in close association with humans, such as dogs or animals in petting zoos, can attack if they feel threatened, are protecting their young or territory, or are injured or ill.

Travelers should be aware that attacks by domestic animals are far more common than attacks by wildlife, and secondary infections of wounds may result in serious illness or death. This section will cover the most common routes of transmission of illness and injury from animals and will highlight those animals that are common reservoirs of zoonotic diseases (Table 3-3). See the respective disease sections in Chapter 4 for more detailed information on specific diseases.

Table 3-3. Common reservoirs of zoonotic diseases and mechanisms/routes of human infection
Animal Reservoir	Diseases Transmitted by Mechanism/Route of Infection		Recommendations for Travelers
Animal Reservoir	Bites & Scratches	Inhalation & Ingestion	Recommendations for Travelers
Dogs & Cats	Globally, dogs pose the highest risk for rabies transmission.	Dogs and cats carry bacteria, viruses, and parasites in their saliva, feces, and urine that can cause severe disease in humans (e.g., Pasteurella spp. or Bartonella spp.).	Avoid unfamiliar dog and cats (even if they appear tame). Clean bite and scratch wounds promptly and seek medical care.
Bats	Globally, bats pose a high risk for rabies transmission. Tiny teeth and lack of apparent wound/trauma may lead people to trivialize a bite or scratch and not seek care.	Bats carry numerous pathogens including Histoplasma spp. and hemorrhagic fever viruses Exposure can occur during adventure activities such as caving ¹ and can include mucosal or cutaneous exposure to bat saliva or droppings.	Seek medical advice even in the absence of an obvious bite wound, including: waking up to find a bat in the room or finding a bat in the room of an unattended small child or other person unable to reliably report a bite.
Monkeys	Monkeys carry serious, often fatal zoonotic viruses. Macaque bites can transmit B virus, a virus related to the herpes simplex viruses.		Avoid interacting with monkeys, even if they appear tame.
Rodents	Rodent bites and scratches can transmit rat-bite fever, lymphocytic choriomeningitis virus, viral hemorrhagic fevers, monkeypox, and many other zoonotic pathogens.	Rodents carry 85 unique zoonotic pathogens Fleas, ticks, and mites on rodents can spread: Plague Rickettsial infections Lyme disease Tickborne encephalitis Tularemia Bartonellosis Diseases transmitted through contact with rodent feces and urine: Lymphocytic choriomeningitis virus Viral hemorrhagic fevers Salmonellosis Leptospirosis• Hantavirus Disease spread through direct contact with rodents: monkeypox	Avoid places with evidence of rodent infestation.
Birds		Associated with cases of highly pathogenic avian influenza in humans Diseases transmitted though bird feces or aerosol exposure: Histoplasmosis Salmonellosis Psittacosis Avian mycobacteriosis	Do not eat uncooked or undercooked poultry or poultry products. Avoid contact with live poultry or wild birds.
¹ A recent example of an indirect exposure is an imported case of Marburg fever in a tourist who had visited a cave inhabited by bats (Python Cave in western Uganda). This case illustrates the risk of acquiring diseases from indirect contact with cave-dwelling bats. This same cave was the source of a fatal case of Marburg hemorrhagic fever in a Dutch tourist in 2008.

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