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Behavioural characteristics associated with dog bites to children presenting to an urban trauma centre
Abstract
Children are the most frequent victims of dog bites presenting to hospital emergency departments (ED), but there are gaps in understanding of the circumstances of such bites. The objective of this study was to characterise the behavioural circumstances of dog bites by interviewing children ≤17 years (or parent proxies for children ≤6 years) presenting with dog bite injuries to The Children's Hospital of Philadelphia about the bite incident, its setting and associated interactions. Of 203 children enrolled, 51% were <7 years old and 55% were male. 72% of children knew the biting dog. Most bites to younger children occurred during positive interactions, initiated by the child, with stationary, familiar dogs, indoors. Most older bitten children had been active (eg, outdoors), unfamiliar with the dog and not interacting. Whereas face bites predominated (70%) in the younger group (<7 years), bites to extremities predominated (72%) in the older group. Recognition of the two distinctive behavioural and circumstantial subgroups of dog bites that emerged can lead to more effective prevention strategies.
... Children in the 1-14-year age range are more at risk than other age ranges [2] and account for about two-thirds of all hospitalisations among young people under the age of 18 years. Two age groups of children were the most bitten [9], those under the age of two [10] and those between the ages of nine and twelve [11]. ...
... Studies also underscore the importance of knowing the child's temperament and, most importantly, their impulsivity; prevention should focus on discouraging the child from establishing close contacts with the animal [35]. Furthermore, a better understanding of the dog's behaviour is crucial in letting the educators to instruct the child on whether to approach the dog or not [10]. Most studies welcome psychological interventions to reduce the risk of dog bites and consider interdisciplinary interventions most suitable for preventing and handling dog bites in children. ...
... The literature underscores the significance of behavioural dynamics preceding dog bites, emphasizing the need for education and supervision. The studies by Reisner et al. [10] and Shen et al. [8] highlight the unfamiliarity of children with the biting dog and the prevalence of unsupervised incidents in domestic settings (although one study found familiar dogs to account for 78% of bites [55]). Such insights advocate for educating both children and adults on appropriate behaviour around dogs and the imperative of supervision. ...
Background/Objectives: Although rare in the Western world, dog bites may be lethal or lead to physically severe outcomes. However, little attention is given to their psychological consequences. We aimed to review their psychological consequences in children 1–14 years of age, focusing on the prevalence and nature of psychological disorders, evaluating the impact on future mental health of children and their families, and assessing the effectiveness of preventive interventions and measures. Methods: On 23 May 2024, we investigated the PubMed, CINAHL, and PsycINFO/PsycARTICLES databases using (“dog bite” OR animal-induced OR animal-caused) AND (psychol* OR mental OR psychiatr* OR anxiety OR anxious OR depress* OR obsess* OR trauma* OR psychosis OR psychotic OR schizophren* OR schizoaffect*) filtered for ages 0–18 years. This resulted in 311 records, of which 50 were eligible. These included original research, case reports, patient surveys, and reviews/meta-analyses. Results: Findings indicate that younger children are particularly vulnerable, often suffering head/neck bites, leading to severe injuries and psychological distress, with post-traumatic stress disorder (PTSD) being a common outcome. Symptoms such as nightmares, flashbacks, anxiety, and social withdrawal were frequently reported. Positive parental support and timely psychological interventions were found to mitigate these effects. Conclusions: Interdisciplinary approaches integrating education, cognitive restructuring, and behaviour modification are needed to effectively prevent and address the psychological impacts of dog bites. Summarising, dog bites in children result in substantial psychological sequelae, necessitating robust prevention and intervention strategies to improve their quality of life and reduce the risk of chronic mental conditions.
... Aggression often does not follow from painful, agonistic or aversive interactions with the dog. It could be elicited by interaction with affectionate intentions, for example, by petting and hugging (REISNER et al., 2011) or even changes in posture or eye contact (REISNER et al., 2007). Infants and small children can occasionally be perceived as prey and attacked by dogs exhibiting predatory behaviour (LUESCHER and REISNER, 2008). ...
... Our results in younger children regarding the area, familiarity, supervision and interaction correspond with earlier research (DE KEUSTER et al., 2006;REISNER et al., 2011). Own or known dogs, lack of supervision and being indoor or outdoor in a nonpublic area such as a house are closely connected. ...
... Rapid movements, such as running or cycling near the dog, may be provocative for the dog and trigger predatory behaviour (LUESCHER and REISNER, 2008). They may also trigger territory guarding, especially towards unfamiliar children close to the dog's home or perceived territory, even without a previous interaction (REISNER et al., 2011). Territorial aggression can also be a motivation for bites during a non-threatening entry to a dog's personal space (CHÁVEZ and OPAZO, 2012), especially when the dog is unfamiliar with the person (KUHNE et al., 2014). ...
Although children are the most frequent victims of dog bites, gaps remain in understanding of the factors that lead to biting incidents. Using a retrospective and victim self-report questionnaire, risk factors for dog bites with respect to younger and older children in Slovenia are examined. The results showed that younger children were more commonly bitten in a non-public place, outside or inside a house when the owner was absent. They had approached and interacted with a dog they knew, which had a history of aggression and had displayed tense or aggressive behaviour before the bite. Older children were mainly bitten outside in a public space, when the owner was not there. They were approached and bitten by an unknown dog while running or cycling, while entering the dog's personal space, or it was completely unprovoked. The dog involved had a history of aggression and before the bite the victims had neither interacted nor attempted to interact with the dog. These results suggest that the risk factors for dog bites involving children might be age-related calling for due attention and further assessment.
... The time span assessed in the studies ranged from 1985 to 2017 [4,9,11,. Majority of the included studies in the review were retrospective studies except 4 studies (2 were prospective studies [11,25] and 2 were cross-sectional questionnaire-based surveys [38,43]). The animals involved in the biting episode were dogs in all the included studies. ...
