The experience of dog bites: A survey of veterinary science and veterinary nursing students

AIM: To investigate the circumstances of dogs biting people in New Zealand.

METHODS: Veterinary science and veterinary nursing students enrolled at Massey University in 2003 completed a questionnaire detailing their lifetime experience of dog bites and their opinions of dog control legislation.

RESULTS: The response rate was 100%. There were 228 completed responses to the survey, and 87 (38%) respondents had been bitten by a dog. Most bites caused minor injury, but 17 (20%) required medical attention. Male respondents were more likely to have been bitten. The highest proportion of respondents (27; 31%) had been bitten while between 6 and 10 years of age, and the hand was the part of the body most often injured. Eighteen (21%) bites involved a stranger's dog, but most bites were by a dog known to the victim. Respondents from rural areas were three times more likely to have been bitten than city dwellers. The victim's home was the place where most (31; 36%) bites occurred. Male dogs were responsible for a larger proportion of bites (38; 44%) than females (24; 28%); respondents were unsure about the sex of the remainder of the dogs (25; 29%) that bit them. Protecting the home, play, accidents, rough handling and pain were identified as the common reasons for dogs to bite. Most (46; 52%) respondents did not believe legislation could have prevented their bite. Only four (5%) bites were reported to authorities.

CONCLUSION: Rural dwellers, people with more experience of dogs, children <11 years of age, and male respondents were bitten by dogs most often. Only legislation relating to the fencing of dog owners′ properties may have prevented a reasonable proportion (25; 29%) of the bites reported here.     

Free‐Roaming Dogs in Nepal: Demographics,Health and Public Knowledge,Attitudes and Practices

In Nepal, most dogs are free to roam and may transmit diseases to humans and animals. These dogs often suffer from malnutrition and lack basic health care. Minimal information is available about their demographics and about public attitudes concerning dogs and diseases. We carried out a study in Chitwan District (central Nepal), to collect baseline data on free‐roaming owned dog demographics, assess knowledge, attitudes and practices of dog owners concerning dogs and rabies, evaluate rabies vaccination coverage and anthelmintic treatment of dogs, measure dogs' response to rabies vaccination and assess dog health through body condition scores and parasites. We conducted household interviews with owners of free‐roaming female dogs (n = 60) and administered dogs with rabies vaccination and anthelmintics. Dog owners regularly fed free‐roaming dogs but provided minimal health care; 42% of respondents did not claim ownership of the dog for which they provided care. We collected skin, faecal and blood samples for parasite identification and for measuring rabies virus‐specific antibodies. Ninety‐two per cent of dog owners were aware of the routes of rabies virus transmission, but only 35% described the correct post‐exposure prophylaxis (PEP) following a dog bite. Twenty‐seven per cent of the dogs had measurable rabies virus‐specific antibody titres and 14% had received anthelmintics in the previous year. Following rabies vaccination, 97% of dogs maintained an adequate antibody titre for ≥6 months. Most dogs appeared healthy, although haemoprotozoans, endoparasites and ectoparasites were identified in 12%, 73% and 40% of the dogs, respectively. Poor skin condition and parasite load were associated. Seventy‐four per cent of the females had litters in 1 year (mean litter size = 4.5). Births occurred between September and February; we estimated 60% mortality in puppies. We concluded that vaccination coverage, PEP awareness and anthelmintic treatment should be emphasized in educational programmes focussed on animal welfare, veterinary and public health.     

