Pet dog bites in children: management and prevention

Welsh hospital admissions due to dog bites and strikes (2014-2022)

OBJECTIVE

To describe the incidence and victim demographics of Welsh hospital admissions due to dog bites and strikes from 2014 to 2022.

STUDY DESIGN

Descriptive analysis of Welsh hospital admissions data.

METHODS

Residents of Wales admitted to a Welsh National Health Service (NHS) hospital for a dog bite or strike, were identified using ICD-10 codes. The annual incidence of dog bite and strike admissions between 2014 and 2022 was calculated and stratified by child-adult status, sex, and Local Health Boards. Trends over time were analysed using the Chi-square test for trends.

RESULTS

Hospital admissions due to dog bites and strikes have significantly increased from 16.3 per 100,000 to 23.7 per 100,000 population in 2022. This was driven by an increase in non-geriatric adults and an increase in three Local Health Boards. The Swansea Bay area has the highest incidence in Wales (56.1 admissions per 100,000).

CONCLUSIONS

Wales has a higher incidence of dog bites and strikes than England or the Republic of Ireland. Work in the communities where incidence is exceptionally high is needed to understand the reasons behind having the highest incidence of dog bites in the British Isles and to establish the most efficacious methods for bite prevention.

Review of psychological effects of dog bites in children

BACKGROUND

Dog bites are a concerning health problem in children and one of the leading causes of non-fatal injuries in this population. Dog attacks not only cause physical injuries but can also lead to long-term psychological problems. A review was performed to investigate the scope of literature on the psychological effects of dog bites on a paediatric population.

METHODS

A literature search was performed on Web of Knowledge database between 1982 to June 2023, returning 249 results. 14 primary studies reporting the psychological consequences of dog bites in children or adolescents were classed as eligible and 9 further studies were added from prior knowledge and bibliographical searches. 23 studies involving 1894 participants met the criteria and were included in this review.

RESULTS

Of these 23 studies, 8 were case studies or small case series reports (up to n=4), 14 larger descriptive studies and 1 analytical cross-sectional study. There was a mixture of retrospective and prospective data-gathering. The most common psychological consequences of dog bites in children were post-traumatic stress disorder, dog phobia, nightmares and symptoms of anxiety and avoidance behaviours.

CONCLUSIONS

Studies on dog bites in a paediatric population with a specific focus on the psychological consequences associated with dog bites and their management are sparse. Future research and practice should more greatly consider the psychological impact on child victims of dog bites and their family members, as well as their management to avoid the development of mental health issues and improve their quality of life. Future research also needs to ascertain the efficacy of using virtual reality in treating children with dog phobia.

Facial dog bites in children: A public health problem highlighted by COVID-19 lockdown

BACKGROUND

Stay-at-home injunction during COVID-19 pandemic led to new dynamics in households and increased the risk of domestic accidents involving pets. The aim of the study was to demonstrate an increase of facial dog bites in children during first lockdown period in France, compared to the same period in 2018 and 2019. Secondary objective was to investigate the demographics and circumstances in which dog bites occurred.

METHODS

A retrospective multicentric study was conducted nationwide. Patients under 18 years old managed in fifteen oral and maxillofacial surgery departments for a dog bite were included.

RESULTS

Eighty-seven patients were included. A significant increase of the number of children managed for facial dog bite was noticed in 2020 (p=0.0005). The male-to-female ratio was significantly reversed in 2020 with more bites in girls than boys (p=0.02). In 2020, children were mostly bitten to cheeks (28.6 %), lips-and-chin region (26.2 %), and eyelids (23.8 %). Severe bites increased in 2020, in comparison with 2018 and 2019. Dog bites occurring while petting or playing significantly increased in 2020 (31 %) (p=0.03).

CONCLUSION

The process leading to bites is highly dependent on the balance of dog-owner relationship. This was strongly disrupted during COVID-19 pandemic, resulting in the increase of dog bites in households. Regarding dog bites, face is the most vulnerable area in children. Its injury has lots of esthetic and functional consequences and maxillofacial surgeons have a key role to play in their prevention. Reminders of some of these management and prevention strategies are presented in this article.

A Multidisciplinary Approach to a Complex Fatal Attack Due to a Pack of Maremma Sheepdogs: Is It Always an Accident?

Deaths due to dog attacks are a worldwide issue. Fatal dog attacks may occur in various environments, including the dog owner's property. A lot of difficulties emerge when the attack involves a pack of dogs, of different species and sizes. In this case, it becomes much more difficult for forensic investigators to evaluate the event, especially regarding the identification of the dog or dogs that caused the death as well as the identification of the owner and the reconstruction of the dynamics for forensic purposes. In this paper, we analyze a specific case of an attack by a herd of Maremma sheepdogs. A crime scene investigation has been carried out. In the first phase of this case, the victim interacted with dogs that had non-aggressive attitudes. Then, after an escape attempt, she was assaulted by about 20 Maremma dogs of different sizes, leading to multiple injuries all over her body. The greatest difficulty was precisely that of reconstructing the dynamics due to the numerous injuries and dogs involved in the attack. The dynamics were divided into several stages following the analysis of the injuries found on the victim. This case study highlights how the forensic multidisciplinary approach has made it possible to precisely reconstruct the event. The analysis of the dogs' state of malnutrition and their suddenly aggressive attitude towards the victim revealed profiles of responsibility of the owner attributable to improper management and training of the animals to defend their property.

The K9-Teen Pandemic: When Good Boy Goes Bad. The Epidemiology, Management and Public Health Ramifications of Facial Dog Bite Injuries: Newcastle, Australia, Experience

The purpose of this study was to investigate the epidemiology, pattern of injury and management of facial dog bite injuries. Methods: The authors conducted a retrospective cohort study over a 5-year period of patients who sustained a facial dog bite injury. The study setting was an Oral and Maxillofacial Surgery Department at a level 1 trauma centre, servicing an estimated catchment population in excess of 950,000 people. Results: In total, 171 patients were managed in the designated period from January 2017 to January 2022. The median age was 9 years (range 11 months to 77 years), with the highest incidence of a single age 4 years. The frequency was slightly greater amongst males (n = 93) than females (n = 78). The most common responsible breed were Pitbull types (n = 26). Overall, bites most often resulted from the family dog (n = 87), in the victim's own home (n = 84) and whilst playing with the dog (n = 64). The primary sites involved were the lips (n = 70), cheek (n = 53) and nose, representing the so called 'target area'. In 53 cases, the injuries were classified as severe. 138 patients required hospital admission, and of these, 130 required surgical management under general anaesthesia. Conclusions: Facial dog bite injuries present a significant burden on the healthcare system and result in physical, functional and/or emotional distress for the patient. As the rates of dog ownership continue to rise, a consequential increase in these injuries is also likely. Further, public health intervention is essential, particularly as the most susceptible demographic remains young male children.

