the Wikipedia page for prevalence of rabies. Treatment The first step in treatment includes washing the bite wound. If there is a low risk of infection the wound may be sutured. Debridement and drainage of bite wounds was practiced in the pre-antibiotic era, but high rates of infection still occurred. A 2019 Cochrane systematic review aimed to evaluate the healing and infection rates in bite wounds based on if/when they were stitched closed. The review authors looked for studies that compared stitching wounds closed straight away, leaving them open for a short time or not stitching them at all. Due to a lack of high-certainty evidence, the review authors concluded that more robust randomised controlled trials were needed to fully answer this question. Antibiotics Antibiotics to prevent infection are recommended for dog and cat bites of the hand, and human bites if they are more than superficial. They are also recommended in those who have poor immune function. Evidence for antibiotics to prevent infection in bites in other areas is not clear. The first choice is amoxicillin with clavulanic acid, and if the person is penicillin-allergic, doxycycline and metronidazole. The antistaphylococcal penicillins (e.g., cloxacillin, nafcillin, flucloxacillin) and the macrolides (e.g., erythromycin, clarithromycin) are not used for empirical therapy, because they do not cover Pasteurella species. Vaccinations Rabies prevention is generally available in North America and the Northern European states. Tetanus toxoid treatment is recommended in those whose vaccinations are not up to date and have a bite that punctures the skin. Tetanus immune globulin is indicated in people with more than 10 years since prior vaccination. Tetanus boosters (Td) should be given every ten years. TT = tetanus toxoid; TIG: tetanus immune globulin Mosquito bites Antihistamines are effective treatment for the symptoms from bites. Many diseases such as malaria and dengue are transmitted by mosquitoes. Epidemiology Human bites are the third most frequent type of bite after dog and cat bites. Dog bites are commonplace, with children the most commonly bitten and the face and scalp the most common target. About 4.7 million dog bites are reported annually in the United States. The US estimated annual count of animal bites is 250,000 human bites, 1 to 2 million dog bites, 400,000 cat bites, and 45,000 bites from snakes. Bites from skunks, horses, squirrels, rats, rabbits, pigs, and monkeys may be up to 1 percent of bite injuries. Pet ferrets attacks