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Himalayan black bear mauling: offense or defense?
American Journal of Otolaryngology–Head and Neck Medicine and Surgery 28 (2007) 247 – 250 www.elsevier.com/locate/amjoto
Himalayan black bear mauling: offense or defense? Jagdeep Singh Thakur, MS4, Chander Mohan, MS, Dev R. Sharma, MS I G Medical College, Otolaryngology—Head and Neck Surgery, IGMC, Shimla, HP, India Received 5 July 2006
Abstract
The Asiatic Black Bear (Ursus thibetanus or Selenarctos thibetanus), also known as the Tibetan black bear, the Himalayan black bear, or the moon bear is a omnivorous mammal. This animal is declared threatened animal and rarely comes in human contact. Recent decrease in forest area has, however, increased the chances of bear-human interaction, hence causing injuries to humans. There is only one published report in English literature on Himalayan black bear mauling. We present 5 cases referred to our department over a period of 1 year. D 2007 Elsevier Inc. All rights reserved.
1. Introduction Serious human injuries from black bear mauling, including fatalities, are uncommon [1]. The Asiatic Black Bear (Ursus thibetanus or Selenarctos thibetanus), also known as the Tibetan black bear, the Himalayan black bear, or the moon bear, is a medium sized, sharp-clawed, blackcolored bear that usually features a distinctive white or cream bVQ marking on its chest. It is a very close relative of the American black bear, with which it is thought to share a European common ancestor. Himalayan black bear grows to approximately 130 to 190 cm (4–6 ft) in length. Males weigh between 110 and 150 kg (242–330 lb), and females weigh between 65 and 90 kg (143–198 lb). The bear’s life span is around 25 years. It can be found in low lands as well as areas with elevations as high as 4700 m (9900 ft). In some parts of this range, the Asiatic black bear shares its habitat with the larger and stronger brown bear (Ursus arctos). However, the smaller black bear has an advantage over its competitor—its climbing skills—which help it reach for fruit and nuts in the trees. The Asiatic Black Bear is an omnivore, which consumes a great variety of foods including fruit, berries, grasses, seeds, nuts, invertebrates, honey, and meat (fish, birds, rodents, and other small mammals as well as
4 Corresponding author. I G Medical College, Otolaryngology—Head and Neck Surgery, IGMC, Shimla, HP 171001, India; Tel.: +91 94184 77400. E-mail address: [email protected] (J.S. Thakur). 0196-0709/$ – see front matter D 2007 Elsevier Inc. All rights reserved. doi:10.1016/j.amjoto.2006.08.014
carcasses). The Asiatic black bear is thought to be somewhat more carnivorous than its American cousin. Nevertheless, meat only makes up a small part of its diet. Himalayan black bear has been known to be quite aggressive toward human beings (more so than the American black bear). Asiatic black bear often retreats when it comes in contact with human beings. The Asiatic black bear is listed as vulnerable on the World Conservation Union’s Red List of Threatened Animals. It is threatened mainly by deforestation and habitat loss. The bears are also killed by farmers because of the threat they pose to livestock. They are also unpopular for their habit of stripping valuable timber trees of bark [2]. 2. Case reports 2.1. Case 1 At about 12 noon, an 8-year-old boy was with his mother on countryside near the forest when he was suddenly attacked by a Himalayan black bear. The child fell into bushes by force. The bear retreated without injuring the mother. The child was retrieved from bushes and rushed to a nearby hospital. The child was bleeding profusely from the face, and both eyes were lacerated. The primary repair of wound was done, and he was referred to our institution. The patient was assessed and hematological, biochemical, and radiological investigations were done. X-ray showed Le Fort II fracture. He was taken up for emergency exploration under general anesthesia (GA). He had cut lacerated injury
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J.S. Thakur et al. / American Journal of Otolaryngology–Head and Neck Medicine and Surgery 28 (2007) 247 – 250
Fig. 1. Patient (case 2) with primary closure of wound, showing the facial wound which injured the Zygomatico-facial branch.
Fig. 3. Patient (case 3) with evisceration of right eye and primary closure of wound.
on the face, both orbits, and Le Fort II fracture. The eyes were damaged, and evisceration was done. The lacerated wounds were explored, cleaned, and closed along with management of Le Fort fracture. Patient was put on oral antibiotics and supportive therapy.
