Canine and human factors related to dog bite injuries

OBJECTIVE: To identify physical traits of biting dogs and characteristics of injured persons and dog owners associated with bite situations for use in public health prevention activities. DESIGN: Retrospective cohort study. STUDY POPULATION: Licensed dog and dog bite report data from June 30, 2002, to July 1, 2003, that were obtained from Animal Control Services of Multnomah County, Oregon. PROCEDURES: To determine the canine and human factors associated with dog bite injuries, the number of bites, dog and injured person characteristics, and the overall canine population were evaluated. Dog owner characteristics at the block group level were defined by use of geographic information system software through 2000 census information based on place of residence. RESULTS: During the study period, 636 dog bites were reported to Animal Control Services, and 47,526 dogs were licensed in Multnomah County. Risk factors associated with biting dogs included breed (terrier, working, herding, and nonsporting breeds), being a sexually intact male, and purebred status. Male children aged 5 to 9 years had the highest rate of injury (178 bites/100,000 children). Biting dogs were more likely than nonbiting dogs to live in neighborhoods where the residents' median incomes were less than the county median income value ($41,278). CONCLUSIONS AND CLINICAL RELEVANCE: Dog bites continue to be a source of preventable injury. Prevention programs should target owners of sexually intact male and purebred dogs and owners who live in lower income neighborhoods.     

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.     

Owned dog demography in Todos Santos Cuchumatán,Guatemala

A thorough knowledge of the dog demography should be an integral element in the planning, implementation and evaluation of dog population control measures. In May 2008, a door-to-door household census of human and owned canine populations was conducted in 12 contiguous neighbourhoods in the town of Todos Santos Cuchumatán, Guatemala. During the census, household and footpath data were recorded using a handheld Global Positioning System (GPS), and used to create digital census route maps, and perimeter and area estimates of the study region. Approximately 99% of all households (472/476) participated in the census, representing 2461 people in the overall estimated study region area of 80 hectares (ha). A total of 382 dogs were owned by 50.8% (240/472) of households, yielding means of 0.8 (382/472) owned dogs per household and 1.6 (382/240) dogs per dog-owning household. Of the total 382 owned dogs, 88.2% (337/382) were aged three months or older; of these, 68.5% (231/337) were reported as not normally being confined on the household property during the average day, and 9.7% (24/247) of the males and none of the females (0/81) were reported to be neutered. Of the households that owned female dogs, 89.7% (52/58) and 91.4% (53/58) reported that they would have females surgically or non-surgically neutered, respectively, if these services were available. Of the households that owned male dogs, 90.3% (176/195) and 92.3% (180/195) reported that they would have males surgically or non-surgically neutered, respectively, if these services were available. Approximately 72% (238/330) of owned dogs were vaccinated for rabies, and 80% (187/238) of these were males. The owned dog male:female ratio was 2.6:1 (275/107), the owned dog:human ratio was 1:6.4 (382/2461), and the absolute density was 478 (382/0.80) owned dogs/km². This knowledge of the owned dog demography was generated using simple means and has been of direct use in support of, and as baseline data for the planning, implementation and evaluation of subsequent dog population control measures in this population; they may be of similar use in other comparable populations.     

Cause,Setting and Ownership Analysis of Dog Bites in Bay County,Florida from 2009 to 2010