The experience of dog bites: a survey of veterinary science and veterinary nursing students

AIM: To investigate the circumstances of dogs biting people in New Zealand. METHODS: Veterinary science and veterinary nursing students enrolled at Massey University in 2003 completed a questionnaire detailing their lifetime experience of dog bites and their opinions of dog control legislation. RESULTS: The response rate was 100%. There were 228 completed responses to the survey, and 87 (38%) respondents had been bitten by a dog. Most bites caused minor injury, but 17 (20%) required medical attention. Male respondents were more likely to have been bitten. The highest proportion of respondents (27; 31%) had been bitten while between 6 and 10 years of age, and the hand was the part of the body most often injured. Eighteen (21%) bites involved a stranger's dog, but most bites were by a dog known to the victim. Respondents from rural areas were three times more likely to have been bitten than city dwellers. The victim's home was the place where most (31; 36%) bites occurred. Male dogs were responsible for a larger proportion of bites (38; 44%) than females (24; 28%); respondents were unsure about the sex of the remainder of the dogs (25; 29%) that bit them. Protecting the home, play, accidents, rough handling and pain were identified as the common reasons for dogs to bite. Most (46; 52%) respondents did not believe legislation could have prevented their bite. Only four (5%) bites were reported to authorities. CONCLUSION: Rural dwellers, people with more experience of dogs, children <11 years of age, and male respondents were bitten by dogs most often. Only legislation relating to the fencing of dog owners' properties may have prevented a reasonable proportion (25; 29%) of the bites reported here.     

Factors Associated with Dog Rabies Vaccination in Bhol,Philippines: Results of a Cross‐Sectional Cluster Survey Conducted Following the Island‐Wide Rabies Elimination Campaign

The Philippines has a long history of rabies control efforts in their dog populations; however, long‐term success of such programmes and the goal of rabies elimination have not yet been realized. The Bohol Rabies Prevention and Elimination Program was developed as an innovative approach to canine rabies control in 2007. The objective of this study was to assess canine rabies vaccination coverage in the owned‐dog population in Bohol and to describe factors associated with rabies vaccination 2 years after implementation of the programme. We utilized a cross‐sectional cluster survey based on the World Health Organization’s Expanded Programme on Immunization coverage survey technique. We sampled 460 households and collected data on 539 dogs residing within these households. Seventy‐seven per cent of surveyed households reported owning at least one dog. The human‐to‐dog ratio was approximately 4 : 1, and the mean number of dogs owned per household was 1.6. Based on this ratio, we calculated an owned‐dog population of almost 300 000. Overall, 71% of dogs were reported as having been vaccinated for rabies at some time in their lives; however, only 64% of dogs were reported as having been recently vaccinated. Dogs in our study were young (median age = 24 months). The odds of vaccination increased with increasing age. Dogs aged 12–23 months had 4.6 times the odds of vaccination compared to dogs aged 3–11 months (95% CI 1.8–12.0; P = 0.002). Confinement of the dog both day and night was also associated with increased odds of vaccination (OR = 2.1; 95% CI 0.9–4.9; P = 0.07), and this result approached statistical significance. While the programme is on track to meet its goal of 80% vaccination coverage, educational efforts should focus on the need to confine dogs and vaccinate young dogs.     

Development of non‐governmental organisation‐academic partnership to tackle rabies in Africa and Asia

Rabies kills approximately 60,000 people each year, mainly in sub‐Saharan Africa and Asia, of which 40% of victims are less than 15 years old. Once clinical signs develop, the disease is almost invariably fatal. Globally, rabies has been estimated to cause 3?7 million disability‐adjusted life years and $8?6B in economic losses annually. The vast majority of human rabies cases are caused by bites from rabies‐infected dogs. Despite this loss of human life and resultant economic and societal costs, rabies can be prevented in both humans and dogs by vaccination. This has been demonstrated in many countries, notably in Central and South America, where large‐scale, high coverage mass dog vaccination programmes have dramatically reduced the incidence of rabies. Even in parts of Africa and Asia, projects have shown that rabies can be eliminated locally. Nevertheless, rabies remains an important cause of mortality in many sub‐Saharan and Asian countries. The reasons why some countries have been able to effectively eliminate rabies whereas others have not are complex and often impossible to definitively identify; commonly cited explanations include political, economic, logistical and societal barriers.     