2.3. Case 3
2.2. Case 2 A 40-year-old woman (Fig. 1) was attacked by Himalayan black bear when she was in a grazing field of forest land at around 3 pm. She was taken to a local hospital, and after first aid, she was referred to our institution. After emergency investigation, she was also taken up for wound exploration and closure. She had class 2 fracture of nasal bone and soft tissue injury on parotid region, leading to loss of zygomaticofacial branch of facial nerve. The nasal bone fracture reduction and wound cleaning and closure was done. The patient was again taken up for septorhinoplasty after 6 weeks. The patient recovered well.
A 35-year-old man (Fig. 2) was attacked by Himalayan black bear at about 1:30 pm in a forest. He was also referred to our institution after first aid in a nearby hospital. In our department, the patient was investigated. The hemoglobin was level was 9.2 g, and x-ray showed no fracture. The patient had avulsed right eye ball and lacerated injury on right parotid region and right pinna. The patient was taken up for emergency exploration of wounds under general anesthesia. There were leaves and dust in the wound. The right eye was enucleated, and primary closure of wound was done (Fig. 3). The facial nerve was normal postoperatively. Patient had external ear canal stenosis, which was managed by canaloplasty. 2.4. Case 4 Around 2 pm, a 65-year-old man was attacked by a Himalayan black bear in grazing fields of a forest. The patient was then taken to hospital and, thereafter, referred to our institution. Patient had lacerated injuries of eyelids, cheeks, nose, and buccal mucosa. There was Le Fort II fracture (midline hard palate split, fracture maxilla, right gingival avulsion, and class 3 nasal bone fracture). The patient was undertaken for exploration and repair of wound, with management of bone injuries. 2.5. Case 5
Fig. 2. Patient (case 3) with severe lacerated wound caused by Himalayan black bear mauling.
A 42-year-old man was attacked by a Himalayan black bear when he was passing through the jungle at around 3 pm. He was referred to us after initial treatment similar to earlier cases. On examination, patient had Le Fort II fracture, soft tissue lacerations on face, and active hemorrhage from nasopharynx. The maxillary arterial rupture was suspected. Wound exploration and maxillary artery ligation were done. However, patient had hemorrhagic shock and was kept in the intensive care unit and managed. The patient recovered fully.
J.S. Thakur et al. / American Journal of Otolaryngology–Head and Neck Medicine and Surgery 28 (2007) 247 – 250
3. Discussion The incidence of the Asiatic black bear mauling human beings has not been mentioned in English literature (Medline search). We came across only one 5-year study of Himalayan black bear mauling, reporting 12 human attacks of Himalayan black bear. There were mainly faciomaxillary injuries, and only one patient sustained cervical spine injury. The 9 attacks on humans occurred in morning hours between 5 and 7 am, whereas in 3 cases, it was between 6 and 8 pm [4]. In a 20-year study in state parks of North America, only 3 cases are reported [3], whereas in another study, 500 cases of black bear injuries were reported between 1907 to1993, of which 37 were fatal and 12 sustained major injuries. The incidence of black bear in North America, when compared with park visitors, was 0.00015% to 0.00001%. The incidence in relation to park hikers and campers was 0.0017% to 0.0087% [5]. We got 5 cases, within a time span of 10 months, of Himalayan black bear mauling, which were referred to us from peripheral health institutions after primary care of injury. There were 4 adults (three men and one woman) and 1 male child. The age ranged between 8 to 65 years (mean age, 38 years). In all cases, bear attack was in the forest between 12 and 3 pm. The attacks were sudden, and sex of the bear could not be identified by the victims. All patients had major injuries as they required surgery and admitted for more than 24 hours [3]. In all the 5 cases, the injuries were on the head and neck area only. There was no evidence of bites. Le Fort II fracture was seen in 3 cases, with midline split in 2 cases. Nasal bone fracture class 2 was present in 1 case. Soft tissue lacerated wounds were present in all 5 cases, of which both eyeball injuries were seen in 1 case and unilateral eyeball was injured in another. In both cases, evisceration was done because eyes were beyond repair. Injury to the nose, lids, cheek, and scalp were present in all 5 cases. Two cases had parotid injury, of which 1 case had transaction of zygomaticofacial branch of facial nerve. Ear injury was present in 1 case. One case had