Emergency department visits for dog bite injuries in Missouri municipalities with and without breed-specific legislation: a propensity score-matched analysis

Breed-Specific Legislation is a type of law that bans or restricts ownership of specific dog breeds. Some local governments - including over seventy municipalities in the state of Missouri - have enacted Breed-Specific Legislation to prevent injuries from dog bites. Several studies from the peer-reviewed literature have found that aggressive behavior is not associated with any particular dog breeds and, since 2018, at least a dozen municipalities in Missouri have repealed these laws. To evaluate the impact of Breed-Specific Legislation on public safety, the 2010-2015 rates of emergency department visits for dog bite-related injuries in Missouri municipalities with and without Breed-Specific Legislation were compared. Propensity-score matched negative binomial regression models were used to assess the effect of breed restrictions on injury rates while balancing the samples on population characteristics and estimates of dog ownership. After matching the sample on population, housing and dog ownership estimates, no association was found between emergency department visits for dog bite injuries and whether the municipality enacted Breed-Specific Legislation. However, the incidence rate ratio of emergency room visits for dog bite-related injuries increased by 13.8% for every 1% increase in the percentage of males aged 5 to 9 in the population (p < 0.01). This study has found breed discriminatory laws have not reduced the risk of emergency department visits for injury from dog bites in Missouri. There appears to be no greater risk to public safety as local governments move to repeal existing breed bans.

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.

Domestic dog attacks on livestock referred to a Veterinary Teaching Hospital

Losses and the economic impact of dog attacks (DAs) on livestock are often overlooked and include factors such as decreased production, expenses for treatment and handling, and death of injured animals. This study evaluated the epidemiological, therapeutic, and pathological findings of DAs on livestock over an 11-year survey using the records of farm animals referred to a Veterinary Teaching Hospital. Livestock attacked by dogs included 31 sheep, 11 horses, 3 cattle, 3 goats, and 2 pigs, totaling 50 animals. Anatomical locations injured by dog bites were identified as head/neck, thoracic/pelvic limbs, abdomen/flank, rump/tail, and multiple affected regions (two or more bite sites). Additionally, the severity of the injuries was classified into four degrees adapted from the classification of dog bite injuries in children. Most livestock presented Grade 1 (26%) and Grade 2 (28%) injuries, while Grade 3 and Grade 4 injuries were observed in 46% of DAs. Furthermore, 35 animals (70%) were discharged, 9 (18%) died, and 6 (12%) were humanely euthanized. DAs may represent a significant cause for referring livestock species to clinical care, severe injuries, and a considerable number of deaths. In this study, we provide information regarding DAs on livestock for the first time in Midwestern Brazil.

Burden of dog bite injuries and wound management practices to prevent rabies among dog owners

Background

Despite members of dog-owning families being at a higher risk of dog bites owing to their proximity to dogs in their household, there are hardly any studies from India which focus on the burden of dog bites among them and their rabies control and prevention practices. This study aimed to estimate the burden of dog bites among dog owners and their wound management practices to prevent rabies.

Materials and Methods

A cross-sectional study was conducted among pet dog owners in a high-end housing society of National Capital Region of Delhi. A pre-tested and pre-validated schedule was used to collect data by consecutive sampling through community survey. Data were analyzed using R software. The incidence of dog bites and the status of rabies prevention practices adopted by the participants are presented as proportions. Chi-square test was applied to compare proportions.

Results

A total of 100 families were studied, which covered 355 family members. The incidence of dog bites in the past 1 year was found to be 44/355, 12.4% (95% confidence interval 9.2-16.3%). Pet dogs were responsible for 31/44 (70.5%) bites. Among 44 dog bite incidents, 30 (68.2%) reported taking any injection after the incident, and 10 (22.7%) reported receiving an anti-rabies vaccine. Only six out of 100 families reported at least one family member covered by rabies pre-exposure prophylaxis.

Conclusion

The incidence of dog bites among the dog owners was high. The rabies pre- and post-exposure prophylaxis practices adopted by the participants were found to be inadequate.

An Infected Dog Bite With Neisseria canis: A Case Report and Review of the Literature

Neisseria is a common bacteria that colonizes in humans. Of the 11 species, only two, N. meningitidis and N. gonorrhea, are pathogenic. Although sparse, there are case reports of other Neisseria species causing infections in humans. Neisseria canis, which is a part of normal flora in the mouths of dogs and cats, has been shown to have potential to be pathogenic in humans. The standard treatment for dog and cat bites is oral amoxicillin/clavulanic acid (Augmentin) or IV ampicillin/sulbactam (Unasyn). However, in cases where the patient has multiple antibiotic allergies, careful antibiotic selection must be made to ensure resolution of infection.

