Animal bites and rabies post-exposure prophylaxis, active and reserve components, U.S. Armed Forces, 2011-2018

During 2011-2018, there were 22,729 diagnoses of animal bites among active and reserve component members of the U.S. Armed Forces. Of these, 899 (4.0%) were documented during medical encounters associated with deployments to overseas theaters of operations. Army, Navy, Air Force, and Marine Corps members were affected by 55.6%, 23.5%, 14.2%, and 6.7% of all animal bites diagnosed in theater, respectively. More than four-fifths of total animal bite cases (82.4%) and bites diagnosed in theater (88.4%) affected enlisted members. The crude overall incidence rate of animal bite diagnoses was 175.7 per 100,000 person-years (p-yrs) among active component service members between 2011 and 2018. Overall rates were highest among active component service members who worked in law enforcement (462.5 per 100,000 p-yrs) or veterinary occupations (437.8 per 100,000 p-yrs). Among active component service members, the crude annual rate of animal bite diagnoses in 2018 was more than twice that in 2001 (194.1 per 100,000 p-yrs and 85.1 per 100,000 p-yrs, respectively). Dog bites accounted for approximately three-quarters (74.8%) of total animal bites during the surveillance period. Only a small proportion of animal bites were associated with documentation of exposure to or post-exposure prophylaxis for rabies. Animal bite avoidance and rabies education should be reinforced before service members travel or deploy to areas where rabies is highly enzootic.