... The age range varies from 0 to 19 years with the mean age varying from 3.6 to 8 years [25,26]. The usual age in all studies analyzed corresponded to preschool and grade school children being the most affected group [22,24,25,[27][28][29][30][31][32][33]37,40,43,46]. The list of breeds commonly causing ABI are given in Table II. ...
... Young children below 5 years and male child seem more vulnerable to be attacked because of their underdeveloped motor skills [22,24,[27][28][29][30]33,40,43,46]. Face especially lips, nose and cheeks, also referred to as 'central target area' is more prone, may be because of comparatively smaller body and larger head size [3,5,6,9,11,[60][61][62][63][64][65][66][67][68][69][70][71]. ...
Objectives: To assess the scientific literature pertaining the risk factors for injuries among victims of animal bite injuries. Data and sources: A systematic review of scientific literature published until May 2020 was carried out in the following databases: PubMed, Cochrane Library, Google Scholar and Journals@ovid. Study selection: A total of 924 records were found, of which 29 articles fulfilled the inclusion criteria and were analyzed. There was a male preponderance in most of the studies with male/female ratio ranging from 0.75:1 to 2.1:1. The age range varies from 0 to 19 years with the mean age varying from 3.6 to 8 years. Pitbulls, Rottweiler's, German shepherds, Bull terriers, Labradors and Dobermans were breeds with higher risk of attack. The animals were familiar to the victim (own, friends, neighbors) in 27–98% instances. Most cases of animal bite injuries were recorded during Summer and Spring months. Head and neck followed by extremities was found to be most inflicted area. Conclusions: The sociodemographic characteristics of victim as well as the biting animal affect the circumstances leading to biting episode. However, the results should be interpreted with caution due to the high heterogeneity among studies and moderate quality evidence.
... Some dog breeds are more commonly involved in reports of attacks to human beings. Dogs of the breeds Pit Bull, Rottweiler, and German Shepherd, probably due to their specific characteristics such as strength and jaw shape, usually present more severe bites that require medical care and are frequently cited in studies (5,11,12,14,16,17,19,20,22,23). Curiously, dogs of the breeds Labrador, Golden Retriever, Border Collie, Jack Russel, and Shih-Tzu, despite being considered good pets for families with children, also present a high incidence of attacks with bites (5,11,14,16,17,22), but these injuries are usually less serious. ...
... When the age increased, we noticed an increase in the frequency of accidents with unknown dogs. This data also agrees with the literature (5,6,10,12,14,23,31,32,34). ...
... The trend observed of younger children being mostly attacked at home and for a provoked cause might indicate some failure in the supervision of the child/dog interaction by the family members. The children's familiarity with their pets might generate a false sensation of safety and result in a longer time of exposure in the absence of an adult individual, and risky behavior with dogs might be sometimes neglected by the parents (23,31,32,34). Education actions targeting parents of children in this age group would result in greater benefit than those directed to the children. ...
Introduction
Accidents involving dog attacks are very common, which makes this type of accident a global public health issue. The estimates point to 20% of the victims of such accidents seeking care in health units, and half of them being children. In addition to acute injuries, dog attacks might result in fractures, infections, scars, and psychological traumas. This study aimed to describe the epidemiological profile of dog attacks to children under 14 years old assisted in a pediatric emergency service in Brazil.
Methods
The database of the Information and Toxicological Assistance Center of Campinas was surveyed to identify cases of children under 14 years old assisted after a dog attack in a 9-years period. Demographic data, number and type of lesions, type of exposure, part of the body affected, dog origin and condition, and the accident location and cause were analyzed. The data were presented in a descriptive way, and the age groups were classified as follows: 0–3 years old, 4–6 years old, and 7–14 years old. The different age groups were compared one to another regarding the markers evaluated using the chi-square test and the Fisher’s exact test. A 0.05 alpha was adopted in all analyses.
Results
The number of children assisted in the study period totaled 1,012. The 7–14-year-old group was the most affected ( n = 498; 49.2%), male patients were also majority ( n = 660; 65.2%). Most injuries were found on the head/neck area ( n = 378; 37.4%). However, the older the patients were, the higher the frequency of lesions on upper and lower limbs was, as well as attacks occurred in external environments, thus involving animals that could not be observed. A significant increase in accidents with provoked causes was observed in younger patients.
Conclusion
Accidents involving dog attacks are more likely to happen among boys. Younger children run higher risks of becoming victims of these accidents inside homes, being attacked by pets, and showing a greater incidence of head and neck lesions. Older children present more injuries on their limbs, which are caused by dogs that cannot be observed.
... Aggression often does not follow from painful, agonistic or aversive interactions with the dog. It could be elicited by interaction with affectionate intentions, for example, by petting and hugging (REISNER et al., 2011) or even changes in posture or eye contact (REISNER et al., 2007). Infants and small children can occasionally be perceived as prey and attacked by dogs exhibiting predatory behaviour (LUESCHER and REISNER, 2008). ...
... Our results in younger children regarding the area, familiarity, supervision and interaction correspond with earlier research (DE KEUSTER et al., 2006;REISNER et al., 2011). Own or known dogs, lack of supervision and being indoor or outdoor in a nonpublic area such as a house are closely connected. ...
... Rapid movements, such as running or cycling near the dog, may be provocative for the dog and trigger predatory behaviour (LUESCHER and REISNER, 2008). They may also trigger territory guarding, especially towards unfamiliar children close to the dog's home or perceived territory, even without a previous interaction (REISNER et al., 2011). Territorial aggression can also be a motivation for bites during a non-threatening entry to a dog's personal space (CHÁVEZ and OPAZO, 2012), especially when the dog is unfamiliar with the person (KUHNE et al., 2014). ...