maxillary artery rupture, leading to the hypovolemic shock, but was revived. For the management, all cases were taken for emergency exploration of wound and repair. All cases were contaminated with foreign bodies in the form of dust, grass, and wood splints due to fall. Foreign bodies were removed and thorough irrigation and cleaning, and debridement was done in all cases. Fractures were managed, and primary closure of soft tissue injuries was done. Every case had antitetanus and antirabies vaccination, as per schedule. Postoperative antibiotics and supportive therapy were also given. Two cases had postoperative nasal deformity and underwent septorhinoplasty. One case had external auditory canal stenosis and managed by canaloplasty. In this study, we have observed that injuries sustained in Himalayan black bear attack were only in head and neck area, with no injury in other parts of the body except abrasion due to fall. Le Fort fractures, nasal bone fracture,
249
and eye injuries were the most common injuries encountered. All the attacks by the Himalayan black bear were in the afternoon between 12 and 3 pm. The state of Himachal Pradesh has 2 national parks and 32 wildlife sanctuaries. The state has dense forest. The forest-covered area is 66.52% of the total geographic area of the state [6]. Total population of the state is 6 077 900, of which 5 482 319 of the population lives in rural area [7]. These people usually take their livestock to the grazing areas near the forest. These people also go into the forest in search of timber for cooking and illegal hunting. At this instance, they have interaction with Himalayan black bear. Although Himalayan black bear does not attack humans and make retreat, it may attack on provocation or in the defense. As the forest area of this state is decreasing, there are more chances of human-bear conflict. Other wildlife animal attacks are also quite common in this state. The leopard is the main culprit, and this is mainly due to their man-eating habits, which are also due to decrease in the forest and prey animals. In contrast, we have not come across any report of a Himalayan black bear eating any human being. We have also not found any teeth marks on the body of the victims. There were only lacerated injuries, either due to nails or abrasions due to fall. 4. Conclusion The special features of Himalayan black bear mauling are as follows: 1. 2. 3.
4.
5.
Attacks in the day time—probably when it comes out in search of food Attack out of fear or in defense Attacks only the face (injuries sustained are mainly due to nails or fall; face is injured because it is the most prominent and accessible part of the human body as bear attacks) Himalayan black bear has no intention to eat the victim because the bears fled the site after attack in all cases. None of the bears were accompanied by cubs, as it has been suggested that female bear tends to attack the human beings to protect its cubs.
Whatever may be the cause and attack, the bear mauling leads to very serious injuries, mainly on the face/head, which has been attributed to its prominence. The physicians as well as surgeons should be well prepared to manage such injuries because patients may go into respiratory obstruction due to aspiration of blood or circulatory shock. The joint approach by physician, head-neck surgeon, and ophthalmologist can manage such cases very well. In emergency, patient should be assessed by x-ray or computed tomography. The hemodynamics should be managed. Patient should be given antirabies vaccine and antibiotics. Patients can be taken up for any cosmetic surgery later.
250
J.S. Thakur et al. / American Journal of Otolaryngology–Head and Neck Medicine and Surgery 28 (2007) 247 – 250
References [1] Dieter Jr RA, Dieter DL, Dieter III RA, et al. Bear mauling: a descriptive review. Int J Circumpolar Health 2001;60:696 - 704 (Abstr). Available at: http://www.medscape.com/medline/publicationbrowser/ 123?pmd = 11768451 [Accessed 15th April 2006]. [2] Himalayan black bear—Wikipedia, the free encyclopedia. Available at: http://en.wikipedia.org [Accessed 16th April 2006]. [3] Herrero S. Bear attack. Their causes and avoidance. New York7 Nick Lyons Book; 1985.
[4] Dvivedi S, Sood S, Mehrotra V, et al. Injuries caused by black Himalayan bear in the foothills of Garhwal, Himalayas. Trop Doct 2003;33:115 - 7. [5] Herrero S, Fleck S. Injury to people inflicted by black, grizzly or polar bear: recent trends and new insights. Int Conf Bear Res Manag 1990; 8:25 - 32. [6] HP Forest. Available at: http://hpforest.nic.in [Accessed 23rd April 2006]. [7] 2001 Indian census, Himachal Pradesh state population. Available at: www.censusindia.net [Accessed 23rd April 2006].