Risk Factors for Pediatric Facial Trauma in an Appalachian Region: An Epidemiological Review at a Single Institution

BACKGROUND

Rural and low-income pediatric populations are at higher risk for trauma. Craniomaxillofacial (CMF) trauma in this population has not been studied.

PURPOSE

This study's purpose was to determine if rural populations or low-income populations are at higher risk for pediatric CMF trauma than urban or high-income populations, respectively, and to determine differences in mechanism of injury (MOI).

STUDY DESIGN, SETTING, SAMPLE

A retrospective cohort study of CMF trauma patients younger than 17 years-old, living in the region served by one institution in Tennessee, and requiring oral and maxillofacial surgery consultation between January 2011 and December 2022 was performed. Exclusion criteria were incomplete medical records.

PREDICTOR VARIABLE

The primary predictor variable was geographic residence of the patient grouped into two categories: rural or urban defined by the state of Tennessee. Secondary variables were postal code (PC) average median household income (MHI) and PC population density.

MAIN OUTCOME VARIABLE(S)

The main outcome variable was pediatric CMF injury rate per 100,000 people. MOI is a secondary outcome variable.

COVARIATE(S)

Covariates included sex, age, and race.

ANALYSES

Frequencies and percentages, Fisher's exact test, and Poisson regression models were utilized. Statistical significance was assumed at P-value <.05.

RESULTS

Rural or urban county designation was not associated with differing trauma rates (incident risk ratio (IRR) = 0.91; 95% confidence interval (CI) 0.78 to 1.05; P = .18) by itself. One standard deviation increase in MHI decreased CMF trauma rates in rural designation counties by 24% (IRR: 0.76, 95% CI: 0.66, 0.88) and 6% in urban designation counties (IRR: 0.94, 95% CI: 0.87, 1.02). Lower rates of CMF trauma were associated with residence in higher income PCs (IRR = 0.91; 95% (CI) 0.86 to 0.97; P = .004), and higher population density (IRR = 0.87; 95% CI 0.79 to 0.94; P < .001). Dog bites and falls were more common in infancy and early childhood. Interpersonal violence was more common in older patients.

CONCLUSIONS AND RELEVANCE

Patients in PCs with lower population density or incomes were at highest risk for CMF injuries. MOI differences by age were similar to findings in other studies. Tennessee's urban/rural county designation has complex interactions with MHI and pediatric CMF trauma rates.

Pediatric Long Bone Fractures After Dog Bites: A Case Series and Systematic Review

This study presents a case series and systematic review of pediatric patients who sustained long bone fractures following dog bites. A systematic review of the studies on "pediatric fracture dog bite" based on a search of PubMed and OVID Medline databases was performed by adhering to PRISMA guidelines. Articles in English describing pediatric long bone fractures due to dog bites were included. Studies not differentiating pediatric from adult patients and not describing long bone fractures due to dog bites were excluded. Study characteristics, fracture epidemiology, management decisions, and follow-up data were extracted. Additionally, a seven-year retrospective chart review of cases treated at our level one pediatric trauma center was performed. Data on fracture characteristics, surgical management, choice of antibiotic therapy, and follow-up were collected. Five studies that met our criteria were analyzed. Pediatric long bone fractures from dog bites were identified in 0.35% (11/3,156) of patients. Such fractures most commonly involved the upper extremity (9/11, 82%). None of the studies described the choice of antibiotics, surgical decision-making, or wound closure preference for an underlying fracture. Our chart review elicited three cases of long bone fractures due to dog bites. Pediatric long bone fractures after dog bites are a rare injury pattern in the United States. These injuries should be treated as contaminated open fractures, and urgent immunization, intravenous antibiotic administration, wound care, and fracture stabilization should be provided. We recommend meticulous surgical debridement in the operating room, as wounds often probe deep into the bone. Nevertheless, there is much that remains unclear about these injuries. Hence, further research with greater power is needed to improve treatment decisions.

Clinical effect analysis of using medical glue versus conventional suturing to treat dog bite in children's maxillofacial region after negative pressure sealing drainage: A randomized trial

BACKGROUND

To compare the clinical effectiveness of applying medical glue versus conventional suturing after primary suturing and continuous vacuum sealing drainage (VSD) technology in the treatment of facial wounds caused by dog bites in children's maxillofacial region, with respect to operation time, wound infection rate, treatment effect, and patient satisfaction.

METHODS

From May 2020 to July 2022, 68 children with a dog bite in the maxillofacial region were randomly divided into medical glue and conventional suturing groups. The patients in both groups were treated with conventional debridement, tetanus and/or rabies immunization, and antibiotic therapy. The medical glue group was treated with VSD after the first-stage of the loose suture of the wound. After 5 days, the suture was removed, and the wound was tightly bonded with medical glue again. The conventional suturing group was treated with VSD after the first-stage of loose suture of the wound. The primary outcomes were the operation time and satisfaction of the 2 groups, and the secondary outcomes was the wound infection rate.

RESULTS

The operation time of the medical glue group was significantly lower than that of the conventional suturing group. However, there was no significant difference between the 2 groups in the wound infection rate. Still, the patient satisfaction was significantly better in the medical glue group than the conventional suturing group with statistically significant difference (P < .05).

CONCLUSION

In conclusion, applying medical glue after using negative pressure sealing drainage in treating maxillofacial dog bites can reduce surgeons work intensity, lessen children's pain, and improve the clinical treatment effect.