Using a web-based questionnaire with 29 close- and open-ended questions about 400 self-reported dog-biting incidents in Slovenia, this research investigated the contexts of dog bites, focusing on characteristics of the dogs and the descriptions of the situations to identify the main risk factors for the occurrence of dog bites. Even though it has been suggested that most dog bites occur during initially non-aggressive interactions with the dog (e.g., during petting, playing), in our study we discerned a wide variety of contexts, including those in which the person did not intend to interact with the dog. Most victims reported unprovoked bites during fast movements near the dog, while coming into close proximity, and during incidents without a reason. These incidents more likely occurred in public than private places and were associated with purebred dogs with a history of aggression.
... Am wirksamsten zur Verhinderung von Bissverletzungen kann die Vermeidung einer Bedrängung des Tieres, v. a. wenn es frisst oder schläft, durch das Kind im häuslichen Umfeld beitragen, da dies die häufigste Unfallursache jüngerer Kinder darstellt [71]. ...
... Elterliche Beaufsichtigung ist also in jedem Fall einer Interaktion zwischen Hund und Kind zu fordern. Zumeist kennen sich Gebissener und beißendes Tier [71]. Abb. ...
... Eine Beugesehnenrekonstruktion ist frühestens 6 Monate nach Abklingen des Infekts möglich [28] Besonderheiten Im Falle der seltenen ausgedehnten lebensbedrohlichen Bissverletzungen ist es das vorrangige Ziel, die Blutung zu stillen. Zumeist ist das Auswaschen und radikale Débridement avitalen Gewebes entscheidend [12,36,71,85], um eine Infektion abzuwenden. ...
Objective
Thorough and profound debridement for acute bite injuries while sparing nerves, vessels and tendons.
Indications
Acute traumatic and late presented bite injuries.
Contraindications
General contraindication for anesthesia or surgery.
Surgical technique
Extensive flabellate local anesthesia/general anesthesia, wound irrigation using 0.9% NaCl or antiseptic solutions, removal of avital tissues, wound debridement, wound edge excision, anew extensive irrigation, drainage if necessary, wound closure where applicable (except older or punctual deep injuries), bandage, elastic wrapping and immobilization. If necessary, plastic surgery with coverage of remaining defects.
Postoperative management
Immobilization with initially daily wound evaluation, removal of drainage/loop on postoperative day 2; if necessary, antibiotic therapy with amoxicillin and clavulanic acid in high-risk wounds (e.g., puncture wounds, joint or bone involvement, extensive soft tissue squeezing), suture removal on day 10–12 after surgery.
Results
Of 142 bite injuries that were treated and retrospectively evaluated, 46% were caused by dogs and 32% by cats. Patients were on average 44 years old; 55% of all dog bites affected women, but 67% of all cat bites. In 48% of the cases, general anesthesia was necessary. The postoperative infection rate was 6.3%.
... Dog bite episodes involving children and infants were more frequently denounced and it is probably due to higher severity of the lesions, which are generally directed to the face and neck (OZANNE-SMITH et al., 2001;POLO et al., 2015;OWCZARCZAK-GARSTECKA et al., 2018). Seventy two percent of the children know the biting dogs (REISNER et al., 2011). This finding suggested that; although, humans and dogs are capable of d' Angelo et al. recognizing the other species' communicative signals and emotions (MOLNÁR et al., 2010;SINISCALCHI et al., 2016;FARAGO et al., 2017;SINISCALCHI et al., 2018a,b;, misunderstandings can occur and this may lead to inappropriate reaction of the dog, particularly toward children, whose ability to correctly identify dog emotions could be less mature (OVERALL & LOVE, 2001). ...
... Among the dog bite episodes registered, it has been reported a higher number of men than women (RODRIGUES et al., 2013;POLO et al., 2015). Bite incidents usually occur within the house when humans initiate an interaction with the dog, whereas the incidents occurring outdoors generally involve unfamiliar dogs in a non-interactive context (OZANNE-SMITH et al., 2001;REISNER et al., 2011;POLO et al., 2015). Concerning the dog features, several studies have reported that male, large dogs of specific breeds, including Rottweiler, German shepherd, Terriers (and Pit bulls), Siberian Husky, are more frequently involved in the denounced biting episodes (OVERALL & LOVE, 2001;GARVEY et al., 2015;O'BRIEN et al., 2015). ...
Dog bite is one of the major public health problems involving people worldwide. Although, several studies have investigated this phenomenon in different countries, little information about the incidence of dog bite episodes in Italy is available. We analysed data about dog biting events between 2010 and 2019 provided by the CRIUV, the Regional Reference Centre for Veterinary Urban Hygiene in the largest city of Southern Italy, namely. Naples. We observed severe and profound inconsistencies in the data collection that reveal structural and significant weaknesses of the current data collection system. Given the multifactorial nature of dog bite, we highlight the need to improve the gathering of all the information related to the factors affecting the occurrence of biting episodes for an accurate assessment of the biting phenomenon.
... 16,17 However, Reisner reported that 77% of dog injuries occur in provoked situations. 18 Young children are more vulnerable to dog bites than adults. 13, 17 Young children usually sustain dog inflicted wounds in an indoor setting with a familiar dog after self-initiated interaction with the dog. ...
... At the same time, adults and teenagers are more likely to be attacked in the outer environment by an unfamiliar dog without voluntary interaction. 10,18 The most common dog breed responsible for fatal bite and ocular injuries 17 is Pitbull's, as they are among one of the highly aggressive dog breeds. 19,20 Other aggressive dog breeds causing injuries are German shepherds, Doberman pinchverus, Bulldogs, Huskies and Akitas etc. 14,15,21 In young children, dogs prefer the oculofacial area such as eyelids, globe, lips, nose and cheek, head and neck for biting. ...
Eye injuries constitute a significant cause of avoidable global blindness. Animal-related injuries are
an increasing public health issue worldwide. The interaction of a man with animals occurs in various
situations, and the danger associated with it are underestimated and also there are underreported wounds.
