(sometimes called hydrophobia). This disease
is caused by a virus that is present in the saliva
of infected animals. The disease occurs most com-
monly in wild animals, but it has been found in
domestic animals and household pets; in fact, it
is probable that all mammals are susceptible to
it. The virus that causes rabies is ordinarily
transmitted by a bite, but it can be transmitted
by the saliva of an infected animal coming in con-
tact with a fresh wound or with the thin mucous
membrane of the lips or nose. The virus does not
penetrate normal unbroken skin. If the skin is
broken, DO NOT attempt wound closure.
If rabies develops in man, it is usually fatal.
A preventive treatment is available that is very ef-
fective if it is started shortly after the bite; this
treatment is outlined in BUMEDINST 6220.6
series. Since the vaccine can be obtained only at
a medical treatment facility or a major ship, any
person bitten by an animal MUST be transferred
quickly to the nearest treatment facility for evalua-
tion, along with a complete report of the cir-
cumstances surrounding the incident. Remember,
prevention is of utmost importance.
Immediate local treatment of the wound
should be given. Wash the wound and the sur-
rounding area carefully, using sterile gauze, soap,
and sterile water. Use sterile gauze to dry the
wound, and then cover the wound with a sterile
dressing. DO NOT use any chemical disinfectant.
Do not attempt to cauterize the wound in any
All of the animals saliva must be removed
from the victims skin to prevent further con-
tamination of the wound. (CAUTION: DO NOT
allow the animals saliva to come in contact with
open sores or cuts on your hands.)
When a person has been bitten by an animal,
every effort must be made to catch the animal to
keep it confined for a minimum of 8 to 10 days.
DO NOT kill it if there is any possible chance of
catching it alive. The symptoms of rabies are not
always present in the animal at the time the bite
occurs, but the saliva may nevertheless contain
the rabies virus. It is essential, therefore, that the
animal is kept under observation until a diagnosis
can be made. The rabies treatment is given if the
animal develops any definite symptoms, if it dies
during the observation period, or if for any reason
the animal cannot be kept under observation.
Remember that any animal bite is dangerous
and MUST be evaluated at a treatment facility.
SPECIAL CONSIDERATIONS IN
Shock is likely to be severe in a person who
has lost a large amount of blood or suffered any
serious wound. The causes and treatment of shock
are explained elsewhere in this chapter.
Although infection may occur in any wound,
it is a particular danger in wounds that do not
bleed freely; in wounds in which torn tissue or
skin falls back into place and prevents the entrance
of air; and in wounds that involve the crushing of
tissues. Incisions, in which there is a free flow of
blood and relatively little crushing of tissues, are
the least likely to become infected.
Battle wounds are especially likely to become
infected. They present the problem of devitalized
tissue, extravasated blood, foreign bodies such as
missile fragments, bits of cloth, dirt, dust, and
a variety of bacteria. The devitalized tissue pro-
teins and extravasated blood provide a nutritional
medium for the support of bacterial growth and
thus are conducive to the development of serious
wound infection. Puncture wounds are also likely
to become infected by the germs causing tetanus.
There are two types of bacteria commonly
in woundsaerobic and
anaerobic. The former bacterial live and multi-
ply in the presence of air or free oxygen, while
the latter are bacterial that live and multiply only
in the absence of air.
The principal aerobic bacteria that cause in-
fection, inflammation, and septicemia (blood
poisoning) are streptococci and staphylococci,
some varieties of which are hemolytic (destroy red
blood cells). The staphylococci and streptococci
may be introduced at the time of infliction, or they
may be introduced to the wound later, at the time
of first aid treatment or in the hospital if
nonsterile instruments or dressings are employed.
Wash minor wounds immediately with soap
and clean water; then dry and paint them with
a mild, nonirritating antiseptic. Apply a dressing
if necessary. In the first aid environment, do not
attempt to wash or clean a large wound, and do
not apply an antiseptic to it since it must be
cleaned thoroughly at a medical treatment facility.
Simply protect it with a large compress or dress-
ing and transport the victim to a medical treat-
ment facility. After an initial soap and water