Barriers and opportunities for improving dog bite prevention and dog management practices in northern Indigenous communities

Globally, people living in northern Indigenous communities are at higher risk of dog bites than the rest of the population living in North America, with annual incidence ranging from 0.61 to 59.6/10,000 inhabitants. Considering that rabies is endemic in wild canid populations in certain regions of the Arctic, the prevention of dog bites and the management of dog populations are of crucial importance for public health in these contexts. Most northern communities lack access to veterinary services, mainly due to their remote geographical location and to limited financial resources. Currently, northern Indigenous communities are using different approaches and strategies to prevent dog bites and manage dog populations, but the effectiveness of these approaches sometimes lacks evidence, and their low acceptability may affect their implementation. This study aims to describe (1) the current access and uses of veterinary services, and (2) the perceived barriers and opportunities related to dog population management practices currently implemented, or that could be implemented, in a Naskapi community and an Innu community located in northern Quebec (Canada). Quantitative data were collected through a survey to inhabitants on veterinary services (n = 122). Qualitative data were collected using individual interviews to inhabitants and health professionals to describe how dog population management measures were perceived, and to identify barriers and opportunities related to their implementation (n = 37). Descriptive and inferential analysis (quantitative data) and thematic analysis (qualitative data) were performed. Results show that the two main measures implemented at the time of the study - dog culling and short-duration veterinary clinics - were not perceived as fully acceptable and sustainable. Reinforcing access to veterinary services and other dog-related services, such as shelters and training programs on dogs, was identified as a need to improve dog bites prevention and dog population management in remote Indigenous communities. The implementation of animal health measures should be decided by concerned Indigenous communities to follow decolonial practices. It includes ensuring informed consent of dog owners, improving communication before, during and after interventions, separating veterinary services from rehoming and, most importantly giving back to Indigenous communities the complete leadership over animal health in their communities.

A Retrospective Observational Study of Facial Dog Bite Injuries and Its Management in a Tertiary Care Center

Background : Facial dog bite injuries result in significant emotional, psychological, and physical trauma to the victims involved and should be considered a significant health issue. The purpose of this study is to share our experience in the management and to add to the existing medical literature regarding the epidemiological patterns of facial dog bite injuries. Materials and Methods : This is a single-center retrospective observational study conducted at Dr. RML Hospital, New Delhi, from January 2021 to January 2022. A total of 105 patients were included. The wounds were managed according to the recommendations made by the national rabies control program and surgical intervention was performed in the form of primary suturing or flap cover. Results : Children of age group 0 to 10 years are most commonly affected. Pet dogs are the cause in 61% of cases and 57.1% of bites were provoked. Midface is most commonly affected and modified Lackmann's class 3A and 3B are the most common wounds. Conclusion : In view of raising incidence of dog bites with pet dogs, the general public needs to be educated regarding the practices to prevent these injuries. Postexposure prophylaxis should be given to all affected individuals irrespective of the vaccination status of the dog. Immediate surgical intervention gives better results.

Microbial Complexity of Oral Cavity of Healthy Dogs Identified by Mass Spectrometry and Next-Generation Sequencing

The high complexity of the oral microbiota of healthy dogs and the close exposure of humans to companion animals represent a risk of the transmission of potential zoonotic microorganisms to humans, especially through dog bites, including multidrug-resistant ones. Nonetheless, a limited number of comprehensive studies have focused on the diversity of the microorganisms that inhabit the oral cavities of healthy dogs, particularly based on modern molecular techniques. We investigated bacterial and fungal organisms in the oral cavities of 100 healthy dogs based on a combination of conventional and selective microbiological culture, mass spectrometry (MALDI-TOF MS), and next-generation sequencing. In addition, in vitro antimicrobial susceptibility patterns of isolates and mecA resistance gene were assessed. A total of 213 bacteria and 20 fungi were isolated. Staphylococcus pseudintermedius (40/100 = 40%), α-hemolytic Streptococcus (37/100 = 37%), and Pasteurella stomatis (22/100 = 22%) were the most prevalent bacteria diagnosed by microbiological culture and MALDI-TOF MS, whereas Aspergillus (10/100 = 10%) was the most common fungi identified. Based on next-generation sequencing of selected 20 sampled dogs, Porphyromonas (32.5%), Moraxella (16.3%), Fusobacterium (12.8%), Conchiformibius (9.5%), Bergeyella (5%), Campylobacter (3.8%), and Capnocytophaga (3.4%) genera were prevalent. A high multidrug resistance rate was observed in Staphylococcus pseudintermedius isolates, particularly to azithromycin (19/19 = 100%), penicillin (15/19 = 78.9%), and sulfamethoxazole/trimethoprim (15/19 = 78.9%). In addition, the mecA resistance gene was detected in 6.1% (3/49) of coagulase-positive staphylococci. Here, we highlight the microbial complexity of the oral mucosa of healthy dogs, including potential zoonotic microorganisms and multidrug-resistant bacteria, contributing with the investigation of the microbiota and antimicrobial resistance patterns of the microorganisms that inhabit the oral cavity of healthy dogs.

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.

Where Rabies Is Not a Disease. Bridging Healthworlds to Improve Mutual Understanding and Prevention of Rabies