Animal-induced ocular injuries are often severe and may lead to visual impairment, blindness and cosmetic
disfigurement. Animal-related ocular injuries are classified according to the geographical distribution,
type of animal, its behavior and availability in the community. This article reviews current literature and
discusses the mechanism and severity of animal inflicted ocular and adnexal injuries in humans and various
management techniques.
... [2][3][4][5][6] A majority of dog bites are a result of the child's own pet, and within their own home. [7][8][9][10] The significant risk of children being bitten by a dog paired with the increasing prevalence of US households owning dogs demonstrates the necessity for solutions to this public health problem and may require more robust efforts be put toward education and prevention. 2 4 At the same time, these injuries may have a significant psychological impact on patients, as trauma sustained during childhood has been shown not only to affect development but also to pose long-term mental health effects. 11 This may be an important consideration for clinicians caring for these patients. ...
... 2-6 8 9 15-36 Six studies were prospective cohort studies, 7 37-41 two were cross-sectional studies, 42 43 and six were experimental studies (five focused on educational/prevention interventions for children and adults and one focused on prophylactic antibiotic therapy) (online supplemental table 1). 10 44-48 Only 9 of the 43 studies had a behavioral health component incorporated into the study design or discussion sections. 7 16 19 38 42-46 Dog bite incidence and cost From 2001 to 2017, there was a clinically significant decrease of 34% in dog bite injuries among children, adolescents, and young adults aged 0-19 years of age. However, during that time period, dog bite injuries still accounted for nearly 2.5 million emergency department (ED) visits in the pediatric population. ...
Introduction
Dog bites are one of the leading causes of non-fatal emergency room visits in children. These injuries not only cause physical harm but can lead to long-term psychological stress. This study evaluated the current literature related to pediatric dog bite injuries to identify research gaps which should be prioritized to improve a major public health concern.
Methods
We performed a keyword search of PubMed, Scopus, and OVID Medline databases (January 1980– March 2020) for all published studies focused on dog bite injuries in the pediatric population (≤18 years of age) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Results
Out of 1859 abstracts screened, 43 studies involving 86 880 patients were included. Twenty-nine studies were retrospective chart reviews characterizing the epidemiology of dog bites and their associated treatment outcomes; six were prospective cohort studies; two were cross-sectional studies; and six were experimental studies. Synthesized results demonstrate that children <9 years of age suffer the greatest burden of injuries, with children <6 years of age at higher risk of more severe injuries involving the head, neck, and face.
Conclusion
Studies analyzing the prevention or psychosocial consequences of dog bites injuries are needed.
... 13,14 Populations under the age of five are more likely to present with head and neck injuries, incurred indoors and with a familiar dog (often belonging to the family). 14,15 Current data suggest that pit bulls are the most dangerous for children younger than 18, whereas dachshunds and shih tzus are possibly dangerous for children younger than 3 years. 13,14 In contrast, adolescents and adults are more likely to suffer injuries to the extremities, occurring outdoors and more often by interactions with unfamiliar dogs. ...
... 13,14 In contrast, adolescents and adults are more likely to suffer injuries to the extremities, occurring outdoors and more often by interactions with unfamiliar dogs. 14,15 Dogs with larger teeth are expected to yield more crush injuries that lead to lacerations and superficial abrasions rather than puncture wounds, which are more common in smaller dogs. 16 Treatment of dog bite wounds is largely predicated on the location of injury and time of presentation. ...
Animal bites are common worldwide. Due to the plethora of animals, there are diverse pathogens with specific associated risks and treatment algorithms. It is crucial to understand these to develop and execute appropriate management plans. This practical review was designed to amalgamate the most common bites worldwide and synthesize data to help guide treatment plans.
Methods:
A PubMed literature search was performed focusing on the major animal bites. High-level studies were preferred and analyzed but lower-level studies were also used if high-level studies did not exist.
Results:
The tables presented in this article cover the pertinent information regarding the incidence, common presentation, initial treatment, and potential complications associated with bites from dogs, cats, horses, rodents, snakes, marine life, and spiders. Many of the pathogens associated with the bites are treatable with various and somewhat common antimicrobials, though some are less easy to access. Basic irrigation, debridement, and wound culture are common to almost every animal and should be the first step in treatment.
Conclusions:
Based on the current studies, the most important factor in treating animal bites is timely presentation to a medical facility and/or physician. It is critical that the offending animal be accurately identified to help guide medical and surgical algorithms, including specific antimicrobial treatment guided by the most commonly presenting pathogens specific to certain animals.
... In this respect, dog bites covered by the first bite scenario appear to be different to the majority of bites within the general population. Moreover, in this study most (83%) bite victims were not familiar with the dog, which is different to previous research on which prevention efforts are based on which suggests that the victims are usually bitten by a dog that they know (Cornelissen and Hopster, 2010;De Keusteret al., 2006;Oxley et al., 2018;Reisner et al., 2011;Rezac et al., 2015;Schalamon et al., 2006). Instead, our observations agree with findings of Westgarth and colleagues which has also shown that bite victims are often bitten by unfamiliar dogs. ...
... Most studies report that the common interaction preceding bites involve casual, tactile contact, such as petting, lifting or playing with a dog (Owczarczak-Garstecka et al., 2018;Oxley et al., 2018;Reisner et al., 2011;Rezac et al., 2015;Shuler et al., 2008;Westgarth and Watkins, 2015). Although these interactions are a part of a normal human-dog repertoire, risk in the occupational context is greater because dogs visiting a veterinary surgery or kennels (boarding kennels, police kennels or dog shelters) are often distressed and may be in pain (Döring et al., 2009;Hennessy, 2013). ...
Dog bites affect the health and wellbeing of the victims and impact the organisations whose employees are injured. However, bites in the course of work or measures used by the employers to remedy them have not been previously explored.