Dog ecology and its implications for rabies control in Gwagwalada,Federal Capital Territory,Abuja, Nigeria

The objectives of this study were to determine the characteristics of a dog population, including their accessibility to vaccination and health care, in urban and semiurban areas of Gwagwalada, Abuja, Nigeria. Direct street counts and a house‐to‐house survey of city streets were performed. A total of 451 households were surveyed comprising 43.7% urban and 53.3% semiurban areas. A total of 848 owned dogs were identified, along with 3,115 corresponding humans. With a dog‐to‐human ratio of 1:3.7, the dog population in the study area was estimated as 103,758. A total of 396 dogs were counted on the streets with the greater proportion (74%) in semiurban areas. Most dogs in semiurban areas (77.3%) had no certificate confirming vaccination against rabies, compared to 47.2% in urban areas (p = .004). The majority of dogs in the urban (60.9%) and semiurban (82.0%) were free roaming. In the multivariable model, age, presence of a collar, region, sex, use and having ever visited a veterinarian were significantly associated with rabies vaccination. The majority (125/197, 63.5%) of respondents with higher education were willing to pay more for the healthcare needs of their dogs as opposed to those with a lower level of education (93/251, 37.1%, p = .001). The study revealed a high dog population density, vaccination coverage below WHO recommendation of 70% and generally reduced healthcare‐seeking behaviour among dog owners in Gwagwalada, Abuja, Nigeria.     

Rabies-vaccination coverage and profiles of the owned-dog population in Santa Cruz de la Sierra, Bolivia

The Bolivian government issued a regulation for rabies control in November 2005, owing to increasing the prevalence of dog and human rabies cases in recent years. An assessment of rabies-vaccination coverage and other factors that might influence the success of the on-going vaccination campaign was needed. The objective of this study was to investigate dog rabies vaccination coverage and risk factors associated with dogs being unvaccinated against rabies, and profiles of the owned-dog population in Santa Cruz de la Sierra, Bolivia, where dog rabies was endemic. Mainly due to logistical reasons, the WHO's expanded programme on immunization cluster-survey method was used. The 390 households were included in the study. Information about dog population and management characteristics was obtained for 542 dogs from 301 households. On average, households had 1.4 dogs and 1.8 dogs per dog-owning household (median = 1). The human-to-dog ratio was 4.6 : 1. During the last 1 year prior to the study, of the 539 dogs aged >or=1 month, 463 (85%; 95% CI 79-91; design effect 3.6) were classified as vaccinated. Amongst the study dogs, dogs aged 1-11 months were the higher risk of dogs not being vaccinated (OR = 8.2; 95% CI 4.3-15.6; P < 0.01). Almost two-thirds of the study dogs were allowed to roam freely throughout the day or in part. Community education efforts should address the importance of dog ownership and movement restriction, and the need to vaccinate young dogs.     

Vaccination coverage and epidemiological parameters of the owned-dog population in Thungsong District, Thailand

Canine rabies vaccination is delivered in Thungsong District, Thailand, as an annual campaign between March 1 and 31, and also at other times through private veterinary clinics, para-veterinarians and health-care staff residing in the villages. The current questionnaire-interview survey was conducted between June 23 and July 18, 2002 to determine: rabies-vaccination coverage amongst the owned-dog population; basic dog-population information; and community awareness about rabies. The modified expand programme on immunization cluster-survey method was used to collect information about dog demography and management characteristics. Household knowledge about rabies and sources of rabies information were assessed. Vaccinated dogs were identified from vaccine certificates or owner reports confirmed by vaccinators. Seventy percent (95%CI 62-78) of 364 eligible owned dogs were vaccinated within the 6 months prior to data collection. Of these 255 vaccinated dogs, 44, 21, 13, 17 and 5% were vaccinated through the annual vaccination campaign, veterinary clinics, para-veterinarians, other vaccinators and owners, respectively. Fifty-four percent of households owned dogs. The sex ratio in dogs was 2 males per female; the dog: human ratio was 1: 4.6 with an average of 0.9 dogs per household (1.7 dogs per dog-owning household). Most dogs roamed freely and these were less likely to be vaccinated compared to dogs being kept on premises or on a leash. Almost all households were aware of rabies and the need for dog rabies vaccination as a control method. Seventy-six percent believed that rabies only occurred in summer. There was little awareness about cat rabies amongst households. Vaccination coverage in the total dog population clearly has not yet reached the 80% target level set by Thailand's official rabies-control programme. Improved effectiveness of the owned-dog rabies-vaccination campaigns in each community is needed-perhaps by more community education about dog management or by better management of ownerless dogs.     