Himalayan black bear mauling: offense or defense? Jagdeep Singh Thakur, MS4, Chander Mohan, MS, Dev R. Sharma, MS I G Medical College, Otolaryngology—Head and Neck Surgery, IGMC, Shimla, HP, India Received 5 July 2006
Abstract
The Asiatic Black Bear (Ursus thibetanus or Selenarctos thibetanus), also known as the Tibetan black bear, the Himalayan black bear, or the moon bear is a omnivorous mammal. This animal is declared threatened animal and rarely comes in human contact. Recent decrease in forest area has, however, increased the chances of bear-human interaction, hence causing injuries to humans. There is only one published report in English literature on Himalayan black bear mauling. We present 5 cases referred to our department over a period of 1 year. D 2007 Elsevier Inc. All rights reserved.
1. Introduction Serious human injuries from black bear mauling, including fatalities, are uncommon [1]. The Asiatic Black Bear (Ursus thibetanus or Selenarctos thibetanus), also known as the Tibetan black bear, the Himalayan black bear, or the moon bear, is a medium sized, sharp-clawed, blackcolored bear that usually features a distinctive white or cream bVQ marking on its chest. It is a very close relative of the American black bear, with which it is thought to share a European common ancestor. Himalayan black bear grows to approximately 130 to 190 cm (4–6 ft) in length. Males weigh between 110 and 150 kg (242–330 lb), and females weigh between 65 and 90 kg (143–198 lb). The bear’s life span is around 25 years. It can be found in low lands as well as areas with elevations as high as 4700 m (9900 ft). In some parts of this range, the Asiatic black bear shares its habitat with the larger and stronger brown bear (Ursus arctos). However, the smaller black bear has an advantage over its competitor—its climbing skills—which help it reach for fruit and nuts in the trees. The Asiatic Black Bear is an omnivore, which consumes a great variety of foods including fruit, berries, grasses, seeds, nuts, invertebrates, honey, and meat (fish, birds, rodents, and other small mammals as well as
4 Corresponding author. I G Medical College, Otolaryngology—Head and Neck Surgery, IGMC, Shimla, HP 171001, India; Tel.: +91 94184 77400. E-mail address: [email protected] (J.S. Thakur). 0196-0709/$ – see front matter D 2007 Elsevier Inc. All rights reserved. doi:10.1016/j.amjoto.2006.08.014
carcasses). The Asiatic black bear is thought to be somewhat more carnivorous than its American cousin. Nevertheless, meat only makes up a small part of its diet. Himalayan black bear has been known to be quite aggressive toward human beings (more so than the American black bear). Asiatic black bear often retreats when it comes in contact with human beings. The Asiatic black bear is listed as vulnerable on the World Conservation Union’s Red List of Threatened Animals. It is threatened mainly by deforestation and habitat loss. The bears are also killed by farmers because of the threat they pose to livestock. They are also unpopular for their habit of stripping valuable timber trees of bark [2]. 2. Case reports 2.1. Case 1 At about 12 noon, an 8-year-old boy was with his mother on countryside near the forest when he was suddenly attacked by a Himalayan black bear. The child fell into bushes by force. The bear retreated without injuring the mother. The child was retrieved from bushes and rushed to a nearby hospital. The child was bleeding profusely from the face, and both eyes were lacerated. The primary repair of wound was done, and he was referred to our institution. The patient was assessed and hematological, biochemical, and radiological investigations were done. X-ray showed Le Fort II fracture. He was taken up for emergency exploration under general anesthesia (GA). He had cut lacerated injury
248
J.S. Thakur et al. / American Journal of Otolaryngology–Head and Neck Medicine and Surgery 28 (2007) 247 – 250
Fig. 1. Patient (case 2) with primary closure of wound, showing the facial wound which injured the Zygomatico-facial branch.
Fig. 3. Patient (case 3) with evisceration of right eye and primary closure of wound.
on the face, both orbits, and Le Fort II fracture. The eyes were damaged, and evisceration was done. The lacerated wounds were explored, cleaned, and closed along with management of Le Fort fracture. Patient was put on oral antibiotics and supportive therapy.