An Assessment of Scientific Evidence Relating to the Effect of Early Experience on the Risk of Human-Directed Aggression by Adult Dogs

Human-directed aggression by domestic dogs is a major worldwide public health problem. The causes of aggression are complex, and research in this area often has to balance ecological validity with pragmatic controls; accordingly, it often does not meet the thresholds for quality typically used in reviews applying a classical "evidence-based" approach. Here, we propose a method of literature assessment that makes the "best use" of available evidence to identify and synthesise evidence relating to the most likely risk factors reported in the scientific literature. We used a systematic review process to initially identify relevant literature relating to potential early life experience (i.e., in the first six months of life) risk factors in the dog for human-directed aggression in the adult animal. Fourteen papers met our initial screening process and were subsequently analysed in detail, with data extracted and effect sizes calculated where possible. This highlighted the potential importance of the source of the animal, the age at which it was rehomed, the reason for the acquisition, the experience level of the owner, the animal's socialisation experiences, the consistent husbandry and management practices, the training, the sex ratio of the litter and the history of dogs that display aggression in the pedigree as risk factors. Taken together, it seems that early experiences which limit the ability to develop effective coping strategies and routines may be particularly important. We provide guidance for the future standardised reporting of risk related to human-directed aggression by dogs to allow greater synthesis of the literature in the future.

Is UK Puppy Purchasing Suffering a Long COVID Effect? Ongoing Negative Impacts of the COVID-19 Pandemic upon Puppy Purchase Motivations and Behaviours in 2021

The COVID-19 pandemic led to a surge in acquisitions of puppies in the UK, dubbed the "Pandemic Puppy" phenomenon. In addition to an increased demand for puppies, widespread changes to both why and how puppies were purchased during this period compared to pre-pandemic 2019 purchases were documented, many of which threatened canine welfare (e.g., puppies being collected away from their place of birth, without seeing their mother). This study aimed to explore which changes to the pre-purchase and purchase motivations and behaviours of UK owners who purchased a puppy aged <16 weeks in the 2020 phase of the COVID-19 pandemic had persisted into 2021 or had returned to pre-pandemic 2019 levels. An online survey was conducted during February to April 2022 from which 2080 valid responses were analysed ("2021 puppies") and compared with previously collected data from comparable cohorts in 2019 (n = 1148, "2019 puppies") and 2020 (n = 4369, "Pandemic Puppies"). While the majority of the peak pandemic changes documented in 2020 had returned to their 2019 pre-pandemic baseline, others persisted into 2021. Multinomial logistic regression models revealed that the shifts during 2020 towards owners viewing their puppy pre-purchase over video calls or via video recordings/photos rather than in-person and towards collecting their puppy from outside of their breeders' property rather than inside had persisted into 2021 and had not returned to pre-pandemic levels. Year-on-year significant rises in the number of puppies sold with a passport were documented between 2019 and 2021, with over 1 in 10 2021 puppies having been sold with a passport, the figure more than doubling since 2019. An increasing number of these puppies sold with a passport were under the minimum legal age for import at sale. Going forward, these concerning changes require further monitoring and human behaviour change interventions to tackle, including increased buyer awareness but also legislative approaches to prevent the greatest harm.

Legal epidemiology of paediatric dog bite injuries

BACKGROUND

Dog bite injuries cause over 100 000 paediatric emergency department visits annually. Our objective was to analyse associations between regional dog ownership laws and incidence of paediatric dog bites.

METHODS

This observational study used an online search to locate local dog-related policies within Ohio cities. Data collected by Ohio Partners For Kids from 2011 through 2020 regarding claims for paediatric dog bite injuries were used to compare areas with and without located policies and the incidence of injury.

RESULTS

Our cohort consisted of 6175 paediatric patients with dog bite injury encounters. A majority were white (79.1%), male (55.0%), 0-5 years old (39.2%) and did not require hospital admission (98.1%). Seventy-nine of 303 cities (26.1%) had city-specific policies related to dogs. Overall, the presence of dog-related policies was associated with lower incidence of dog bite injury claims (p=0.01). Specifically, metropolitan areas and the Central Ohio region had a significantly lower incidence when dog-related policies were present (324.85 per 100 000 children per year when present vs 398.56 when absent; p<0.05; 304.87 per 100 000 children per year when present vs 411.43 when absent; p<0.05).

CONCLUSIONS

The presence of city-specific dog-related policies is associated with lower incidence of paediatric dog bite injury claims, suggesting that local policy impacts this important public health issue. There are limited dog-related policies addressing dog bite prevention, with inconsistencies in breadth and depth. Creating consistent, practical requirements among policies with vigorous enforcement could ameliorate public health concerns from paediatric dog bite injuries.

A 10-year retrospective analysis (2012-2021) of hospitalizations resulting from dog bites in Southern Italy

This study aimed to describe the incidence and characteristics of dog-bite injury hospitalizations (DBIH) in the largest administrative region of Italy (Sicily) over the 10-year period: 2012-2021. Four hundred and forty-nine cases were analyzed. Patients were divided into seven age groups: preschoolers (0-5 years), school-age children (6-12 years), teenagers (13-19 years), young adults (20-39 years), middle-aged adults (40-59 years), old adults (60-74 years), and the elderly (≥75 years). Association among categorical variables (age, gender, principal injury location) was evaluated using chi-square tests, and mean differences for normally distributed variables were assessed using one-way analysis of variance. Finally, a Poisson regression general linear model (GLM) analysis was used to model incidence data. The results revealed that the incidence of DBIH per 100,000 population increased from 0.648 in 2012 (95%CI 0.565-0.731) to 1.162 in 2021 (95%CI 1.078-1.247, P < 0.01). Incidence for both male and female victims also increased over the studied period (P < 0.05). We found an increasing trend of incidence in young and middle-aged adults (P < 0.05 and P < 0.005 respectively). Moreover, the most frequently injured age group by dogs was the preschooler group and, whilst we found a lower risk of being injured for males older than 20 years, no difference with females was observed. The location of lesions depended on the age group (P < 0.001). The number of days of DBIH increased significantly with age (P < 0.01). The increase of DBIH represents a public health problem that requires the development of preventive approaches.