Emergency room and hospital discharge data have been used to describe the risk factors and public health impact of dog bites. These data sets are based on financial charges for severe bites and underestimates dog bite burdens within communities. This study expands both the source of information and risk factor data collected to provide demographic analysis of dog bite injury risk factors reported in Bay County, Florida in 2009–2010. Extended data for dog bites reported by various sources from January 1, 2009 to December 31, 2010 were collected by Florida Department of Health in Bay County. Data collected included bite victim's age and gender, primary reported cause of bite, setting, dog's restraint status and relationship between the victim and the dog. A total of 799 bites were reported. Most bites (55%) were reported first by healthcare practitioners, particularly bites involving children <6 years. Bites involving unfamiliar dogs and dogs off the owner's property were more likely to be reported by other sources. Boys aged 6–14 years accounted for 2.24 times more bites than same‐aged females (P < 0.001) and had the highest incidence with 424 bites per 100 000 persons per year. Persons 6 years or older were 3.6 times more likely to be bitten by an unfamiliar dog. Inappropriate behaviour management was the most common cause of bites (26%), followed by protective behaviour (24%). Bites of unknown cause were 2.5 times more likely in children <6 years. Separating dog fights was the most common cause of bites for persons 15 years or older (24%); females were significantly more likely to be bit than males (P = 0.01). Bites by unrestrained dogs off the owner's property (32% of all bites) most commonly involved males. Estimates based solely on healthcare discharge data significantly underestimate dog bite burden within a community. Characterizing these risks by age group or gender provides an opportunity to implement targeted interventions to prevent dog bites.     

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.     

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.     

Breeds of dogs involved in fatal human attacks in the United States between 1979 and 1998

OBJECTIVE: To summarize breeds of dogs involved in fatal human attacks during a 20-year period and to assess policy implications. ANIMALS: Dogs for which breed was reported involved in attacks on humans between 1979 and 1998 that resulted in human dog bite-related fatalities (DBRF). PROCEDURE: Data for human DBRF identified previously for the period of 1979 through 1996 were combined with human DBRF newly identified for 1997 and 1998. Human DBRF were identified by searching news accounts and by use of The Humane Society of the United States' registry databank. RESULTS: During 1997 and 1998, at least 27 people died of dog bite attacks (18 in 1997 and 9 in 1998). At least 25 breeds of dogs have been involved in 238 human DBRF during the past 20 years. Pit bull-type dogs and Rottweilers were involved in more than half of these deaths. Of 227 reports with relevant data, 55 (24%) human deaths involved unrestrained dogs off their owners' property, 133 (58%) involved unrestrained dogs on their owners' property, 38 (17%) involved restrained dogs on their owners' property, and 1 (< 1%) involved a restrained dog off its owner's property. CONCLUSIONS: Although fatal attacks on humans appear to be a breed-specific problem (pit bull-type dogs and Rottweilers), other breeds may bite and cause fatalities at higher rates. Because of difficulties inherent in determining a dog's breed with certainty, enforcement of breed-specific ordinances raises constitutional and practical issues. Fatal attacks represent a small proportion of dog bite injuries to humans and, therefore, should not be the primary factor driving public policy concerning dangerous dogs. Many practical alternatives to breed-specific ordinances exist and hold promise for prevention of dog bites.     

Canine aggression toward people. Bite scenarios and prevention

This article reviews studies of different dog bites directed toward people. Typical bite events are summarized by describing the characteristics of the dog, victim, and wound; serious bites (severe and fatal bites) are described separately. Suggestions for the prevention of dog bites are presented.     

A survey of animal bites on humans in Bursa,Turkey

Animal bites are a major public health problem. The aim of this study was to conduct a survey of animal bites in Bursa, Turkey. Patients who sought medical care for animal bites over an 18-month period were included in our study (n = 1,715). Data were obtained from the registry of the Bursa State Hospital; 71.84% of the patients were men and 28.16% were women. Bites were most frequent among patients who were >18 years of age (comprising 60.83% of all bites). The anatomical site of the bite was recorded in all 1,715 cases, and 1,778 bite locations on the body were reported. The upper extremities were the most frequent sites of animal bites (53.83%), followed by the lower extremities (38.03%). Bites were most frequently inflicted by dogs (68.04%), followed by cats (28.45%), mice (2.56%), and other animals (hamsters, donkeys, horses, foxes, and rabbits together comprised 0.95% of the bites). As a result, bite incidents were mostly associated with males aged >18 years and occurred in the upper extremities. This study showed that dog bites constitute a major animal bite problem in Bursa, Turkey.     