2.3. Case 3
2.2. Case 2 A 40-year-old woman (Fig. 1) was attacked by Himalayan black bear when she was in a grazing field of forest land at around 3 pm. She was taken to a local hospital, and after first aid, she was referred to our institution. After emergency investigation, she was also taken up for wound exploration and closure. She had class 2 fracture of nasal bone and soft tissue injury on parotid region, leading to loss of zygomaticofacial branch of facial nerve. The nasal bone fracture reduction and wound cleaning and closure was done. The patient was again taken up for septorhinoplasty after 6 weeks. The patient recovered well.
A 35-year-old man (Fig. 2) was attacked by Himalayan black bear at about 1:30 pm in a forest. He was also referred to our institution after first aid in a nearby hospital. In our department, the patient was investigated. The hemoglobin was level was 9.2 g, and x-ray showed no fracture. The patient had avulsed right eye ball and lacerated injury on right parotid region and right pinna. The patient was taken up for emergency exploration of wounds under general anesthesia. There were leaves and dust in the wound. The right eye was enucleated, and primary closure of wound was done (Fig. 3). The facial nerve was normal postoperatively. Patient had external ear canal stenosis, which was managed by canaloplasty. 2.4. Case 4 Around 2 pm, a 65-year-old man was attacked by a Himalayan black bear in grazing fields of a forest. The patient was then taken to hospital and, thereafter, referred to our institution. Patient had lacerated injuries of eyelids, cheeks, nose, and buccal mucosa. There was Le Fort II fracture (midline hard palate split, fracture maxilla, right gingival avulsion, and class 3 nasal bone fracture). The patient was undertaken for exploration and repair of wound, with management of bone injuries. 2.5. Case 5
Fig. 2. Patient (case 3) with severe lacerated wound caused by Himalayan black bear mauling.
A 42-year-old man was attacked by a Himalayan black bear when he was passing through the jungle at around 3 pm. He was referred to us after initial treatment similar to earlier cases. On examination, patient had Le Fort II fracture, soft tissue lacerations on face, and active hemorrhage from nasopharynx. The maxillary arterial rupture was suspected. Wound exploration and maxillary artery ligation were done. However, patient had hemorrhagic shock and was kept in the intensive care unit and managed. The patient recovered fully.
J.S. Thakur et al. / American Journal of Otolaryngology–Head and Neck Medicine and Surgery 28 (2007) 247 – 250
3. Discussion The incidence of the Asiatic black bear mauling human beings has not been mentioned in English literature (Medline search). We came across only one 5-year study of Himalayan black bear mauling, reporting 12 human attacks of Himalayan black bear. There were mainly faciomaxillary injuries, and only one patient sustained cervical spine injury. The 9 attacks on humans occurred in morning hours between 5 and 7 am, whereas in 3 cases, it was between 6 and 8 pm [4]. In a 20-year study in state parks of North America, only 3 cases are reported [3], whereas in another study, 500 cases of black bear injuries were reported between 1907 to1993, of which 37 were fatal and 12 sustained major injuries. The incidence of black bear in North America, when compared with park visitors, was 0.00015% to 0.00001%. The incidence in relation to park hikers and campers was 0.0017% to 0.0087% [5]. We got 5 cases, within a time span of 10 months, of Himalayan black bear mauling, which were referred to us from peripheral health institutions after primary care of injury. There were 4 adults (three men and one woman) and 1 male child. The age ranged between 8 to 65 years (mean age, 38 years). In all cases, bear attack was in the forest between 12 and 3 pm. The attacks were sudden, and sex of the bear could not be identified by the victims. All patients had major injuries as they required surgery and admitted for more than 24 hours [3]. In all the 5 cases, the injuries were on the head and neck area only. There was no evidence of bites. Le Fort II fracture was seen in 3 cases, with midline split in 2 cases. Nasal bone fracture class 2 was present in 1 case. Soft tissue lacerated wounds were present in all 5 cases, of which both eyeball injuries were seen in 1 case and unilateral eyeball was injured in another. In both cases, evisceration was done because eyes were beyond repair. Injury to the nose, lids, cheek, and scalp were present in all 5 cases. Two cases had parotid injury, of which 1 case had transaction of zygomaticofacial branch of facial nerve. Ear injury was present in 1 case. One case had