Deeply embedded in local social, cultural, and religious settings, traditional healing is part of dog bite and rabies management in many rabies endemic countries. Faith healing, which usually encompasses a more holistic approach to health including physical, mental and social dimensions, is rare in the context of rabies. In Gujarat, Western India, the Hindu goddess Hadkai Mata is worshiped by low-caste communities as the Mother of Rabies in the event of a dog bite to a person or their livestock. This belief might influence people's attitudes and behaviors toward rabies prevention but has never been investigated. Through 31 in-depth interviews with healers and staff of Hadkai Mata temples, this paper explores the system of knowledge around dog and human rabies that is built and shared in these places of worship and healing. Qualitative and quantitative data were analyzed looking for convergences and divergences with the recently launched National Action Plan for dog-mediated Rabies Elimination. Results suggest that while the etiology of human rabies as a social illness is usually explained as the goddess's wish to correct misbehaving people and restore positive interpersonal relations, there is some appreciation for the biological processes of infection that lead to rabies as a physical disease. Hadkai Mata is believed to cure rabies if her patients undergo the necessary process of moral growth. Although conventional post-exposure prophylaxis is not opposed per se, it is often delayed by patients who seek traditional treatment first. Some reluctance was expressed toward mass dog vaccination because it is seen as an interference in how the goddess controls dogs, by enraging them-hence infecting them with rabies-and sending them to bite wrongdoers. Addressing these cultural perceptions is likely to be critical in achieving effective control of dog rabies in this region. The study highlights the value of multidisciplinary approaches in the control and elimination of rabies, as well as other zoonoses. This includes the importance of understanding different culturally- and religiously- mediated ways in which humans relate to animals; and looking for points of convergence and mutual understanding, upon which context-tailored, linguistically-accurate, locally acceptable, feasible and effective strategies can be designed.

Occurrence and Risk Factors of Dog Bites in Northern Indigenous Communities: A Scoping Review

The relationship between northern Indigenous people and dogs has evolved over the past years alongside events such as colonization, settlement, proliferation of snowmobiling and other socio-cultural and environmental changes. These changes have had negative impacts on this relationship, and with the endemic presence of arctic fox rabies, dog bites have become an important public health burden. The objective of this study was to synthesize the state of knowledge regarding the occurrence of dog bites and associated risk factors in the specific context of northern Indigenous communities. A scoping review was conducted in seven bibliographic databases, from June 2018 to May 2020. From this search, 257 original studies were identified and eight papers were included for final analysis. Annual occurrence of dog bites in northern Indigenous communities ranged from 0.61 to 59.6/10,000 inhabitants. Dog bites affected 27–62.9% of the population in those regions during their lifetime. Very few studies compared the occurrence of dog bites between people living in northern communities with other populations or settings, but available evidence suggests that Indigenous people living in northern communities are at higher risk of dog bites than the rest of the population. Several individual and environmental risk factors were identified in the selected studies, although the strength of evidence varied significantly. Age (children) and gender (male) were well documented individual risk factors. Other factors, such as organizational barriers to dog management and lack of access to veterinary services, were identified and discussed by several authors. The results of this study support concerns about the higher risk of bites in northern Indigenous communities, and underscore the urgent need for more research into the contextual and environmental factors that impact the mitigation of these risks.

"If You Don't See the Dog, What Can You Do?" Using Procedures to Negotiate the Risk of Dog Bites in Occupational Contexts

Dog bites are a health risk in a number of workplaces such as the delivery, veterinary and dog rescue sectors. This study aimed to explore how workers negotiate the risk of dog bites in daily interactions with dogs and the role of procedures in workplace safety. Participants who encounter dogs at work were recruited using snowball sampling. Ethnographic methods (interviews, focus group discussions, participant-observations) were used for data collection. All data were coded qualitatively into themes. Six themes describing dog bite risk management were identified: ‘Surveillance of dogs’; ‘Communicating risk; ‘Actions taken to manage perceived risk’; ‘Reporting bites and near-misses’, ‘Investigating bites and near-misses’, and; ‘Learning and teaching safety’. While the procedures described dog bite risk as objective, when interacting with dogs, participants drew on experiential knowledge and subjective judgment of risk. There was a discrepancy between risks that the procedures aimed to guard against and the risk participants were experiencing in the course of work. This often led to disregarding procedures. Paradoxically, procedures generated risks to individual wellbeing and sometimes employment, by contributing to blaming employees for bites. Dog bite prevention could be improved by clarifying definitions of bites, involving at risk staff in procedure development, and avoiding blaming the victim for the incident.

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.

A Bite So Bad: Septic Shock Due to Capnocytophaga Canimorsus Following a Dog Bite

Infection by Capnocytophaga canimorsus (C. canimorsus), a Gram-negative rod found in the normal oral flora of canine and feline species and transmitted through bites or scratches, is a rare phenomenon. Infections most commonly occur in alcoholics and immunocompromised patients. In this report, we describe the case of a middle-aged male with a history of alcohol abuse who presented with septic shock and multisystem organ failure following a suspected dog bite. The patient was a 59-year-old Caucasian male with alcohol abuse disorder who initially presented with encephalopathy and lethargy. The patient had scratches and multiple healing wounds, with a mottled appearance on his extremities. According to his wife, the patient had been playing aggressively with his dog at home. On admission, he was febrile, tachycardic, and saturating in the 80s on ambient air. His extremities rapidly developed diffuse purpura and dry gangrene of all digits along with the tip of his nose and genitals. The patient developed septic shock and multisystem organ failure. Blood cultures initially grew Gram-positive cocci and Gram-negative rods for which broad-spectrum antibiotics were initiated. Follow-up blood cultures were positive for C. canimorsus and the antibiotic regimen was adjusted accordingly. His condition continued to deteriorate. His family opted for comfort measures only and he died soon after. Common sequelae of C. canimorsus infection include septic shock with multisystem organ failure, disseminated purpuric lesions, hypotension, encephalopathy, and acute renal failure. As seen in our patient, C. canimorsus infection should be considered in such patients, particularly if there is a recent history of an animal bite. Prompt initiation of appropriate treatment is essential to improve patient prognosis.

