Animal Bite Incidence Climbed Across an 11-Year Registry in Iran
A decade-long registry from Torbat Heydariyeh County in Razavi Khorasan Province captures a steady rise in animal bites and the public health burden that follows each exposure. Investigators reviewed 12,079 recorded bites in a population covered by Torbat Heydariyeh University of Medical Sciences between 2015 and 2025, tracing when, where, and to whom these injuries occurred. The overall pattern is not subtle: incidence rose across the study window, dipped during 2020 to 2021, then climbed again to a peak in 2024 before easing slightly in 2025.
The annual incidence increased by 16.33 cases per 100,000 population per year, with a statistically significant trend. In practical terms, this is not a static background problem but a growing injury stream that places continued demand on rabies prevention and treatment services, especially in settings where prompt post-exposure care determines whether an exposure remains a wound or becomes a fatal infection risk.
Dogs Drove Most Exposures, and Rural Men Bore the Largest Share
Dogs accounted for 83.70% of bites, while cats were responsible for 15.70%. The animal distribution alone shapes prevention strategy: in this region, bite control is overwhelmingly a dog-associated problem, not a broad multispecies issue. Seasonal clustering followed a familiar epidemiologic rhythm, with the highest incidence in spring at 31.80%, then summer at 29.80%, and the lowest in winter at 17.20%.
Male patients represented 78.00% of cases, and rural residents made up 65.60%. Those proportions point to exposure patterns tied to daily movement, occupational contact, and likely proximity to free-roaming animals outside dense urban environments. Rural geography also changes the response burden; longer travel times to care, delayed wound cleansing, and later arrival for rabies prophylaxis can all widen the gap between exposure and protection.
Single injuries accounted for 59.60% of cases. The most common anatomical sites were the thighs and legs, which together represented 57.50% of injuries. Lower-extremity bites often suggest contact during walking, field work, herding, or other ground-level encounters in which animals strike at the nearest exposed target. In rabies prevention, the body site matters because lower-limb wounds can still be severe, but the pattern reveals a preventable exposure ecology rather than random injury distribution.
The 2020–2021 Dip Did Not Last
After the decline seen during 2020 to 2021, incidence climbed again and reached its highest level in 2024 at 513.36 per 100,000 population. It then fell modestly to 475.83 per 100,000 population in 2025. The rebound matters more than the brief pause, because it indicates that the underlying exposure environment remained active rather than resolved. A temporary decline in one period does not erase a structurally persistent injury source.
Among 11,469 animal-bite cases, six deaths were recorded, a mortality proportion of 0.10%. The death count is small relative to the case volume, yet it carries heavy clinical meaning because rabies is almost uniformly fatal once symptoms begin. Even a low mortality share becomes a serious public health signal when the exposures are frequent, preventable, and linked to a disease with no room for delayed action.
Why the Pattern Matters for Rabies Prevention
This registry speaks to more than injury surveillance. It maps the operational burden of rabies prevention centers, where every bite triggers wound care, risk assessment, vaccination decisions, and often rabies immunoglobulin when indicated. As dog bites remain the dominant exposure, prevention efforts will need to focus on dog population management, bite avoidance education, and faster access to post-exposure prophylaxis in rural communities.
The age or pediatric profile is not described in the registry summary, so the clearest actionable signal comes from sex, residence, season, and animal species. Those variables are enough to direct intervention planning. Spring and summer demand stronger community messaging and service readiness; rural districts need easier access to treatment centers; and male-dominated exposure settings call for targeted education in work environments where people encounter dogs during routine outdoor activity.
The most important implication is simple: bite prevention and rabies control must be treated as an ongoing systems problem, not an episodic injury issue. When incidence rises year after year, the response cannot rely on reactive case management alone. It has to include animal control, community education, environmental monitoring, and rapid treatment access linked to the geography of exposure.
Registry Data Point to a Persistently Exposed Population
The study used a retrospective registry-based design and analyzed all recorded cases at rabies prevention and treatment centers over 11 years. That makes the dataset useful for describing real-world service demand, even if it cannot explain every behavioral or ecological driver behind the rise. The analytic framework included trend testing and standard comparisons across demographic and injury variables, giving the findings statistical weight as well as operational relevance.
What stands out is the consistency of the exposure profile: mostly dogs, mostly men, mostly rural residents, and mostly lower-extremity injuries. Those features describe a stable risk ecology that public health teams can recognize and target. When the same pattern repeats across years, the burden shifts from surveillance to intervention.
The study ends on a concrete warning rather than an abstract one. Animal bites in this Iranian county continued to rise over the observation period, and the pattern aligns with a preventable, geographically concentrated exposure burden that will keep feeding rabies services unless prevention reaches the people and places where bites are happening most often.