Knowledge and perceptions of dog-associated zoonoses: Brazos County,Texas, USA

In order to assess the knowledge and perceptions of dog-associated zoonoses in Brazos County, Texas, random digit dialing was used to select 922 households for participation in a cross-sectional telephone survey. The interviews were completed during June 2008 and yielded a response rate of 55% (922/1691). Fifty-six percent of the respondents who completed the questionnaire owned dogs. Eighty-six percent of the respondents indicated they would report being bitten by a dog that they did not own. Five factors were shown to be significantly associated with such reporting. Those respondents who believed that rabies could be transmitted by bats were 5.5 times more likely (95% CI: 1.6, 18.6) to report a dog bite compared to people who did not hold this belief. Respondents who would seek emergency treatment if they believed they had been exposed to rabies were 3.1 times more likely to report a bite (95% CI: 1.8, 5.4). Those who were over 60 years of age were 2.3 times more likely (95% CI: 1.2, 4.4) to report being bitten when compared to respondents who were under the age of 60. Living inside the city limits also increased the chance that the respondent would report being bitten by a dog (OR 2.3, 95% CI: 1.4, 3.9). Females were 2.3 times more likely (95% CI: 1.3, 3.7) to report being bitten than their male counterparts. Dog ownership did not have a significant impact on reporting. Only 85% of respondents stated that they would seek emergency treatment if they believed that they may have been exposed to rabies. In addition, only 59% of respondents were aware that exposure to rabies without treatment could lead to death. While 98% of respondents had heard of rabies and knew that it was possible to get it from a dog, only 54% of respondents knew that worms could be transmitted from dogs to people. This study demonstrated that many people surveyed lacked knowledge about dog-associated zoonotic diseases, which could seriously impact their health and the health of their families. It is important to find a method of getting information out to the public in order to correct this deficiency.     

湖南部分地区犬狂犬病病毒的监测研究

对湖南部分地域的8个县(市、区)的8个城区、乡镇和农村的健康犬抽样采集脑组织标本142份,应用RT-PCR和直接荧光抗体试验(FAT)检测,检测结果142份犬脑样中均不含狂犬病病毒。调查上述监测点及周边近三年狂犬病的免疫情况,免疫率均超过70%。表明湖南部分犬免疫工作较好的地区,通过加大群免疫密度,可以使犬狂犬病病毒携带率降低,这可能与形成免疫屏障有关。     

Canine ecology and socioeconomic factors associated with dogs unvaccinated against rabies in a Mexican city across the US-Mexico border

A cross-sectional study was conducted to identify ecologic and socioeconomic factors associated with dogs unvaccinated against rabies in Mexicali, the capital city of Baja California, Mexico (located across the US-Mexico border). A total of 1100 households were selected by random sampling from a list of all 180,000 households. A questionnaire was filled in during a personal interview with the household head or another adult person to gather information of epidemiological interest (such as canine ecology, social and economic factors that might influence owners' decision to allow their dog to be vaccinated). There were 910 dogs identified. The human-to-dog ratio was 4.3:1. The male-to-female dog ratio was 1.5:1. Out of 791 dogs > or = 3 months old, 577 (73%) were classified as vaccinated against rabies. Most dogs (95%) were not spayed. Neighborhood dogs had 25 times higher risk of nonvaccination compared to dogs owned by a family. Dogs 3-11 months old had three times higher risk of nonvaccination compared to dogs > or = 1 year old. Dogs that were obtained as a gift, born at home or found had two times higher risk of nonvaccination compared to dogs that were reportedly purchased. Crossbred dogs had 1.5 times higher risk of nonvaccination compared to purebred dogs. The canine-ecology structure is similar to that in regions were rabies is endemic.     