A Retrospective Study Examining the Presentation and Management of Maxillofacial Soft Tissue Injuries Over 3 Years at a Regional Children's Hospital and the Introduction of a Maxillofacial Laceration Grading Scale

Pediatric trauma has been affected by COVID-19, school closures, and stay at home advice. Health seeking behavior has decreased. The aim of this study is to assess trends in the presentation of maxillofacial soft tissue injuries and subsequent management within a regional pediatric hospital. Retrospective study over a 3-year period (from 2019 to 2021 between the months of January and April). Inclusion of all pediatric patients seen by Oral and Maxillofacial Surgery team. Between 2019 and 2021, the total number of patients dropped by over half. The average age dropped from 5.9 in 2019 to 3.8 in 2021. Males were more commonly seen. Falls are the most common cause of injuries across 2019 to 2021. Extraoral injuries increased by 21%. Intraoral injuries reduced by 8%. Lip lacerations accounted for most injuries. In 2020, there was 21% reduction in conservative management of injuries. Wound closure under local anesthetic peaked in 2020, by 12%. Wound closure under general anesthetic has increased by 5%, and accounts for nearly a third of all injuries in 2020 and 2021. Patients are becoming younger and more likely to be male. Conservative management is most common but closure under local anesthetic and general anesthetic has increased. This may indicate an increase in the severity of soft tissue injuries or a trend toward operative management. We also introduce a laceration grading scale for clinician use to assist in assessing and documenting injury severity. Further research is needed to assess whether these trends continue or revert to prepandemic trends.

Are children and dogs best friends? A scoping review to explore the positive and negative effects of child-dog interactions

Personal wellbeing is greatly influenced by our childhood and adolescence, and the relationships formed during those phases of our development. The human-dog bond represents a significant relationship that started thousands of years ago. There is a higher prevalence of dog ownership around the world, especially in households including children. This has resulted in a growing number of researchers studying our interactions with dogs and an expanding evidence base from the exploration of child-dog interactions. We review the potential effects of child-dog interactions on the physical, mental, and social wellbeing of both species. A search of the SCOPUS database identified documents published between January 1980 and April 2022. Filtering for key inclusion criteria, duplicate removals, and inspecting the references of these documents for additional sources, we reviewed a total of 393 documents, 88% of which were scientific articles. We were able to define the numerous ways in which children and dogs interact, be it neutral (e.g., sharing a common area), positive (e.g., petting), or negative (e.g., biting). Then, we found evidence for an association between childhood interaction with dogs and an array of benefits such as increased physical activities, a reduction of stress, and the development of empathy. Nonetheless, several detrimental outcomes have also been identified for both humans and dogs. Children are the most at-risk population regarding dog bites and dog-borne zoonoses, which may lead to injuries/illness, a subsequent fear of dogs, or even death. Moreover, pet bereavement is generally inevitable when living with a canine companion and should not be trivialized. With a canine focus, children sometimes take part in caretaking behaviors toward them, such as feeding or going for walks. These represent opportunities for dogs to relieve themselves outside, but also to exercise and socialize. By contrast, a lack of physical activity can lead to the onset of obesity in both dogs and children. Dogs may present greater levels of stress when in the presence of children. Finally, the welfare of assistance, therapy, and free-roaming dogs who may interact with children remains underexplored. Overall, it appears that the benefits of child-dog interactions outweigh the risks for children but not for dogs; determination of the effects on both species, positive as well as negative, still requires further development. We call for longitudinal studies and cross-cultural research in the future to better understand the impact of child-dog interactions. Our review is important for people in and outside of the scientific community, to pediatricians, veterinarians, and current or future dog owners seeking to extend their knowledge, and to inform future research of scientists studying dogs and human-animal interactions.

Study of dog control strategies

OBJECTIVES

(1) To explore the relationship between regionally implemented dog control strategies and dog bite injuries (DBIs) and (2) to evaluate current implementation of dog control strategies.

METHODS

Observational study using a nationwide online survey of territorial authorities (TAs). Domains of interest included complaints for attacks on people, dog population, primary and secondary prevention strategies, resourcing and perspectives of current strategies. Quantitative variables were compared with DBI Accident Compensation Corporation (ACC) claims by region from 2014 to 2018.

RESULTS

Two-thirds of TAs (70%; n=47/67) responded to the survey. No clear relationship was observed between DBIs and: registered dog population, proportion sterilisations or microchipping, classifications due to dog behaviour, or existing limited resourcing. Legislated breeds and infringements for failure to control a dog or non-registration were higher in areas with greater DBIs. Educational messages varied widely and were predominantly victim directed (67%; n=71/106). Complaints for dog attacks on people were lower than DBIs in most areas, with no formal cross-agency notification policies. Few prosecutions or dog destruction orders were made.

CONCLUSIONS

Regional inequity in DBIs could not be explained by differences in the registered dog population or dog control strategies. Minimal and inequitable resourcing exists to implement current dog control strategies and provide owner-directed education. Gaps in legislation include environmental barrier requirements for all dogs (leash/muzzle use, adequate fencing), notification of incidents and child protection. Partnership with the Indigenous community (Māori) and other community groups will be required to implement these measures successfully.

Canine Saliva as a Possible Source of Antimicrobial Resistance Genes

While the One Health issues of intensive animal farming are commonly discussed, keeping companion animals is less associated with the interspecies headway of antimicrobial resistance. With the constant advance in veterinary standards, antibiotics are regularly applied in companion animal medicine. Due to the close coexistence of dogs and humans, dog bites and other casual encounters with dog saliva (e.g., licking the owner) are common. According to our metagenome study, based on 26 new generation sequencing canine saliva datasets from 2020 and 2021 reposited in NCBI SRA by The 10,000 Dog Genome Consortium and the Broad Institute within Darwin’s Ark project, canine saliva is rich in bacteria with predictably transferable antimicrobial resistance genes (ARGs). In the genome of potentially pathogenic Bacteroides, Capnocytophaga, Corynebacterium, Fusobacterium, Pasteurella, Porphyromonas, Staphylococcus and Streptococcus species, which are some of the most relevant bacteria in dog bite infections, ARGs against aminoglycosides, carbapenems, cephalosporins, glycylcyclines, lincosamides, macrolides, oxazolidinone, penams, phenicols, pleuromutilins, streptogramins, sulfonamides and tetracyclines could be identified. Several ARGs, including ones against amoxicillin–clavulanate, the most commonly applied antimicrobial agent for dog bites, were predicted to be potentially transferable based on their association with mobile genetic elements (e.g., plasmids, prophages and integrated mobile genetic elements). According to our findings, canine saliva may be a source of transfer for ARG-rich bacteria that can either colonize the human body or transport ARGs to the host bacteriota, and thus can be considered as a risk in the spread of antimicrobial resistance.