This study used the Health and Safety Executive’s database (Reporting of Injuries, Diseases and Dangerous Occurrences Regulation) to understand: (1) The occupational and demographic characteristics of bite victims; (2) Circumstances in which they were bitten; and (3) The remedial actions listed by the employers.
Between April 2011- March 2018, 1812 dog bites were reported; middle-age men were most often bitten demographic. Dog bites occurred in two distinct scenarios. Firstly, entering or leaving a private property, typically whilst delivering mail with a dog owner often present and the victim usually not interacting with or aware of the dog before the bite. In the second scenario, the victim was usually a female, dog professional, familiar with the dog and interacting with them before the bite.
The remedial actions used by the employers focused on reducing the risk by acting pre- or during the bite event (e.g. euthanizing the offending dog, restricting dog access to employees or providing protective equipment). Post-event counter-measures were rare, but included counselling to the victims. Risk was addressed primarily through administrative measures (e.g. policies), which commonly targeted changing individuals’ behaviour, which may limit effectiveness of prevention.
Drawing on injury prevention models we suggest novel ways of preventing bites, e.g. equipment re-design and addressing social norms.
... Most bites to younger children were provoked and occurred during positive interactions, initiated by the child, with familiar dogs, indoors, while older children were outdoors, unfamiliar with the dog and not interacting. 15,16 Similarly, our findings showed that in most cases the dog was known to the child. Results of some studies suggested that dog owners frequently have only limited knowledge of dog behavior and often were unaware of factors that increased the risk of dog bites to children. ...
... Similarly, other reports showed a predominance of face bites (70%) in the younger group (<7 years) and to extremities (72%) in the older group. 16 A study on facial dog related injuries of the face by Mcheik et al. showed that 59% were simple wounds without lacerations or muscular injury, 35% were multiple injuries with tissular lacerations and muscular injury and 6% caused tissue loss. 10 Our data confirmed the findings of most studies for wounds characteristics 1, 3, 7, 10 , giving further evidence that in children 7 years old or younger wounds affect more frequently head and neck region. ...
Background.
Dog bites are a major cause of traumatic injury in children. Aim of this study was to determine experience, management and outcome of dog bite injuries in our department.
Methods.
We retrospectively reviewed the clinical records for 127 patients (mean age 7.15 ± 4.24 years, range 1 to 17 years; 68 males) affected by dog‐related injuries, from 2012 to 2018. Characteristics of patients and dogs, type and severity of injuries, circumstances of the accident, treatment and outcome were analysed.
Results.
Of 141 wounds 73 (51.8%) affected head and neck, 62 (44%) limbs, 6 (4.2%) trunk. According to Mcheik classification, 107 lesions (75.9%) were stage 1, 26 (18.4%) stage 2, and 8 (5.7%) stage 3. 78% were known dogs. The breed of the dog was recorded in 62/127 cases (48.8%) and most common were mongrel (23/62, 37.1%). 75% of attacks occurred during spring and summer. All patients underwent antibiotic prophylaxis and immediate surgical repair. Wound infection was observed in 2 patients. Three unsightly scars required revision with good cosmetic results in all cases..
Conclusions.
Our results are consistent with previous data, showing that the typical dog related injury occurs by a known dog, during spring and summer and in younger boys, who are frequently exposed to head and neck wounds. Our experience showed the feasibility and safety of primary repair and antibiotic prophylaxis in all patients, with very low incidence of infection and good cosmetic results.
... Although the use of the term "provoked" is very controversial, it has been acknowledged that some forms of interactions are highly prone to elicit aggressive behavior in dogs linked to territoriality, protection and guarding, or fear [5,33,47,50]. Although sometimes labeled as "play-bites" or positive interactions [51], it is important to distinguish situations where the human and the dog are playing from those where the intention to play comes only from the victim's side [34]. Misinterpretations of a dog's signaling behavior and an inappropriate attitude on the part of the human in a risky situation (e.g. ...
... Misinterpretations of a dog's signaling behavior and an inappropriate attitude on the part of the human in a risky situation (e.g. female with litter, a sleeping dog) are often overlooked, especially in the case of children, despite the fact that they play a major role in triggering aggressive behavior [51][52][53]. ...
Background:
In Nunavik, Arctic rabies is still endemic due to a spillover from wildlife to dogs. The prevention of human exposure and the management of potential exposure is a significant public health concern in this region.
Methods:
This study retrospectively describes cases of potential exposure to rabies in humans as reported to the Nunavik Public Health Board through their registry of reported cases. We used multi-correspondence analysis as well as univariable and multivariable regression models to test for differences between children and adults in reported cases, and to examine the contexts of exposure to dogs and dog attacks.
Results:
From 2008 to 2017, 320 cases of potential exposure to rabies were reported, 92% of which were linked to dogs. The annual incidence rate was 2.5 per 1000 people. The incidence increased significantly during the study period, although the reasons for this are unclear. Fifteen cases of exposure were with rabid animals, mostly dogs (9 of 15). No human cases of rabies occurred thanks to adequate medical case management. Two specific profiles for potential exposure to rabies were identified based on age and gender. The first was children (< 15 y/o), male or female, who were more likely to be exposed through playing with dogs and were more often injured in the head and/or neck. The second was young male adults (aged 15 to 34 y/o), who were more involved with wildlife than other age groups and mostly injured in the upper limbs and as a result of a reaction by the animal.
Conclusion:
Rabies is a real public health threat in Nunavik. Potential human exposure needs to be prevented, and prevention measures should be tailored to the two risk profiles identified based on age, gender and animal species involved.
... Although the use of the term "provoked" is very controversial, it has been acknowledged that some forms of interactions are highly prone to elicit aggressive behavior in dogs linked to territoriality, protection and guarding, or fear (5,33,47,50). Although sometimes labeled as "play-bites" or positive interactions (51), it is important to distinguish situations where the human and the dog are playing from those where the intention to play comes only from the victim's side (34). Misinterpretations of a dog's signaling behavior and an inappropriate attitude on the part of the human in a risky situation (e.g. ...
