Animal Bite Incidence Climbed Across 11 Years in Torbat Heydariyeh
Animal bites remained a steadily growing public health burden in the population covered by Torbat Heydariyeh University of Medical Sciences in Iran, with the heaviest load falling on rural residents, men, and springtime months. The registry captured 12,079 cases between 2015 and 2025, creating a long view of how exposure patterns evolved across the county and how the risk concentrated in everyday community life rather than in isolated outbreaks.
The overall incidence followed an upward trajectory despite year-to-year fluctuations. After a decline during 2020 and 2021, the rate rose sharply and reached 513.36 per 100,000 population in 2024 before easing slightly to 475.83 per 100,000 in 2025. Annual incidence increased by 16.33 cases per 100,000 population each year, with the trend estimate reaching statistical significance (β = 16.33; 95% CI: 7.13–25.53; p = 0.003). In practical terms, the burden did not behave like a random scatter of injuries; it intensified over time, pointing to persistent exposure at the human-animal interface and ongoing gaps in prevention.
Dogs Drove Most Exposures, and Rural Men Carried the Largest Share
Dogs accounted for 83.70% of all bites, far outpacing cats, which made up 15.70%. That distribution matters clinically because dog bites often drive rabies concern, wound severity assessment, and post-exposure prophylaxis decisions in settings where vaccination status of the animal may be uncertain. The dominance of dogs also suggests a mix of domestic, stray, and community-dwelling animal contact patterns that likely shape daily risk across neighborhoods and villages.
Sex and residence patterns were just as striking. Men represented 78.00% of reported cases, while rural residents accounted for 65.60%. These numbers point to exposure linked with outdoor work, movement through shared spaces, and closer proximity to animals in agricultural or village environments. The burden was not evenly distributed, and it was not confined to a narrow age band in the information provided; the social geography of exposure was the defining feature.
The anatomical pattern also fits a predictable injury mechanism. Thighs and legs were the most common sites, appearing in 57.50% of cases, and single injuries accounted for 59.60% of events. Lower-extremity bites are consistent with animal attacks occurring at ground level during walking, working, or field activity, where the victim often cannot quickly escape or protect the legs. When the bite lands below the waist, the immediate concern extends beyond local tissue injury to the possibility of deeper puncture, contamination, and the need for timely wound management.
Spring Peaks and the Post-Pandemic Rebound Point to Seasonal Risk
Seasonality gave the registry a clear rhythm. Incidence peaked in spring at 31.80%, remained high in summer at 29.80%, and fell to its lowest level in winter at 17.20%. Warmer months likely expand outdoor work, pedestrian activity, and encounters with animals, which can raise exposure frequency across both rural and peri-urban settings. Seasonal clustering like this is useful because it shifts prevention from a generic public message to a timed intervention strategy that can be deployed before the high-risk months begin.
The sharp rise after 2021 deserves attention even without speculation beyond the data. A dip during 2020–2021 gave way to renewed growth in 2024 and 2025, suggesting that whatever temporarily reduced exposure did not hold. Seasonal patterns, animal movement, human behavior, and local prevention coverage likely interacted, but the registry itself leaves the most defensible conclusion intact: exposure resumed its upward path and did so quickly.
A small but real mortality signal emerged as well. Among 11,469 animal-bite cases, six deaths were recorded, a proportion of 0.10%. The study did not describe the circumstances of those deaths, so the safest reading is restrained but important: bites in this setting were not benign events, and the combination of rabies risk, delayed presentation, and wound complications can carry consequences far beyond the initial skin injury. Even a low fatality count reinforces why bite surveillance cannot be treated as a purely administrative exercise.
Registry Data Support Targeted Rabies Prevention and Rural Outreach
The design of the study gives it public health value. This was a retrospective registry-based epidemiological analysis using routinely recorded bite cases from rabies prevention and treatment centers over an 11-year period, which makes the findings especially relevant for service planning. The data were drawn from all recorded cases in the catchment population, and the analysis used standard statistical tools to evaluate trends and differences across time and groups. Because the cohort came from treatment centers, it reflects the burden reaching formal care, where rabies prophylaxis and wound treatment are delivered.
For health authorities, the pattern argues for prevention that is both geographic and seasonal. Rural communities need tailored education on animal avoidance, immediate wound washing, and prompt referral for prophylaxis. Men in outdoor occupations likely merit focused messaging as well, since their exposure profile is heavily overrepresented in the registry. Dog control, vaccination of animals, and rapid response systems after bites would fit the epidemiology better than broad, untargeted messaging alone.
The county-level rise also suggests that surveillance should be used as an early warning instrument rather than a passive record. When incidence climbs by double digits per 100,000 population annually, prevention programs must be reassessed for reach, timing, and rural coverage. The central public health challenge is not simply counting bites after they happen; it is shrinking the conditions that keep producing them.
Ethics approval was obtained from Torbat Heydariyeh University of Medical Sciences, and the work relied on de-identified registry data with consent waived by the ethics committee. Those features strengthen the feasibility of similar surveillance efforts elsewhere. Regions with comparable rural exposure, dog predominance, and seasonal clustering can use this pattern as a template for local control planning, especially where rabies remains a pressing concern.