COVID-19 pandemic and lockdown increase the frequency and severity of periorbital dog bite injuries in children

Objective

To determine whether the COVID-19 pandemic and lockdown increase the risk of head, neck, and face (HNF) dog bite injuries in children.

Methods

Using a retrospective cohort study design, the investigators enrolled a sample of children presenting with HNF dog bite injuries during 22 weeks before and 22 weeks during the COVID-19 pandemic in a German level 1 trauma center. The predictor variables were COVID-19 pandemic and lockdown. The outcome variables were grouped into demographic, anatomic, injury-related, and therapeutic. Appropriate statistics were computed, and statistical significance was set at P ≤ .05.

Results

The sample included 36 subjects (19.4% girls; 97.2% Caucasians; 50% isolated periorbital injuries; 61.1% during the lockdown; 16.7% after the lockdown) with an average age of 8 ± 3.3 years. Compared to the pre-COVID-19 period, pediatric HNF dog bite injuries increased ca. 5.5- and 1.5-fold during and after the lockdown, respectively. The COVID-19 pandemic was significantly associated with severe household injury from a pet dog, number of inpatients and treatments in the operating room, and prolonged hospitalization. Isolated periorbital injury was common during the COVID-19 pandemic (P = 0.04; relative risk [RR], 4.86; 95% confidence interval [95% CI], 0.76 to 31.12), especially during the lockdown (P = 0.02; RR, 4.36; 95% CI, 0.72 to 26.6).

Conclusion

During the COVID-19 pandemic, especially during the lockdown, there is an increasing tendency of frequency and severity of domestic HNF dog injuries in children, and periorbital region is the most injury-prone.

US Adults' Perceptions of Dog Breed Bans, Dog Aggression and Breed-Specific Laws

Dog aggression directed towards people is a leading reason for relinquishment and a major public health hazard. In response to the threat of dog aggression and dog bites, breed-specific legislation has been introduced in numerous cities within the United States and countries throughout the world. There is limited evidence, however, to suggest that such laws are effective. This study explored, through an online, anonymous, cross-sectional survey, US residents' views about the bite risk of common dog breeds, breed-specific legislation, and alternative options for improved public safety. A total of 586 surveys were completed by adult US residents, 48.8% female and 48.6% male. Approximately half of the respondents reported feeling that dog bites are a serious public health issue. Although 70% of respondents were opposed to a breed ban, only 56% felt that banning specific breeds creates an animal welfare issue. Females were less likely to support a ban or agree that specific breed bans improve public safety. When participants were asked to indicate their support of several alternatives to breed-specific legislation, the most frequently endorsed options included public education about animal welfare and animal behavior, and stricter leash laws. Further research pertaining to the most effective public education dissemination methods is warranted.

The Typology and Topography of Child Abuse and Neglect: The Experience of a Tertiary Children's Centre

Effective child protection systems and processes require reliable and accurate data. The aim of this study was to determine what data could be extracted from hospital records in a single site that reflected a child’s journey from admission with suspected abuse to the decisions regarding substantiation made by the multidisciplinary child protection team. A retrospective study of the case records of 452 children referred to a major UK children’s tertiary centre for suspected child maltreatment was undertaken. Child maltreatment was substantiated in 65% of referred cases, with the majority of referrals coming from children living in the most deprived neighbourhoods in the country. Domestic violence and abuse and the child’s previous involvement with statutory bodies were associated with case substantiation. Physical abuse predominated, with soft tissue injuries, including dog bites and burns, most frequent. Burns were related almost exclusively to supervisory neglect. There were also cases of medical neglect. Emotional abuse was associated with exposure to domestic violence and abuse and to self-harm. The strengths and limitations for single-centre data systems were explored, concluding with a recommendation to establish an agreed national and international minimum data set to protect children from maltreatment.

Changes to Adult Dog Social Behaviour during and after COVID-19 Lockdowns in England: A Qualitative Analysis of Owner Perception

Simple Summary

Throughout the COVID-19 pandemic, dogs have provided their owners with support and comfort, potentially helping owners cope. However, there could also be negative aspects of pet ownership during and after this period as there are fears that problem behaviours, such as aggression, could increase. Potential social behaviour changes throughout the COVID-19 pandemic have been identified but, so far, the focus has been on puppies rather than adult dogs. This study aims to investigate the perceived impact on canine social behaviour from the owner’s perspective. Fifteen owners of dogs aged between 3 and 6 years were recruited for interviews about their dogs’ social behaviours before, during and after lockdown. The results of this study illustrate that many households have faced different experiences. Owners regarded lockdown as a positive experience for their pet dogs; however, many dogs faced difficulties when restrictions were lifted. Emphasis was placed on the negative impact of lockdown with dogs becoming either overexcited or showing fear-related behaviours, particularly following the lockdowns. Further research into the long-term implications of the pandemic is required to understand the social behaviour of dogs more thoroughly.