... are often overlooked, especially in the case of children, despite the fact that they play a major role in triggering aggressive behavior (51)(52)(53). ...
Background In Nunavik, arctic rabies is still endemic with spillover from wildlife to dogs. The prevention of human exposure and the management of potential exposure is a high public health concern there.
Methods The study retrospectively described cases of potential exposure to rabies in human reported to the Nunavik Public Health Board using the registry of declared cases. Multi-correspondence analysis as well as univariable and multivariable regression models were used to appraise the difference between children and adults and the importance of dogs.
Results From 2008 to 2017, 320 cases of potential exposures to rabies were reported, 92% linked to dogs. The annual incidence rate was 2.5 per 1,000 population. The incidence increased significantly during the study period without clear explanation for that. Fifteen exposures actually were with rabid animals, mostly dogs (9 out of the 15). No human cases of rabies occurred thank to adequate medical case management. Two specific profiles for potential exposure to rabies were identified based on age and gender. Children (< 15 y/o), male or female, were more likely to be exposed through playing with dogs and more often injured in the head and/or the neck. Young male adult cases (aged 15 to 34 y/o) were more involved with wildlife than other age groups and mostly injured in the upper limbs and as a reaction from the animal.
Conclusions Rabies being a serious and genuine public health threat in Nunavik, potential exposure to rabies needs to be prevented and prevention measures should be tailored to the two risk profiles identified based on age, gender and the animal involved.
... Although the use of the term "provoked" is very controversial, it has been acknowledged that some forms of interactions are highly prone to elicit aggressive behavior in dogs linked to territoriality, protection and guarding, or fear (5,33,47,50). Although sometimes labeled as "play-bites" or positive interactions (51), it is important to distinguish situations where the human and the dog are playing from those where the intention to play comes only from the victim's side (34). Misinterpretations of a dog's signaling behavior and an inappropriate attitude on the part of the human in a risky situation (e.g. ...
... are often overlooked, especially in the case of children, despite the fact that they play a major role in triggering aggressive behavior (51)(52)(53). ...
Background: In Nunavik, Arctic rabies is still endemic due to a spillover from wildlife to dogs. The prevention of human exposure and the management of potential exposure is a significant public health concern in this region. Methods: This study retrospectively describes cases of potential exposure to rabies in humans as reported to the Nunavik Public Health Board through their registry of reported cases. We used multi-correspondence analysis as well as univariable and multivariable regression models to test for differences between children and adults in reported cases, and to examine to contexts of exposure to dogs and dog attacks. Results: From 2008 to 2017, 320 cases of potential exposure to rabies were reported, 92% of which were linked to dogs. The annual incidence rate was 2.5 per 1,000 people. The incidence increased significantly during the study period, although the reasons for this are unclear. Fifteen cases of exposure were with rabid animals, mostly dogs (9 of 15). No human cases of rabies occurred thanks to adequate medical case management. Two specific profiles for potential exposure to rabies were identified based on age and gender. The first was children (
... The majority of bite accidents (about 75%) occur in the home environment and involve children bitten by a familiar dog [e.g., (25), (44)(45)(46)(47)]; see also (48) for similar data on adults]. Childinitiated interactions, such as approaching the dog while eating or surprising it while sleeping, seem to trigger up to 86% of accidents at home (44). ...
... It is important to stress that factors that are known to reduce a dog's wellbeing will reduce a dog's threshold for stress and arousal and increase the odds of using escalation strategies in a stressful encounter. Wellknown examples are sensory deficits, physical illness, chronical pain or dogs suffering from anxiety (45,47,77). In addition, other signals may be shown [e.g., (57,71,74)]. ...
Safe human-dog relationships require understanding of dogs' signaling. As children are at particularly high risk of dog bites, we investigated longitudinally how children from 3 to 5 years and parents perceive and interpret dogs' distress signaling gestures. All participants were then taught how to link their perception of the dog with the correct interpretation of dogs' behavioral signals and tested again. Results show a significant increase in learning for children and adults, with them showing greater understanding of dogs' signaling after intervention. Better learning effects were found with increasing age and depended on the type of distress signaling of the dogs. Effects endured over time and it can be concluded that children and adults can be taught to interpret dogs' distress signaling more correctly. Awareness and recognition of dogs' stress signaling can be seen as an important first step in understanding the dog's perspective and are vital to enable safe interactions.
... Studies of dog bite incidents and aggression tend to be retrospective in nature, with many study populations drawn from medical records of bite victims (Vertalka et al., 2018;Mair et al., 2019;Tuckel and Milczarski, 2020), clinical behaviour or veterinary records (Jagoe and Serpell, 1996;Reisner et al., 2011) or surveys of dog owners (Matos, 2015;Mikkola et al., 2021). Despite there being a significant amount of research on dog bite injuries, providing useful insights into what is clearly a serious public health issue, systematic research of potential risk factors from unbiased samples is very limited. ...
... The findings of this study suggest that many dog-related injuries are frequently not preceded by an interaction with or approach to a dog, as caregivers clearly described how dogs frequently invaded children's space, and compromised their real or perceived sense of safety, in both public and private spaces. This is consistent with studies showing that dogs may be activated into attacking children in a variety of situations, including when guarding properties or food; predatory behaviour as part of a group of dogs; when children are walking to or from school; or after minor interactions such as walking, running or cycling past a dog, or patting a dog (Borchelt et al., 1974;Reisner et al., 2007Reisner et al., , 2011Shen et al., 2014;Notari et al., 2020;Gobbo and Zupan Š emrov, 2022). ...
We explored the views of caregivers regarding the value of dogs and the effects of caregiver views on children in
private and public spaces in New Zealand.