Epidemiologic factors, clinical findings, and vaccination status of rabies in cats and dogs in the United States in 1988. National Study Group on Rabies

Despite the availability of rabies vaccination through private veterinarians and government-sponsored rabies control programs, rabies was reported in an average of 338 cats and dogs per year from 1980 through 1987 in the United States. Information was collected on 90% of the 183 cats and 97% of the 119 dogs that were reported to have rabies in the continental United States in 1988. The median age of rabid cats and dogs was 1 year, and 81% were from rural areas. Compared with rabid cats, rabid dogs were more likely to have been male (66 vs 42%, odds ratio = 2.6), to have been kept as pets (84 vs 43%, odds ratio = 6.8), and to have had reported contact with wildlife before onset of illness (38 vs 14%, odds ratio = 3.8). Rabid cats accounted for a greater proportion of human rabies postexposure prophylaxis, bites to people, and exposures to other animals than did rabid dogs. Although the clinical signs of rabies varied, rabid cats were more likely than dogs to have had aggressive behavior (55 vs 31%, odds ratio = 2.8). In contrast, rabid dogs were more likely than cats to have had an illness consistent with a paralytic process. The median period between onset of illness and death was 3 days (range, less than 1 to 10) in rabid cats and dogs that were allowed to die of rabies. Vaccine failures were documented in 3 (1%) rabid animals (2 cats and 1 dog). All animals had received only a single dose of vaccine in their lifetime and were vaccinated when they were between 3 and 6 months old.     

Characteristics of 234 dog bite incidents in Ireland during 2004 and 2005

Information was obtained by telephone interview from 100 dog owners whose dog had bitten a person, and from 134 victims of bites by a dog not owned by the victim. Three-quarters of the victims were female and aged from 21 to 60 years. The majority of the dogs were owned, male, two to six years old, over 10 kg in bodyweight and belonged to the popular breeds: collies, cocker/springer spaniels, terrier breeds, Jack Russell terriers, German shepherd dogs, golden retrievers and crossbreeds. The numbers of bites by the different breeds indicated that those that inflicted the most bites were the popular breeds rather than the breeds with any greater propensity to bite. Most attacks were rapid single bites and in 50 per cent of the cases, neither the owner nor the victim was able to identify any signal of the dog's intention to bite. Overall, 21 per cent of the incidents were rated as 'serious' and 2 per cent as 'life threatening'. One fifth of the dogs were euthanased as a result of the incident. Half the incidents required professional medical assistance for the victim. Almost half the incidents took place while the victim was walking or passing close to the dog's territory, or while the victim was interacting with the dog at home.     

Determinants of health seeking behaviour following rabies exposure in Ethiopia

The objective of this study was to identify factors that determine medical treatment seeking behaviour following potential rabies exposure after being bitten by a suspected dog and the likelihood of compliance to receive sufficient doses of post‐exposure prophylaxis after the visit to a health centre visit. A detailed survey based on case investigation was conducted on suspected rabid dog bite cases in three areas of Ethiopia. Two multivariable logistic regression models were created with a set of putative variables to explain treatment seeking and compliance outcomes. Based on the registered bite cases at each health centre and the set of unregistered bite cases derived by contact tracing, 655 bite victim cases were identified to have occurred between September 2013 and August 2014. Of these evaluated bite incidences, 465 cases were considered to have been caused by a potentially rabid dog. About 77% of these suspected rabid dog bite victims visited a health centre, while 57% received sufficient doses of PEP. The overall likelihood of seeking medical services following rabies exposure was higher for people bitten by dogs of unknown ownership, where the bite was severe, being bitten on the leg, spend of more than 100 USD per month and where the victim lived close to the nearest health centre, while the likelihood of receiving sufficient doses of PEP was sensitive to monthly spending and distance to health centre. However, the evaluated factors did only explain a part of the variation among the three districts. The district in which victims lived appeared to have a relevant influence on the likelihood of seeking medical treatment but did not improve the prediction on the likelihood of treatment compliance. Given the insights obtained from this study, improvements in the rural districts with regard to accessibility of post‐exposure prophylaxis delivering health centres in shorter distance could improve health seeking behaviour. In addition, in rural districts, majority of exposed persons who seek medical treatment tend to comply with treatment regimen, indicating that the promotion of medical treatment through awareness creation campaigns could be beneficial.     