maxillary artery rupture, leading to the hypovolemic shock, but was revived. For the management, all cases were taken for emergency exploration of wound and repair. All cases were contaminated with foreign bodies in the form of dust, grass, and wood splints due to fall. Foreign bodies were removed and thorough irrigation and cleaning, and debridement was done in all cases. Fractures were managed, and primary closure of soft tissue injuries was done. Every case had antitetanus and antirabies vaccination, as per schedule. Postoperative antibiotics and supportive therapy were also given. Two cases had postoperative nasal deformity and underwent septorhinoplasty. One case had external auditory canal stenosis and managed by canaloplasty. In this study, we have observed that injuries sustained in Himalayan black bear attack were only in head and neck area, with no injury in other parts of the body except abrasion due to fall. Le Fort fractures, nasal bone fracture,
249
and eye injuries were the most common injuries encountered. All the attacks by the Himalayan black bear were in the afternoon between 12 and 3 pm. The state of Himachal Pradesh has 2 national parks and 32 wildlife sanctuaries. The state has dense forest. The forest-covered area is 66.52% of the total geographic area of the state [6]. Total population of the state is 6 077 900, of which 5 482 319 of the population lives in rural area [7]. These people usually take their livestock to the grazing areas near the forest. These people also go into the forest in search of timber for cooking and illegal hunting. At this instance, they have interaction with Himalayan black bear. Although Himalayan black bear does not attack humans and make retreat, it may attack on provocation or in the defense. As the forest area of this state is decreasing, there are more chances of human-bear conflict. Other wildlife animal attacks are also quite common in this state. The leopard is the main culprit, and this is mainly due to their man-eating habits, which are also due to decrease in the forest and prey animals. In contrast, we have not come across any report of a Himalayan black bear eating any human being. We have also not found any teeth marks on the body of the victims. There were only lacerated injuries, either due to nails or abrasions due to fall. 4. Conclusion The special features of Himalayan black bear mauling are as follows: 1. 2. 3.
4.
5.
Attacks in the day time—probably when it comes out in search of food Attack out of fear or in defense Attacks only the face (injuries sustained are mainly due to nails or fall; face is injured because it is the most prominent and accessible part of the human body as bear attacks) Himalayan black bear has no intention to eat the victim because the bears fled the site after attack in all cases. None of the bears were accompanied by cubs, as it has been suggested that female bear tends to attack the human beings to protect its cubs.
Whatever may be the cause and attack, the bear mauling leads to very serious injuries, mainly on the face/head, which has been attributed to its prominence. The physicians as well as surgeons should be well prepared to manage such injuries because patients may go into respiratory obstruction due to aspiration of blood or circulatory shock. The joint approach by physician, head-neck surgeon, and ophthalmologist can manage such cases very well. In emergency, patient should be assessed by x-ray or computed tomography. The hemodynamics should be managed. Patient should be given antirabies vaccine and antibiotics. Patients can be taken up for any cosmetic surgery later.
250
J.S. Thakur et al. / American Journal of Otolaryngology–Head and Neck Medicine and Surgery 28 (2007) 247 – 250
References [1] Dieter Jr RA, Dieter DL, Dieter III RA, et al. Bear mauling: a descriptive review. Int J Circumpolar Health 2001;60:696 - 704 (Abstr). Available at: http://www.medscape.com/medline/publicationbrowser/ 123?pmd = 11768451 [Accessed 15th April 2006]. [2] Himalayan black bear—Wikipedia, the free encyclopedia. Available at: http://en.wikipedia.org [Accessed 16th April 2006]. [3] Herrero S. Bear attack. Their causes and avoidance. New York7 Nick Lyons Book; 1985.
[4] Dvivedi S, Sood S, Mehrotra V, et al. Injuries caused by black Himalayan bear in the foothills of Garhwal, Himalayas. Trop Doct 2003;33:115 - 7. [5] Herrero S, Fleck S. Injury to people inflicted by black, grizzly or polar bear: recent trends and new insights. Int Conf Bear Res Manag 1990; 8:25 - 32. [6] HP Forest. Available at: http://hpforest.nic.in [Accessed 23rd April 2006]. [7] 2001 Indian census, Himachal Pradesh state population. Available at: www.censusindia.net [Accessed 23rd April 2006].