Systematic Review: Comparison of the Main Variables of Interest in Publications of Canine Bite Accidents in the Written Press, Gray and Scientific Literature in Chile and Spain, between the Years 2013 and 2017

Simple Summary

Dog bites are a major public health problem throughout the world. The different types of information sources that exist in relation to this issue are influencing decision making to control and prevent these incidents. For this reason, the present study aims to compare the main variables of interest in the publications of dog bite accidents in the written and grey press and scientific literature in Chile and Spain, between 2013 and 2017. The results showed that sensationalist variables in dog bite articles are reported more frequently in the press literature compared to the indexed and grey literature. Examples of these variables are involvement of potentially dangerous breeds, articles with death reports, among others. In conclusion, an improvement in the quality of the information that reaches the population about dog bites could be achieved through better and more fluid communication between scientists and journalists who publish on this topic.

Abstract

Dog bites are a major public health problem, with consequences such as physical injury, psychological trauma, transmission of zoonoses, infections, and economic costs. For this reason, it is necessary to develop preventive programs, which require quality information to support the authorities’ decision-making and to raise public awareness about the application of the proposed measures. The objective of this review was to analyze the press, indexed and gray dog bite literature published during the 2013–2017 period. During that period, 385 articles from three sources of information were analyzed: Press literature, scientific literature, and gray literature. Of these, the greatest amount of information corresponding to the context and the aggressor animal was found in the press literature, where it was recorded that the greatest number of records reported in the Chilean articles were caused by potentially dangerous breeds (87.50%), having significant differences with the gray literature (p = 0.030), and in Spain, the greatest number of attacks was also made by potentially dangerous dogs 91.30% (21/23), statistically significant differences with the gray literature (p = 0.002) and with the indexed (p < 0.001). In the case of the scientific and gray literature, the greatest amount of information was found about the victim of the attack and the treatments applied to them. In these cases, the highest percentage of victims included in the reports contained both sexes for the two literatures (44.62% and 87.71%, respectively). Regarding the treatment applied, in the scientific literature in most of the reports, the patients received washings, rabies vaccine, and tetanus vaccine (46.26%) and presented significant differences in Chile with the information contained in the gray literature (p = 0.023), in Spain with the gray (p = 0.017) and with the press (p = 0.023). In conclusion, the press literature differs in multiple variables with the information reported in the scientific literature and, in some cases, with the gray literature. The reason why the material that is being distributed to the population would not coincide in multiple relevant variables in other literature and the representative reality of the problem is the basis for this topic.

Epidemiology of Dog Bite Incidents in Chile: Factors Related to the Patterns of Human-Dog Relationship

Dog bites are one of the main public health problems. They produce important consequences for those who suffer them (physical and psychological injuries, secondary infections, sequelae, risk of transmission of zoonoses and surgeries, among others). The objective of this study was to characterize epidemiologically the incidents of bites in Chile and the patterns of human-dog relationship involved. The records analyzed in this article were obtained from bitten patients who attended the main public health facilities in Chile during the period 17 September 2017 and 17 September 2018: In the period studied, 17,299 animal bites were recorded; however, only 7220 (41.74%) cases were analyzed in which the offending species could be identified. Of the bites analyzed, 6533 were caused by dogs (90.48%). Of these, 41.05% were caused by medium-sized dogs. Most bites were caused by dogs of mixed breeds (55.99%), followed by dogs of the German Shepherd breed (8.50%). Most of the dogs that bit were known to the victim (99.95%) and most of the attacks occurred indoors (57.48%). Although dog bite records have improved in Chile, it would be useful to also include background information on the context in which the incident occurred, which would be very useful for developing effective bite prevention programs.

Combined Pharyngeal Laceration and Laryngeal Fracture Secondary to Dog Bite: A Case Report

Dog bites are the most common animal bites, typically occurring in the head and neck region or extremities. The majority of dog bite-related injuries are superficial and require minimal medical intervention. Less commonly, dog bite injuries can be very serious when involving the airway, major blood vessels, or extensive tissue loss. To this day, there are very few case reports in the medical literature that describe severe dog bites and outline their management. We present a case of successfully treating an extensive pharyngeal laceration with a laryngeal cartilage fracture produced by an unvaccinated dog bite.

A Retrospective Analysis of Dog-Dog and Dog-Human Cases of Aggression in Northern Italy

Simple Summary

The prevention of dog bites is an important issue with multiple safety and welfare aspects. We investigated the characteristics of dog bite incidents reported to public authorities in the North of Italy with the aim of providing more data for future risk assessment and prevention tools. We found that no breeds in particular were responsible for severe or multiple bites towards either humans or dogs, but there was a trend of defensive bites towards human beings in private homes and a trend of offensive bites towards other dogs in public areas. We also found that crossbreed dogs and dogs adopted from shelters were significantly more likely to show defensive aggression towards their owners. Our findings indicate that defensive aggression towards owners is linked to fear and anxiety, and we suggest that helping owners to have a better understanding of their dogs’ welfare, behaviour and communication via educational programs is an important prevention tool.