This was an observational study utilizing a national anonymized online survey and focus groups in Auckland
and Kaikohe to explore caregiver perceptions of the value of dogs within wh¯anau (families) or the community,
experiences of dog-related harm in the context of children, and the perceived importance of education as a
prevention strategy. Quantitative and qualitative data were sought, using a general inductive approach.
256 caregivers responded to the online survey, and 12 caregivers participated in focus groups. Dogs were
highly valued by M¯aori and non-M¯aori, predominantly as part of family. 233 dog-related incidents were
described, occurring in both public and private settings, with both bite and non-bite harm from being charged at,
knocked over, jumped on or attacked, as often significantly intimidating or traumatic experiences for children
and their caregivers. Key themes were the emotional effect of an attack, the perception that children could avoid
harm through education, blame placed on children, minimization of the trauma a dog can cause, and owner
underestimation of risk.
This study revealed a broader picture of how children are physically and emotionally affected by dogs in both
private and public spaces, indicating the need for proactive approaches in both. Dogs may become activated to
attack due to their nature and unpredictable tendencies in response to children’s natural movements, and future
strategies may need to include a focus on owner-perception of risk to children in addition to creating child-safe
environments and addressing systemic issues, rather than relying on child or dog behavior to prevent harm. The
finding of high value people have for dogs is important to understand as this may be a barrier to implementation
of evidence-based strategies.
... School-age children are frequent victims admitted to hospital emergency departments. According to Reisner et al., most children already knew the attacking dog (72%) and the accident occurred during positive interactions, initiated by the dog [5]. ...
... Studies show that children are more likely to engage in behaviours that provoke aggression from a dog and, due to their smaller stature, may be less threatening to dogs. 26,27 In addition, studies conducted in Nigeria, Tanzania and Kenya reported that children had a higher risk of dog bite because they are less likely to recognise when a dog is agitated or frightened and thus may not respond appropriately. 21,24,28 Therefore, it can be hypothesised that the non-threatening stature of a child and lack of recognition of an aggressive dog increased the risk of dog bites in children. ...
Introduction
Dog bites continue to be a serious public health issue due to their association with the transmission of rabies virus. In Kenya, there are no studies estimating dog‐bite incidence. Annual mortalities resulting from dog‐mediated rabies are estimated at 523 (95% confidence interval 134–1100). The main objective of this study was to assess major risk factors associated with dog bites in Kitui South subcounty, Kenya, between 2017 and 2021.
Methods
We recruited 387 dog‐bite patients (cases) and 387 non‐bite patients (controls) for the case–control study from the Mutomo Mission Hospital and the Ikutha Level 4 Hospital records. Multivariable logistic regression analysis evaluated the association between risk factors and dog‐bite cases. In the final model, pairwise interactions among variables were evaluated. The model fit was evaluated using receiver operating characteristics and area under the curve.
Results
The study found that the dog‐bite incidence was highest in Kanziko ward in Kitui South subcounty. Fifty‐one percent (108 bites) of dog‐bite victims were children under 15 years of age, with 53% (N = 68) being men and 36% (N = 77) being bitten on the limbs. Dog bites mostly (44%, N = 93) occurred between October and December (short rainy season). Age group and season were identified as the most significant variables for high dog‐bite incidence in Kitui South subcounty.
Conclusions
Promotion of responsible dog ownership and reinforcement of dog control policies may prove more effective in reducing dog‐bite injuries in Kitui South subcounty.
... Children are the most common dog bite victims (Abubakar and Bakari, 2012) especially male children aged below 15 years old (Ghosh et al., 2016). The majority of dog bite incidence among young children involved family pet dog that is familiar to them (Reisner et al., 2011;Davis et al., 2012) as compared to stray and unfamiliar dogs (Seligsohn, 2014). ...
... Dogs do not necessarily enjoy being physically close to and tactile with a child [121]. Studies suggest that dogs may well find close interactions such as kissing or petting stressful, as evidenced by increases in cortisol [122] and behavioral indices [123,124]. ...
The prevalence of mental health disorders, driven by current global crises, is notably high. During the past decades, the popularity of dogs assisting humans with a wide spectrum of mental health disorders has significantly increased. Notwithstanding these dogs’ doubtless value, research on their legal status, certification processes, training and management practices, as well as their welfare status, has been scarce. This scoping review highlights that in contrast to other assistance dogs such as guide dogs, there exists no consistent terminology to mark dogs that assist humans with impaired mental health. Legal authorities monitoring the accreditation process, training and tracking of mental health supporting dogs are broadly lacking, with only few exceptions. This review emphasizes the need to address several topics in the promotion of progress in legal and welfare issues related to assistance dogs as well as emotional support dogs for humans with a mental health disorder. The current body of knowledge was assessed in three different areas of focus: (1) the legal dimension including definitions and certification processes; (2) the dimension of performed tasks; and (3) the dog welfare dimension including aspects of the relationship with the handler and risks associated with children recipients. Considering the challenges associated with a mental health diagnosis, collaborations of dog provider organizations and health care professionals would be desirable to continuously assess the efficiency of the human-dog dyad regarding their overall compatibility, general satisfaction and mutual well-being.
... Dog bite injuries are one of the leading causes of non-fatal emergency department (ED) visits in children across the USA, annually accounting for more than 100 000 ED visits and 10 000 hospital admissions. 1 2 In addition, there are over 89 million dogs in the USA owned as pets. 2 While up to 45% of dog bite injuries involve a dog that lives in the same home as the victim, many bites occur in public or on private property involving a dog not owned by the victim's family, and the overall lifetime risk of a child being bitten by a dog is >50%. [1][2][3][4][5][6][7][8] Children 0-9 years of age account for 80% of injuries, and children <6 years of age are known to be at significantly increased risk of bites to the head, neck and face, often causing more severe injuries and more frequently requiring operative repair. 1-3 8-14 The tendency of dogs to bite is complex and known to be a combination of factors related to the sociopolitical environment, owner, dog and/or victim. ...