Abstract

Reports suggest that dogs have experienced more quality time with their owners and have exhibited less separation-related behaviour during COVID-19. This study aims to define and explore the changes in the social behaviour of adult dogs, identify any perceived short- and long-term effects and identify the implications that future events may have due to the implementation and withdrawal of COVID-19 restrictions. Owners of dogs aged between 3 and 6 years living in England were recruited for semi-structured interviews about their dogs’ social behaviours before, during and after lockdown. Interviews were transcribed and thematic analysis was used to identify key themes. Fifteen owners of eighteen dogs were interviewed in December 2021 to January 2022. All owners interviewed noticed a change in behaviour either during or following the COVID-19 lockdowns. Many owners found that fear-related and aggressive behaviours increased, particularly after lockdown restrictions had been lifted. There is a risk to human and animal safety if fear-related behaviours are not properly managed and there is a danger to dog welfare through relinquishment as owners struggle to cope with problematic behaviours. An increase in the duration of walks is comparable to other studies; however, this study found that many owners continued to walk their dogs more than restrictions allowed. Reliable information or behavioural support by qualified professionals may be needed to aid owners in mitigating the impacts of the COVID-19 pandemic. Behaviour modification plans or information could include positive techniques such as desensitisation and counterconditioning. More widely, owners should be prepared for any future behavioural changes due to unpredictable events which may alter the dog–owner dynamic. Results can be adapted to the increase in at-home working following the pandemic or other novel experiences and changes of routine such as retirement, job change or relocation. More awareness of the long-term implications of the COVID-19 pandemic is needed to prepare dog behaviour professionals for future owner concerns.

Pediatric Dog Bite Injuries: A 5-Year Nationwide Study and Implications of the COVID-19 Pandemic

Although single institution studies have analyzed various animal attacks, there has not been multicenter investigation into dog bites in children. The purpose of this study was to characterize national trends and investigate the characteristics of pediatric dog bites.

Systematic review of dog bite prevention strategies

BACKGROUND

The prevention of dog bites is an increasingly important public health topic, as the incidence of serious injury continues to rise.

OBJECTIVES

To evaluate the effectiveness of interventions to prevent dog bites and aggression.

METHODS

Online databases were searched (PubMed, Cochrane Library, Embase and Google Scholar), using the search terms: dog/s, canine, canis, kuri, bite/s, bitten, aggression, attack, death, fatal, mortality, injury/ies, prevention, intervention, for studies between 1960 and 2021. All study designs were considered. Outcomes of interest were the incidence of dog bites or dog aggression. Non-English studies, and those without full-text access were excluded.

RESULTS

Forty-three studies met the review criteria, including 15 observational and 27 interventional studies. Fifteen studies investigating dog-control legislation, including leash laws, stray dog control and infringements indicated this can reduce dog bite rates. Breed-specific legislation had less of an effect. Six studies investigating sterilisation, showed while this may reduce dog bites through a reduction in the dog population, the effect on dog aggression was unclear. An alcohol reduction programme showed a significant reduction in dog bite rates in one study. Seven studies assessing educational approaches found that intensive adult-directed education may be effective, with one study showing child-directed education was not effective. Eight studies on dog training (two police-dog related), and six evaluating dog medication or diet were generally low quality and inconclusive.

CONCLUSIONS

Multiple strategies including effective engagement with indigenous communities and organisations will be required to reduce dog-bites and other incidents involving dog aggression. This review provides some evidence that legislated dog control strategies reduce dog bite rates. Available evidence suggests greater restrictions should be made for all dogs, rather than based on breed alone. Due to a burden of child injury, protection of children should be a focus of legislation and further investigations. Prevention strategies in children require redirection away from a focus on child-directed education and future research should investigate the effectiveness of engineering barriers and reporting strategies.

Pandemic Puppies: Demographic Characteristics, Health and Early Life Experiences of Puppies Acquired during the 2020 Phase of the COVID-19 Pandemic in the UK

The UK recorded sharp rises in puppy purchasing during the 2020 phase of the COVID-19 pandemic, with many first-time dog owners purchasing puppies to improve their mental health during this challenging period. Government restrictions on movement and social interaction during the pandemic led to animal welfare concerns over puppies’ reduced time-sensitive exposures to key environmental and social stimuli during their critical developmental period. This study aimed to compare demographics, health and early-life experiences of puppies purchased and brought home < 16 weeks of age between 23 March−31 December 2020 (“Pandemic Puppies”), with dogs purchased and brought home < 16 weeks during the same date period in 2019 (“2019 puppies”). An online survey of UK-based puppy owners was conducted between 10 November and 31 December 2020 with valid responses representing 5517 puppies (Pandemic Puppies: n = 4369; 2019 puppies: n = 1148). Multivariable logistic regression modelling revealed that Pandemic Puppies were less likely to have attended puppy training classes (67.9% 2019 vs. 28.9% 2020; p < 0.001) or had visitors to their home (94.5% 2019 vs. 81.8% 2020; p < 0.001) aged < 16 weeks compared with 2019 puppies. Fewer Pandemic Puppies underwent veterinary checks prior to purchase than 2019 puppies (2019: 91.3% vs. 2020: 87.4%; p < 0.001), but more were sold with a passport (2019: 4.1% vs. 2020: 7.1%; p < 0.001). Pandemic Puppies were significantly more likely to be ‘Designer Crossbreeds’ (2019: 18.8% vs. 2020: 26.1%; p < 0.001) and less likely to be Kennel Club registered than 2019 puppies (2019: 58.2% vs. 2020: 46.2%; p < 0.001). Greater support from veterinary and animal behavioural professionals is likely needed to ameliorate the health and behavioural impacts of growing up in a pandemic upon this vulnerable population.

Pets and their owners during the first COVID-19 lockdown period: Perceived changes in routines and emotions - An exploratory study

An international online questionnaire Pets in Lockdown was conducted during the first COVID-19 lockdown during the months of April and May 2020 to assess how pet owners perceived some aspects of their relationship with their pets, including time spent together and how much they enjoyed it, difficulties taking care of their pets, the amount of comfort they obtained from interacting with their pets, and whether they had observed any changes in their pets' resting time and behavior. Most pet owners did not describe any changes in the relationship with their pets or in their pets' behaviour. Horse owners expressed more difficulties taking care of their animals than owners of other species. Approximately 20% of the animals had less time available to rest undisturbed. Of the animals that displayed behavioral changes, remaining closer to the owner was the most frequently described change followed by descriptions of higher arousal and increased negative affective states.

Epidemiological profile of dog attacks to patients under 14 years old assisted at the pediatric referral emergency unit of a tertiary hospital in Campinas, Brazil

INTRODUCTION

Accidents involving dog attacks are very common, which makes this type of accident a global public health issue. The estimates point to 20% of the victims of such accidents seeking care in health units, and half of them being children. In addition to acute injuries, dog attacks might result in fractures, infections, scars, and psychological traumas. This study aimed to describe the epidemiological profile of dog attacks to children under 14 years old assisted in a pediatric emergency service in Brazil.