Abstract

In this survey, a caseload of aggressive dogs (n = 170) was analysed to increase the available information about biting dog characteristics, contribute to risk evaluation and improve bite prevention tools. All dog data were collected from questionnaires completed by veterinary behaviourists in Northern Italy. All dogs were referred to them by public authorities to be evaluated and treated due to the incidence of one or more episodes of aggression. Between the two groups of human-directed and dog-directed aggressive dogs, significant associations were found: the dog-directed aggressive group inflicted significantly more severe bites (p < 0.01) and offensive aggression (p < 0.01), whereas defensive aggression was significantly more numerous in the human-directed aggression group (p < 0.01) and more significantly located in private homes (p < 0.01). No significant associations were found between the severity of bites and one or more specific breeds in either group. The prevalence of defensive bites in private homes in human-directed aggression indicate that owners’ understanding of their dogs’ behaviour and communication is fundamental to preventing aggression, and that owner education programmes are fundamental tools to reduce aggression risk factors and prevent aggression.

A dog bite study in a dog rabies-affected area in South Africa

Background

Rabies is an untreatable and highly fatal viral zoonosis. Despite the ability to control and prevent the disease, it is estimated that one person dies of rabies every 10 minutes in developing countries. However, the true burden of the disease remains undefined in most developing countries because of a lack of systematic surveillance. Dog bite data obtained from healthcare facilities where dog bite victims seek medical care may provide an additional source of information that can be used to inform the burden of disease and identify points for interventions for improved delivery of post-exposure prophylaxis (PEP) to prevent the disease.

Methods

A descriptive epidemiological study was conducted using data obtained from dog bite registers and patient case files at a healthcare facility for a two year period (2015-2017).

Results

The study reported frequency, demographics, source, geographic and temporal distribution of bite cases reported to a hospital serving a rabies-affected community. In addition, the post-exposure management of dog bite cases at this facility is described.

Conclusion

Dog bites was not an infrequently reported at the healthcare facility, with up to 29 cases reported in a month during the study period. The affected population was defined and it is motivated that this information is useful for targeted health interventions. Findings related to the delivery of PEP may also be used to direct training and re-training of healthcare workers for improved delivery of PEP.

Ouch! A cross-sectional study investigating self-reported human exposure to dog bites in rural and urban households in southern Ontario, Canada

This study investigated self-reported dog bites in humans in rural and urban households in southern Ontario, Canada. Our objectives were to determine, and compare, the incidence of dog bites in rural and urban households, and to describe the profile of bite victims, biting dogs, and the proportion of biting dogs that respondents self-reported as being not up to date on rabies vaccination. We conducted a cross-sectional observational study using an online questionnaire. The 2,006 respondents, each representing one household, included 1,002 rural and 1,004 urban residences. The incidence risk of at least one person in the household being bitten over the previous year in rural households (6.09% per year) was less than in urban households (10.76% per year). In 53.20% of households from which at least one person had been bitten within the past year, only a single person had been bitten. Mostly, victims were 25 to 34 years old (21.67%), male (54.19%), and playing with or interacting with the biting dog at the time of the incident (59.11%). Most biting dogs were 3 to 5 years old (32.02%), males (53.69%), and unleashed (76.85%). Based on self-reporting by respondents, 83.33% of respondent-owned biting dogs were vaccinated against rabies at the time of the biting incident. Irrespective of dog ownership, the odds of an individual in a rural household being bitten by a dog were 0.53 (95% CI: 0.38-0.73) the odds for an individual in an urban household. Dog bites constitute a serious, yet preventable, public health concern that requires targeted, community-specific efforts. Public health organizations could consider findings in developing messaging, particularly as we highlight biting dogs reported by their owners as not up to date on rabies vaccination.

Preventing Dog Bites: It Is Not Only about the Dog

Simple Summary

Dog bites can have an array of negative health impacts on human victims. Research on the correlates of bites focused on limited sets of variables and produced conflicting findings. Data were drawn from police department reports of dog bites in the city of Detroit between 2007–2015. This project expands knowledge about the correlates of dog bites by exploring a comprehensive set of variables related to the breed type of dog, the nature of its surroundings, and the circumstances surrounding the bite. The greatest risk of bites does not come from wandering feral dogs, nor is it primarily related to the nature of the victim. Based on multiple regression, the victim was most likely bitten in their own yard by a single neighborhood dog that escaped from its home or yard. Human error often contributes to bites.

Abstract

Background: Dog bites can have an array of negative health impacts on victims. Research focusing on the correlates of bites focused on limited sets of variables and produced conflicting findings. Objective: To expand knowledge about the correlates of dog bites by exploring a comprehensive set of variables related to the nature of the dog and the circumstances surrounding the bite not commonly explored in extant research. Methods: Data were drawn from police department reports of dog bites in the city of Detroit between 2007–2015; 478 dog bites were reported. Multiple regression was used to determine the significant correlates of dog bites, focusing on the nature of the dog and the circumstances surrounding the bite. Results: Bites were caused by a neighborhood dog. Thirty-two percent of the reports involved dogs running loose; 25% dogs that had escaped from a fenced or unfenced yard; 9% escaped from their home; and 8% had broken off a chain, were being walked, or were in their own home. Based on multiple regression, the victim was most likely bitten in their own yard by a single neighborhood dog that escaped from its home or yard. Breed of dog was not correlated with bites in multiple regression. Conclusions: The greatest risk of bites does not come from wandering feral dogs. Based on multiple regression, the victim was most likely bitten in their own yard by a single neighborhood dog that escaped from its home or yard. Human error often contributes to bites.