Evaluation of Pet‐Related Management Factors and the Risk of Salmonella spp. Carriage in Pet Dogs from Volunteer Households in Ontario (2005–2006)

The purpose of this study was to determine pet‐related management factors that may be associated with the presence of Salmonella spp. in feces of pet dogs from volunteer households. From October 2005 until May 2006, 138 dogs from 84 households in Ontario were recruited to participate in a cross‐sectional study. Five consecutive daily fecal samples were collected from each dog and enrichment culture for Salmonella spp. was performed. A higher than expected number of the dogs (23.2%; 32/138) had at least one fecal sample positive for Salmonella, and 25% (21/84) of the households had at least one dog shedding Salmonella. Twelve serotypes of Salmonella enterica subsp. enterica were identified, with the predominant serotypes being Typhimurium (33.3%; 13/39), Kentucky (15.4%; 6/39), Brandenburg (15.4%; 6/39) and Heidelberg (12.8%; 5/39). Univariable logistic regression models were created with a random effect for household to account for clustering. Statistically significant risk factors for a dog testing positive included having contact with livestock, receiving a probiotic in the previous 30 days, feeding a commercial or homemade raw food diet, feeding raw meat and eggs, feeding a homemade cooked diet, and having more than one dog in the household. In two‐variable models that controlled for feeding raw food, the non‐dietary variables were no longer statistically significant. These results highlight the potential public health risk of including raw animal products in canine diets.     

Why your housecat's trite little bite could cause you quite a fright: a study of domestic felines on the occurrence and antibiotic susceptibility of Pasteurella multocida

Approximately four to five million animal bite wounds are reported in the USA each year. Domestic companion animals inflict the majority of these wounds. Although canine bites far outnumber feline bites, unlike the dog, the cat's bite is worse than its bark; 20-80% of all cat bites will become infected, compared with only 3-18% of dog bite wounds. Pasteurella multocida is the most commonly cultured bacterium from infected cat bite wounds. Anyone seeking medical attention for a cat-inflicted bite wound is given prophylactic/empiric penicillin or a derivative to prevent Pasteurella infection (provided they are not allergic to penicillins). In an effort to establish a carriage rate of P. multocida in the domestic feline, bacterial samples from the gingival margins of domestic northern Ohio cats (n=409) were cultured. Isolates were tested for antibiotic sensitivity as prophylactic/empiric use of penicillin and its derivatives could potentially give rise to antibiotic resistance in P. multocida. The high carriage rate (approximately 90%) of P. multocida observed was found to be independent of physiological and behavioural variables including age, breed, food type, gingival scale, lifestyle and sex. High antibiotic susceptibility percentages were observed for benzylpenicillin, amoxicillin-clavulanate, cefazolin, and azithromycin (100%, 100%, 98.37% and 94.02%, respectively) in P. multocida isolates. The high prevalence of P. multocida in the feline oral cavity indicates that prophylactic/empiric antibiotic therapy is still an appropriate response to cat bite wounds. Additionally, the susceptibility of P. multocida to penicillin and its derivatives indicates that they remain reliable choices for preventing and treating P. multocida infections.     

The human-canine environment: a risk factor for non-play bites?

Few dog bite risk factor studies have been conducted. This veterinary clinic-based retrospective cohort study was aimed at identifying human-canine environmental risk factors for non-play bites in Kingston, Jamaica (660) and San Francisco (SF), USA (452). Data were analysed using modified Poisson regression with confounders selected using directed acyclic graphs (DAGs) and the change-in-estimate procedure. Dogs acquired for companionship were more likely (RR=1.66; 95% CI 1.02-2.70) to bite than those acquired for protection. Routinely allowing a dog into the presence of visitors was also positively associated with it biting. A dog sleeping in a family member's bedroom was a risk factor for biting in Kingston (RR=2.54; 95% CI 1.43-4.54) but not in SF, while being able to leave the yard unaccompanied was a risk factor for biting in SF (RR=3.40; 95% CI 1.98-5.85) but not in Kingston. Overall, dogs which were less restricted in their interactions with humans were at elevated risk for biting. An observed association with dog bites in one cultural setting might not exist in another.     