METHODS

The database of the Information and Toxicological Assistance Center of Campinas was surveyed to identify cases of children under 14 years old assisted after a dog attack in a 9-years period. Demographic data, number and type of lesions, type of exposure, part of the body affected, dog origin and condition, and the accident location and cause were analyzed. The data were presented in a descriptive way, and the age groups were classified as follows: 0-3 years old, 4-6 years old, and 7-14 years old. The different age groups were compared one to another regarding the markers evaluated using the chi-square test and the Fisher's exact test. A 0.05 alpha was adopted in all analyses.

RESULTS

The number of children assisted in the study period totaled 1,012. The 7-14-year-old group was the most affected (n = 498; 49.2%), male patients were also majority (n = 660; 65.2%). Most injuries were found on the head/neck area (n = 378; 37.4%). However, the older the patients were, the higher the frequency of lesions on upper and lower limbs was, as well as attacks occurred in external environments, thus involving animals that could not be observed. A significant increase in accidents with provoked causes was observed in younger patients.

CONCLUSION

Accidents involving dog attacks are more likely to happen among boys. Younger children run higher risks of becoming victims of these accidents inside homes, being attacked by pets, and showing a greater incidence of head and neck lesions. Older children present more injuries on their limbs, which are caused by dogs that cannot be observed.

A Cross-Sectional Study of Knowledge on Ownership, Zoonoses and Practices among Pet Owners in Northern Portugal

Simple Summary

Pet ownership is common in most countries, but few published studies have addressed pet owners’ knowledge of zoonoses, pet contact practices, or awareness of zoonotic disease risks posed by pets. The aim of this study was to assess household knowledge, attitudes, and risks related to pet ownership and zoonoses in northern Portugal. A questionnaire was developed to gather information regarding participants’ demographic characteristics; household pet types and their importance to the family; pet contact-related attitudes; knowledge of zoonoses, high-risk groups, disease transmission pathways, and disease protection measures. It was observed that most participants considered pets an important part of the family. Nevertheless, high-risk practices were recurrent and pet owners’ knowledge was limited. These results reinforce the importance of further studies to better understand the existing gaps in knowledge of pet ownership and zoonoses and strengthens the need to adopt the One Health concept.

Abstract

Pet ownership is common in modern society. In Portugal, 38% and 31% of all households own at least one dog or cat, respectively. Few studies have ascertained the knowledge of pet owners on pet ownership and zoonoses, and none have been carried out in Portugal. The aim of the present study was to assess household knowledge and practices related to pet ownership and zoonoses in northern Portugal. A face-to-face questionnaire was completed by 424 pet owners, from November 2019 to February 2020. Most respondents (97.2%) considered pets as an important part of the family, especially women (p = 0.036); 73.1% allowed their pets to live an indoor/outdoor life; 41.3% denied sharing the bed with their pets while 29% assumed they did it daily; 20.3% reported never kissing their pets/pets licking their faces. Furthermore, 73.6% considered animals as potential sources of human diseases, but only 25.9% reported knowing the definition of zoonoses; 96.9% considered the role of veterinarians important in protecting public health. The low level of knowledge of pet owners and the occurrence of high-risk behaviors indicates a need to strengthen communication between veterinarians, physicians, pet owners, and the general public towards reduce the risk of acquisition and transmission of zoonoses.

Human-Animal Interaction and Perinatal Mental Health: A Narrative Review of Selected Literature and Call for Research

There is a paucity of research exploring how relationships with household pets may impact maternal mental health. We are unaware of any study to date that has examined associations between individuals' relationships with their pets and psychological adjustment in the perinatal period. Using a biobehavioral lens, this paper provides a narrative overview of the literature on perinatal mental health and human-animal interaction (HAI). We focus on the role of social relationships, stress, and stress reduction in relation to perinatal mental health; the role of HAI in perceptions of social support, stressors, and stress reduction; and gaps in empirical knowledge concerning the role of HAI in perinatal mental health. Finally, we integrate contemporary biobehavioral models of perinatal mental health and HAI (i.e., Comprehensive Model of Mental Health during the Perinatal Period and the HAI-HPA Transactional Model) to propose a new conceptual framework that depicts ways in which HAI during the perinatal period may influence maternal and child health and wellbeing. To our knowledge, this is the first paper to consider the role of HAI in biobehavioral responses and mental health during the perinatal period. We conclude with recommendations for future research and improved perinatal care.

Dog Pulling on the Leash: Effects of Restraint by a Neck Collar vs. a Chest Harness

Leash pulling is a concern for dog owners and can be detrimental to the health and welfare of dogs. Neck-collars and back-connection harnesses are popular restraint types. Harnesses have been proposed as a better and more considerate option for canine health and welfare. Anecdotally, dogs pull more when wearing a back-connection harness; however, there is no scientific evidence for this perception. This study aimed to investigate how strongly dogs pull on the lead to achieve a food treat or toy under restraint by a neck-collar versus a back-connection harness. A within-subject counterbalanced design was used for the study, involving 52 shelter dogs. A customised canine leash tension metre was connected to the collar or harness to record the pulling of the dogs, including measuring the maximal and mean leash tension, and the time spent pulling. In addition, dog behaviours were recorded using two cameras from two separate directions. The maximal and mean leash tension and the pulling time were greater under restraint by harness when attracting dogs with food treats. No significant difference between harness and collar was found in potential stress-related behaviours (e.g. tail and ear positions, lip-licking, and panting). However, dogs looked at the experimenter more often when restrained by harness than collar in the food treat attraction test. No significant difference was detected between harness and collar with respect to leash tension and stress-related behaviours in the toy attraction test. These findings suggest that dogs tend to pull stronger and more steadily when wearing a back-connection harness compared to a neck collar to reach the food treat but not the toy.