An Audit of Patients with Dog-bite Wounds Presenting to a Tertiary Level Hospital Emergency Department in South Africa

Background

Dog-bite wounds are a common emergency department (ED) presentation, accounting for approximately 5% of traumatic wounds in the US. However, only 20-50% of patients actually present to the ED for medical attention following a dog-bite wound.

Methods

This was a transverse, retrospective audit of medical records of patients that had presented to the Tembisa Provincial Academic Hospital ED with dog-bite wounds during the 2014 calendar year.

Results

Of the 269 patients that were included in the study, 148 (55%) were male. The median age of all study patients was 27 years (range: 3-77 years). Most patients presented between 18h00-24h00 (n = 111, 41.3%). Most wounds were sustained on the lower limbs (n = 80, 68.18%), followed by the upper limbs (n = 74, 28.03%). Patients who were ≤12 years of age had a higher prevalence of buttock/perineum (p = 0.0002) and head/face/neck (p = 0.009) wounds, whereas patients who were >12 years of age had a higher prevalence of lower limb wounds (p = 0.0006). Only 15 (5.6%) wounds were sutured, and antibiotics were prescribed to 120 (45.1%) patients. Tetanus toxoid vaccine (TTV) and the first dose of the rabies vaccine (RV) were administered to 152 (57.4%) and 240 (89.1%) patients, respectively.

Conclusion

Children are more likely to present with wounds to the head/face/neck or buttock/perineum regions, while adults are more likely to present with wounds to the lower limbs. Proper strategies should be implemented to ensure that clinicians adhere to the current antibiotics protocols as well as rabies and tetanus post-exposure prophylaxis (PEP)-prescribing guidelines. 

The first report evaluating the post-exposure rabies prophylaxis in children exposed to animals in the Lublin Province (Eastern Poland) in 2010-2016 - a retrospective study

INTRODUCTION

Rabies continues to be one of the most important viral diseases and remains a significant threat to public health across the globe. The World Health Organization (WHO) has determined that most rabies cases occur in children. Dog bites on humans are a major public-health problem. Poland has not achieved rabies free status yet. Post-exposure prophylaxis (PEP) in humans can effectively prevent death after exposure to a potentially infected animal.

THE AIM

The main objective of this study was to estimate the frequency of PEP among children exposed to animals, who had attended consultations at the Department of Infectious Diseases for Children in the Jan Boży Hospital in Lublin.

PATIENTS AND METHODS

We retrospectively analyzed the medical records from the period of 2010-2016 of all pediatric patients (0-17 years of age) who had been exposed to animals and attended consultations at the Department of Infectious Diseases for Children in the Jan Boży Hospital in Lublin.

RESULTS

During the studied period, 519 children who had been exposed to animals attended consultations, and a prophylactic procedure consisting of active immunization was applied to 32.8%. The male children accounted for 55.3%. The mean age was 9.2 years. The biggest group of children (406) had been exposed to dogs, 62 children to cats, and 15 to rats. Most children had upper-limbs injuries. During the studied period, i.e. 2010-2016, there were 1713 confirmed cases of rabid animals in Poland, and 60 cases were recorded in the Lublin Province. We did not observe any cases of rabies in our exposed and vaccinated patients.

CONCLUSIONS

The number of rabid animals in the Lublin Province had decreased to low levels, but the expected decrease in the number of PEP's administered did not occur. Since all children were vaccinated in accordance with the recommendations, the possible reason for vaccination's being administered in the quantities greater than the number of rabid animals recorded in the Lublin Province are bites by animals unavailable for veterinary observations and also the lack of more frequent reports regarding the current epizootic situation of rabies. The use of rabies immunoglobulin (RIG) in children in the Lublin Province is at a very low level, i.e. at 0.58%. The yearly numbers of exposed pediatric patients were at similar levels, which indicates that education programs should be introduce to reduce the number of animal bites in children.

The incidence of public sector hospitalisations due to dog bites in Australia 2001-2013

OBJECTIVE

To estimate the incidence of dog bite-related injuries requiring public sector hospitalisation in Australia during the period 2001-13.

METHODS

Summary data on public sector hospitalisations due to dog bite-related injuries with an ICD 10-AM W54.0 coding were sourced from the Australian Institute of Health and Welfare for the study period 2001-2013.

RESULTS

In Australia, on average, 2,061 persons were hospitalised each year for treatment for dog bite injuries at an annual rate of 12.39 (95%CI 12.25-12.53) per 100,000 during 2001-13. The highest annual rates of 25.95 (95%CI 25.16-26.72) and 18.42 (95%CI 17.75-19.07) per 100,000 were for age groups 0-4 and 5-9 years respectively. Rates of recorded events increased over the study period and reached 16.15 (95%CI 15.78-16.52) per 100,000 during 2011-13.

CONCLUSION

Dog bites are a largely unrecognised and growing public health problem in Australia. Implications for public health: There is an increasing public sector burden of hospitalisations for injuries from dog bites in Australia.

