I write a lot about animal bites, and for good reason since they are common and can be very severe. Usually, it’s dog bites. Sometimes it’s cat bites, or more rarely injuries from birds or other critters. Monkey bites not so much, but they happen. I had an email question about rabies exposure from a monkey bite the other day, and there was a paper in the October edition of Emerging Infectious Diseases about monkey bites amongst US military personnel in Afghanistan.
Some highlights of that paper:
From 2001-2010, 643 animal bites were reported by US military personnel.
- More probably occurred since bites are often underreported.
Dogs accounted for 50% of bites, but many other animals were also involved, including rhesus macaques, a type of primate that is present in the wild and also kept as pets in Afghanistan.
- Macaque bites are even more of a concern than dog bites. In addition to the ever-present risk of rabies exposure, these animals can also transmit Macacine herpesvirus B, which is a very serious pathogen that can kill people. Like any animal, macaques also have a wide array of bacteria in their mouths that can cause infections after a bite.
10 monkey bites were reported in this series.
- Most people who were bitten were young (less than 30 years of age) and male. All were junior enlisted personnel or non-commissioned officers.
- Eight of the monkeys that bit were pets, including one that somehow belonged to US military members (despite orders that US military personnel not adopt or interact with local animals or pets).
- Appropriate wound care was provided following only six of the bites. So, there are deficiencies in understanding basic first aid following bites.
- Only five people received appropriate treatment for herpes B exposure. That’s a concern because of how serious this infection can be.
- Eight received antibiotics. Antibiotics are only indicated in a subset of bites, mainly based on what part of the body is bitten, so it’s not clear whether this was really needed (while more concerning issues went unchecked).
- Eight received treatment for rabies exposure.
- No one got sick, fortunately.
Monkey bites aren’t something that most people need to be concerned about in their daily lives, but they are a concern for people living in areas where there are monkeys, as well as those who visit such areas. (I have a vivid memory of swinging a camera case at a monkey in Barbados that for some reason seemed to be less than impressed with my existence).
Bites happen, but some are avoidable. Common sense can reduce the risk. If common sense isn’t enough and you’re bitten, don’t panic, but you also can’t ignore it. After thoroughly cleaning the wound, it’s important to get medical advice about what diseases are of concern and whether anything else can or needs to be done. Physicians working in foreign countries also need to be trained on geographically-relevant risks. Monkey-associated infections are not high on the curriculum of US medical schools, so geographically-relevant training is required for people heading elsewhere to work.