Representations of Free-Living and Unrestrained Dogs as an Emerging Public Health Issue in Australian Newspapers

That dogs can live and breed as free-living animals contributes to public health risks including zoonotic transmission, dog bites, and compromising people’s sense of safety in public spaces. In Australia, free-living dog populations are comprised of domestic dogs, dingoes, and dog–dingo hybrids, and are described using various terms (for example, stray or community), depending on social or geographic context. Urban expansion and regional migration mean that risks associated with contact between humans and free-living dogs are increasing. Public health authorities, local governments, and community organisations have called for transdisciplinary partnerships to address dog-related health risks with a sustainable long-term approach. Values pluralism and a lack of sustained community engagement in affected areas have meant that the outcome of such efforts to date has been mixed. To identify ideas in public circulation about the impact of unrestrained and free-living dogs on human health and well-being, and understand the framework through which these animals are problematised and solutions are proposed in public discourse, we systematically examined coverage of these issues in print media. Our analyses indicate that reporting in Australian newspapers tends to frame the public health impacts of free-living dogs as problems of public order requiring direct government action to re-establish control. The public health impacts of free-living dog populations in Australia have complex causes that intersect at the nexus between human and canine behaviour, agricultural and land management practices, local bylaws, and efforts to conserve ecological systems. Placing responsibility on governments limits opportunities for greater community involvement in developing integrated One Health approaches. Better-quality evidence of the impacts of dog populations on community health and well-being, and broad community support are needed to reshape public debates on animal control, which, ultimately, will promote more effective approaches to mitigate dog-related public health risks at the human–animal–environment interface.

Dog Tethering in Slovakia: Legal, Ethical and Behavioral Aspects and Dog Welfare Implications

Simple Summary

On the basis of legislative provisions and the behavioral needs of dogs, the authors describe the potential consequences and negative impacts of the long-term tethering of dogs. Dogs should be kept under conditions that allow them, with respect to their size, temperament, stage of their development, and degree of adaptation, to maintain good health and meet their physiological, ethological, and social needs. Despite the adoption of new legislative provisions, this issue has not yet been resolved and we are still coming across various cases involving cruelty to animals of various character and intensity. The current situation can be changed by adopting legislative regulations that explicitly define the responsibilities of owners/keepers including a ban on the tethering of dogs in order to prevent potential circumvention of the legislative rules.

Abstract

Long-term tethering of dogs, or their keeping under unsuitable conditions can result in issues related to changes in their behavior as they may not satisfy their basic needs of life. These needs are discussed in this paper, along with cases when dogs unnecessarily have to endure cruelty and pain. The unavoidable tethering of a dog must not cause trauma and must be arranged in a way that it guarantees physical comfort. Failure to meet the basic needs of an animal may result in manifestation of fear and subsequent aggressiveness. Owners of animals are responsible for their life and health, and their obligations include eliminating the possibility of them hurting themselves or other beings. The relevant adopted legislative provisions should provide protection to animals and be enforceable, which currently appears rather difficult. Controlling and observation of the legislative provisions related to the tethering of dogs raises some difficulties for animal protection inspectors. It is necessary to focus on the specificities of keeping conditions of various dog breeds and on their individual features. Based on research and the relevant Slovak legislative provisions, this paper discusses various views on the practice of tethering dogs from the point of view of public safety and the ethical consequences of permanent dog tethering. Data on dog tethering in Slovakia were evaluated based on a survey and Slovak legal rules governing this issue were analyzed along with various views of public safety and the ethical consequences of permanent dog tethering.

Paediatric emergency department dog bite attendance during the COVID-19 pandemic: an audit at a tertiary children's hospital

BACKGROUND

Responses to the COVID-19 pandemic include strict public health measures, such as national lockdowns. During these measures, paediatric emergency department attendances have declined and the prevalence of presenting complaints has changed. This study sought to identify whether dog bite attendance and victim demographics changed during COVID-19 public health measures.

METHODS

An audit was conducted of emergency department attendance data from a UK tertiary paediatric hospital between January 2016 and September 2020. Dog bite attendance and victim demographics were explored using χ² tests and multivariable Poisson regression. The mean monthly percentage of attendance due to dog bites in 2020 was compared against predicted percentages based on previous years' data.

RESULTS

Dog bite attendance rose in conjunction with the introduction of COVID-19 public health measures and reached a peak in July 2020 (44 dog bites, 1.3% of all attendances were due to dog bites). This was a threefold increase in dog bite attendance. By September 2020, attendance had returned to normal. The demographic profile of child dog bite victims remained the same. Boys had the highest attendance rates in 7-12 year-olds, girls in 4-6 year-olds. Girls showed higher attendance rates in the summer, while boys' attendance rates were constant throughout the year. COVID-19 public health measures were associated with a 78% increase in attendance for boys and a 66% increase in girls.

CONCLUSIONS

COVID-19 national public health measures were associated with an increase in paediatric emergency department dog bite attendance, and may be due to increased child exposure to dogs via 'stay at home' orders and school closures. National lockdowns are likely to continue globally throughout the COVID-19 pandemic; this is likely to result in more dog bites. Urgent public health communication and injury prevention strategies are needed to help prevent these avoidable injuries.

The Concerns, Difficulties, and Stressors of Caring for Pets during COVID-19: Results from a Large Survey of U.S. Pet Owners

Pets may be a positive presence for their owners during the Coronavirus Disease 2019 (COVID-19) pandemic. However, it is pertinent to identify the hardships associated with pet ownership. We conducted a large-scale survey of U.S. pet owners (n = 2254) in spring and summer 2020 to assess the ways that relationships with pets impacted life during COVID-19. We used thematic analysis to analyze 3671 open-ended responses to three prompts. Reported concerns fell into three major categories: (1) pet-focused (meeting needs of pets; procuring supplies; accessing veterinary care; new and emerging behavioral issues; fate of the pet if owner becomes ill; general safety and well-being), (2) human-focused (issues with working from home; well-being and mental health; balancing responsibilities), and (3) household-focused (disease spread; economic issues). Quantitative analyses showed that the owner's strength of attachment to their pet, economic resources, and relationship status were associated with the types of concerns expressed. Results from this study indicate that pet owners experienced unique hardships related to changes in everyday life from the COVID-19 pandemic. These hardships should be considered alongside the potential benefits found in other studies in order to manage pet owner expectations, prevent pet relinquishment, and more fully understand multifaceted human-companion animal relationships.