A fatal case of hypothermia caused by dog bites

Death from hypothermia usually *We presented a fatal case of hypothermia after being bitten by dog in this article. occurs among people exposed to cold and humid environmental conditions when they are homeless, aged, suffering from natural or psychiatric diseases and drug or alcohol intoxication. A normal healthy person dying from hypothermia due to dog bites is unusual and rare. Here, we present a fatal case of hypothermia following dog bites causing blood loss and multiple wounds on the body. A 56-year-old man was found dead in a remote roadside puddle of a small village, early in the morning. He was naked, and his body trunk and limbs had multiple irregular wounds. Gray animal hairs could be seen in parts of the wound cavities and surrounding areas. In addition, there was a kennel near the scene. Family members argued that the deceased was bitten to death by a dog. However, autopsy revealed several findings which were strongly supportive of fatal hypothermia. Moreover, we saw no obvious changes caused by blood loss, either on the body surface or internal organs. Accordingly, we concluded the true cause of his death was fatal hypothermia; bites from a dog was a necessary causative factor.

[Responsible ownership of dogs and human health in neighborhoods of San Carlos de Bariloche, Argentina]

Human relationship with dogs associates with numerous and varied benefits on human health; however, it also presents significant risks. The goal of this study was to describe demographic parameters and characteristics of dog ownership with possible implications on human health and to evaluate the prevalence of dog bites and traffic accidents due to dogs. Interviews were conducted in the neighborhoods of Nuestras Malvinas and Nahuel Hue in San Carlos de Bariloche. The percentage of homes with at least one dog, the average number of dogs per home, the prevalence of dog bites and traffic accidents due to dogs and the general awareness of the population on dog transmitted zoonoses were estimated. Regarding ownership characteristics, the degree of sterilization, vaccination and parasite control and the percentage of dogs allowed to roam freely in public places were evaluated. A total of 141 interviews were conducted; 87% of the households had at least one dog, with an average of 2.2 dogs. In 26% of the households someone had suffered a traffic accident caused by dogs and in 41% someone had been bitten. Antiparasite treatment was administered to 83% of the dogs in the last 12 months, on average 1.4 times (recommended 6 times), 51% were sterilized, 55% were allowed to roam freely. This study shows a disturbing situation regarding the canine population of the evaluated neighborhoods. The number of dogs allowed to roam freely and the low level of parasite control and sterilization provide suitable conditions for the spread of zoonoses.

Burden of Bites by Dogs and Other Animals in Los Angeles County, California, 2009-2011

OBJECTIVES

The objective of this study was to analyze all animal-to-human bite reports during a 3-year period from a regional surveillance database. Results helped to inform local efforts to reduce and prevent animal-to-human bites.

METHODS

We reviewed all cases of animal-to-human bites occurring from 2009 through 2011 that were reported to the Los Angeles County Department of Public Health's Animal Bites Database. We collected data on the bite victim's date of birth, age, and address; bite circumstances (ie, date, time, location, how bite occurred); anatomic site and treatment of bite; type of reporting facility; and breed and management of biting animal.

RESULTS

From 2009 through 2011, 26   169 animal-to-human bites were reported, of which 23   103 (88%) were dog bites. Most animal-to-human bites (n = 7673, 29%) occurred between 4 pm and 8 pm and peaked during the month of July (n = 2663, 10%). Most animal-to-human bites occurred outdoors (n = 8772, 34%) and while victims engaged in recreational activities (n = 4353, 17%). The hands were the most common injury site (n = 9130, 35%), and only 1% of animal bites (n = 267) resulted in hospitalization. A total of 4115 bite victims (16%) received tetanus vaccinations. Of all animal-to-human bite cases, medical organizations reported 13   451 (51%), and animal control agencies reported 10   682 (41%).

CONCLUSIONS

Animal-to-human bites can often lead to medical complications. Surveillance is essential in helping to identify, manage, and reduce these highly preventable injuries and direct public health actions and policies on animal bite risk and prevention.

Awareness of rabies and response to dog bites in a Bangladesh community

Community awareness regarding rabies and treatment seeking behaviours are critical both for the prevention and control of the disease in human and animals. We conducted a study to explore people's awareness about rabies, their attitudes towards dogs and practices associated with treating dog bites in Satkhira Sadar, a south-western sub-district of Bangladesh. Of the total 3200 households (HHs) surveyed, the majority of the respondents have heard about rabies (73%) and there was a high level of awareness that dog bite is the main cause of rabies (86%), and that rabies can be prevented by vaccination (85%). However, 59% of the dog bite victims first seek treatment from traditional healers instead of visiting the hospitals, 29% received the rabies vaccine, 2% practiced proper wound washing with soap and water, while 4.8% have not taken any measures. None of the victims have received rabies immunoglobulin (RIG). Of the respondents, 5.2% reported a history of dog bite in at least one family member, and 11.8% reported a history of dog bite in domestic animals during the previous year. The HHs having a higher number of family members (OR: 1.13, 95% CI: 1.07-1.2), having a pet dog (OR: 2.1, 95% CI: 1.4-3.2) and caring or feeding a community dog (OR: 2.1, 95% CI: 1.4-2.9) showed an increased risk of getting a dog bite. Among the bite victims, 3.6% (n = 6) humans and 15.8% (n = 60) animals died. As a measure for dog population management (DPM), 56% preferred sterilization while the rest preferred killing of dogs. The current treatment seeking behaviours of the respondents should be improved through additional education and awareness programme and better availability for the provision of post-exposure prophylaxis in Bangladesh. We recommend scaling up national mass dog vaccination and DPM to reduce the burden of rabies cases and dog bites in Bangladesh.