Stabilizing Dog Populations and Improving Animal and Public Health Through a Participatory Approach in Indigenous Communities

Free‐roaming dog populations are a global concern for animal and human health including transmission of infectious disease (e.g. rabies, distemper and parasites), dog bite injuries/mortalities, animal welfare and adverse effects on wildlife. In Saskatchewan (SK), Canada, veterinary care is difficult to access in the remote and sparsely inhabited northern half of the province, where the population is predominately Indigenous. Even where veterinary clinics are readily available, there are important barriers such as cost, lack of transportation, unique cultural perspectives on dog husbandry and perceived need for veterinary care. We report the effects of introducing a community action plan designed to improve animal and human health, increase animal health literacy and benefit community well‐being in two Indigenous communities where a dog‐related child fatality recently occurred. Initial door‐to‐door dog demographic surveys indicated that most dogs were sexually intact (92% of 382 dogs), and few had ever been vaccinated (6%) or dewormed (6%). Approximately three animal‐related injuries requiring medical care were reported in the communities per 1000 persons per year (95% CL: 1.6–6.6), and approximately 86% of 145 environmentally collected dog faecal samples contained parasites, far above levels reported in other urban or rural settings in SK. Following two subsidized spay/neuter clinics and active rehoming of dogs, parasite levels in dog faeces decreased significantly (P < 0.001), and important changes were observed in the dog demographic profile. This project demonstrates the importance of engaging people using familiar, local resources and taking a community specific approach. As well, it highlights the value of integrated, cross‐jurisdictional cooperation, utilizing the resources of university researchers, veterinary personnel, public health, environmental health and community‐based advocates to work together to solve complex issues in One Health. On‐going surveillance on dog bites, parasite levels and dog demographics are needed to measure the long‐term sustainability of benefits to dog, human and wildlife health.     

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.     

Epidemiology of dog bites: a Belgian experience of canine behaviour and public health concerns

This paper reviews three studies that have been conducted in Belgium on dog bites on children. (1) A telephone study revealed that 22/1000 children <15 years of age were victims of dog bites annually. (2) Data on the characteristics of dog bites were collected prospectively over a period of 8.5 months in six hospital emergency departments. "Dangerous dogs" were not responsible for the majority of the accidents. In 67/100, incidents documented, the bites appeared to be triggered by an interaction of the child. Education appeared to be the preventive measure with the highest priority. (3) Among 22 child victims of dog bites, 12 had symptoms of post-traumatic stress disorders some seven months following the accident. Based on these local studies, several initiatives have been undertaken to favour both primary and secondary prevention measures. An appropriate psychological preventive intervention should be offered to all victims of dog bites.     

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.     

Animal control measures and their relationship to the reported incidence of dog bites in urban Canadian municipalities

Various measures, including ticketing, licensing, and breed-specific legislation, are used by municipalities to control dog bites, but their effectiveness is largely unknown. Thirty-six urban Canadian municipalities provided information about their animal control practices, resourcing, and (for 22 municipalities) rate of reported dog bites. Municipalities differed widely in rates of licensing (4% to 75%) and ticketing (0.1 to 83 per 10 000 people), even where staffing and budgets were similar. Reported frequency of dog bites ranged from 0 to 9.0 (median 1.9) per 10 000 people. Rates were generally higher in municipalities with higher ticketing, licensing, staffing, and budget levels. However, in municipalities with very active ticketing the reported bite rate was much lower than predicted by a linear regression on ticketing rate (quadratic regression, R² = 0.52), likely reflecting a reduction in actual bites with very active enforcement. Municipalities with and without breed-specific legislation did not differ in reported bite rate. Ticketing appeared most effective in reducing dog bites, although it may also lead to increased reporting.