Dogs Entering the United States from Rabies‐Endemic Countries, 2011–2012

International dog imports pose a risk because of the potential movement of disease agents, including the canine rabies virus variant which has been eliminated from the United States since 2007. US regulations require a rabies vaccination certificate for dogs arriving from rabies‐endemic countries, but permit the importation of dogs that have not been adequately immunized against rabies, provided that the dogs are confined under conditions that restrict their contact with humans and other animals until they have been immunized. CDC Form 75.37, ‘Notice to Owners and Importers of Dogs’, explains the confinement requirements and serves as a binding confinement agreement with the importer. In this evaluation, we describe the characteristics of unimmunized dogs imported into the United States over a 1‐year period based upon dog confinement agreements recorded at the Centers for Disease Control and Prevention (CDC) quarantine stations. Confinement agreements were issued for nearly 2800 unimmunized dogs that entered the United States during 1 June 2011–31 May 2012, the majority of which travelled to the United States by air and without any seasonal pattern in import volume. Over 60% of these animals were puppies <3 months of age and included a wide variety of breeds. The dogs arrived from 81 countries, with the majority arriving from North America or Europe. Dogs placed on confinement agreements had final destinations in 49 states. California, New York, Texas, Washington and Florida received the largest number of dogs on confinement agreements. These results (which do not reflect human travel or US dog ownership data) suggest that a large portion of unimmunized dogs arrive from rabies‐endemic countries for commercial, shelter and rescue purposes. Further evaluation and key stakeholder involvement are needed to assess whether the current dog importation regulations are an adequate compromise between the benefits and risks of dog importation.     

Will breed-specific legislation reduce dog bites?

So how do we deal with biting dogs? To start with, we must remind ourselves that biting is a natural activity of all dogs, and that there is potential for injury. All dog owners must understand this and must be made aware that they are fully responsible for the actions of their dogs. I am not convinced that this is universally understood by dog owners, nor am I satisfied that every dog owner takes the necessary steps to train and socialize their dog. Owners need to be encouraged to actively work at inhibiting biting behaviour when dogs are young. As well, all dogs should be socialized to accept children, regardless of whether or not there are children living with the dog. Adults without dogs need to learn that dogs don''t understand "people''s rights," and that dogs should not be expected to act differently with different people. Adults also need to understand that young children should never be left alone with a dog (or a cat) without supervision, and that all children should be taught how to behave around dogs, particulary around dogs they don''t know. So long as we have dogs living with us there will be people who get bitten. The most effective way to prevent bites is to encourage dog owners to become knowledgeable about their animals and to train and socialize them so that they can become good dog neighbours. Many municipalities already have by-laws that deal with animal bites, and in Ontario the Dog Owners Liability Act has proven to be effective in confining, restraining or disposing of biting or attacking dogs judged to be a definite threat to public health and safety, and when evidence warrants, there is always Section #221 of the Criminal Code of Canada. Most legislation deals with bites after the fact. If we want to prevent all bites, there is only one sure way and that is to ban all dogs. That is of course as unrealistic as trying to prevent bites by enacting breed specific legislation.