Profile of dog bite victims in Jos Plateau State, Nigeria: a review of dog bite records (2006-2008)

Introduction

Dogs are the major reservoir of rabies virus in Nigeria; transmission to humans is via a bite by rabid dog. Between 2006 and 2008 National Veterinary Research Institute (NVRI) rabies laboratory reported increased numbers of rabies in dogs and human dog bites. The objective of the study was to use veterinary and health records to develop a profile of bite victims and recommend appropriate public health actions.

Methods

We used the dog brain specimen result register of Rabies Laboratory of NVRI, from “January, 2006” to “December, 2008” and traced dog bite cases. Structured questionnaires were administered to persons who reported dog bite incident and could be traced. We reviewed records from Evangelical Churches of West Africa (ECWA) clinic from “January, 2006” to “December, 2008” to collect detailed profiles of bite victims.

Results

Bite victims linked to positive dog samples were traced to “ECWA clinic” from “January, 2006” to “December, 2008”. Most bite victims were <16 years 141 (72.3%), male 128 (65.6%), and 48.2% had primary school education. Bites were unprovoked 184 (94.4%), mostly on arms. 54.4% victims received complete post exposure prophylaxis (PEP). Majority of the biting dogs were housed and unvaccinated.

Conclusion

This study provided important information on the profile of dog bite victims and highlights the need for a sustained awareness and education of children on the dangers of dog bite. It has shown lack of enforcement of regulations for licensing of dogs and rabies vaccination.

Response to a rabies epidemic, Bali, Indonesia, 2008-2011

Emergency vaccinations and culling failed to contain an outbreak of rabies in Bali, Indonesia, during 2008-2009. Subsequent island-wide mass vaccination (reaching 70% coverage, >200,000 dogs) led to substantial declines in rabies incidence and spread. However, the incidence of dog bites remains high, and repeat campaigns are necessary to eliminate rabies in Bali.

Dog bites: an opportunity for parent education in the pediatric emergency department

OBJECTIVES

This study focuses on parental report of exposure to dogs and highlights the potential for using a computer kiosk in an urban pediatric emergency department to increase knowledge around dog bite safety.

METHODS

Nine hundred one parents of young children completed a kiosk assessment and received a report that contained information aimed at increasing knowledge about either dog bite prevention (PAR-DB, n = 453) or other safety behaviors (PAR-S, n = 448). The participants who received the dog bite prevention report (PAR-DB) were asked questions about exposure to dogs as part of the baseline assessment. All participants were telephoned 2 to 4 weeks later for a follow-up interview to measure knowledge differences.

RESULTS

The majority of respondents who answered the exposure questions reported seeing stray dogs (53%) and having dangerous dogs (43%) in their neighborhood. Few respondents reported that their child had been bitten by a dog (1%), but the majority (56%) reported having knowledge of another child having been bitten. Few respondents reported having a dog in their home (11%), and only 1 reported that her dog had bitten a child. A majority (56%) of dogs had not been spayed or neutered. Of families with dogs in the home, 20% reported leaving their child unattended with the dog. A minority (45%) of dogs left alone with children had been spayed or neutered.

CONCLUSIONS

PAR-DB parents achieved knowledge gains as a result of the Parent Action Report generated by the kiosk, demonstrating the potential to improve knowledge via a computer kiosk in a busy pediatric emergency department.

Dog bite risk: an assessment of child temperament and child-dog interactions

Annually approximately 400,000 American children receive treatment for dog bites. Young children are at greatest risk and are frequently bitten following behavior that provokes familiar dogs. This study investigated the effects of child temperament on children’s interaction with dogs. Eighty-eight children aged 3.5–6 years interacted with a live dog. Dog and child behaviors were assessed through observational coding. Four child temperament constructs—impulsivity, inhibitory control, approach and shyness—were assessed via the parent-report Children’s Behavioral Questionnaire. Less shy children took greater risks with the dog, even after controlling for child and dog characteristics. No other temperament traits were associated with risk-taking with the dog. Based on these results, children’s behavior with unfamiliar dogs may parallel behavior with other novel or uncertain situations. Implications for dog bite intervention programs include targeting at-risk children and merging child- and parent-oriented interventions with existing programs geared toward the physical environment and the dog.

Cephradine in the prophylactic treatment of dog bites

Four hundred and twenty patients with one or more open dog bite wounds were studied. Cephradine or no antibiotic was used for treatment. The wounds were debrided, irrigated, and dressed; 3.6% required suturing. Six patients treated prophylactically with cephradine developed wound infections and three of these had to be hospitalized in order to receive parenteral antibiotics. Five of the wounds grew Enterobacter species, and the sixth grew Pseudomonas aeruginosa. In the control group, only two patients developed infections, one with Staphylococcus aureus, and the other with Bacillus subtilis. Both were treated as outpatients with oral antibiotics after wound treatment. Although there is no statistically significant difference between the prophylactic and control groups, there was a trend toward more serious infections in those treated with cephradine. This investigation demonstrates that prophylactic cephradine is not useful in cases of uninfected dog bite wounds.