Background
Dog bite injuries cause over 100 000 paediatric emergency department visits annually. Our objective was to analyse associations between regional dog ownership laws and incidence of paediatric dog bites.
Methods
This observational study used an online search to locate local dog-related policies within Ohio cities. Data collected by Ohio Partners For Kids from 2011 through 2020 regarding claims for paediatric dog bite injuries were used to compare areas with and without located policies and the incidence of injury.
Results
Our cohort consisted of 6175 paediatric patients with dog bite injury encounters. A majority were white (79.1%), male (55.0%), 0–5 years old (39.2%) and did not require hospital admission (98.1%). Seventy-nine of 303 cities (26.1%) had city-specific policies related to dogs. Overall, the presence of dog-related policies was associated with lower incidence of dog bite injury claims (p = 0.01). Specifically, metropolitan areas and the Central Ohio region had a significantly lower incidence when dog-related policies were present (324.85 per 100 000 children per year when present vs 398.56 when absent; p<0.05; 304.87 per 100 000 children per year when present vs 411.43 when absent; p<0.05).
Conclusions
The presence of city-specific dog-related policies is associated with lower incidence of paediatric dog bite injury claims, suggesting that local policy impacts this important public health issue. There are limited dog-related policies addressing dog bite prevention, with inconsistencies in breadth and depth. Creating consistent, practical requirements among policies with vigorous enforcement could ameliorate public health concerns from paediatric dog bite injuries.
... Up until now, no study has investigated dog bites in different areas of the dog's body that occurred inside and outside the biting dog's household. The effect of these 2 places on bites to various parts of the body has been examined only when dogs bit people ( Reisner et al., 2011 ). In this context, it is clear that the etiology of bites occurring in the biting dog's household might be different from those inflicted outside. ...
Dogs biting other dogs have been investigated less than dogs biting people. The aim of this study was to examine the association of biting dog-related factors with the bite to the specified body part (head, neck, trunk or limbs) compared to other body parts using dogs that bit inside their own household and, separately, for those that bit outside their own household. We also assessed potential risk factors for whether the victim dog received medical treatment. Data on 347 incidents of a dog biting another dog were analyzed. Companion and guard dogs had 2.7 and 2.8 times lower odds, respectively, for biting to limbs outside their household rather than to other body areas compared to hunting dogs. Small and medium-sized dogs had 3.4 and 2.2 times lower odds, respectively, for biting to the trunk outside their household rather than to other body areas compared to large dogs. Small dogs had 3 times the odds for bites to the head outside their household and 7.8 times the odds for biting to limbs inside their household rather than to other body areas compared to large dogs. Females had 3.1 times the odds for bites to the head inside their household rather than to other body areas compared to males. Dogs bitten outside the biting dog's household by male dogs had 2.5 times the odds for seeking medical treatment than those that were bitten by females. Dogs bitten inside the biting dog's household by large dogs had 6.3 times the odds for seeking medical treatment than those that were bitten by small dogs. In conclusion, the biting dog's sex and size can influence the bite at different areas of the dog's body and the need for medical treatment.
... It is the case for age and gender, which tend to interact (24,25,(49)(50)(51). Provocative behavior toward dogs, often by children, is also frequently mentioned as a risk factor in the literature (24,52,53). It is not specific to northern Indigenous communities (54, 55). ...
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.
... In recent years, many studies have been carried out in order to understand the epidemiology of dog bites. Several authors have investigated the victim features, the characteristics of biting dogs and the context in which attacks occur [3,[8][9][10]. This led to the definition of a dog bite as a multifactorial phenomenon, whose expression is regulated by genetic, physiological, developmental, environmental and social factors [4]. ...
Simple Summary
Dog bites are a worldwide problem that have severe consequences for both the animal and the victim involved in the incident. Epidemiological studies have analyzed the victim features, the characteristics of biting dogs and the context in which attacks occur. Little is known regarding the role of emotions in predatory attacks toward humans and conspecifics in dogs. This paper aims at proposing the potential involvement of emotions for the expression of predatory motor patterns. It is suggested that the reporting of dog biting episodes needs to consider this crucial factor, which is fundamental for providing a realistic and reliable picture of the dog bite phenomenon.
Abstract
Dog biting events pose severe public health and animal welfare concerns. They result in several consequences for both humans (including physical and psychological trauma) and the dog involved in the biting episode (abandonment, relocation to shelter and euthanasia). Although numerous epidemiological studies have analyzed the different factors influencing the occurrence of such events, to date the role of emotions in the expression of predatory attacks toward humans has been scarcely investigated. This paper focuses on the influence of emotional states on triggering predatory attacks in dogs, particularly in some breeds whose aggression causes severe consequences to human victims. We suggest that a comprehensive analysis of the dog bite phenomenon should consider the emotional state of biting dogs in order to collect reliable and realistic data about bite episodes.
... Explanations proposed for this greater risk in children include their short stature, which leads to more bites closer to the head (Hon et al., 2007); their unpredictable behavior, which is linked to their stage of cognitive, social, and physical development Shen et al., 2016); and their lesser strength (Van de Voorde & Dingeman, 2017). Risk factors for dog bites specific to children include being a boy (Avner & Baker, 1991;Borud & Friedman, 2000;, knowing the dog (Keuster et al., 2006;Reisner et al., 2011;Schalamon et al., 2006), and doing something that provokes the dog (Cornelissen & Hopster, 2010). ...
While dogs can have a positive impact on physical and mental health, they also represent a public health risk in terms of bites and zoonotic diseases. In the specific context of Inuit villages, the role, care, and value of dogs are culturally different than in southern Canada. Furthermore, rabies is endemic to the region. Dogs are frequently kept outside, and the risk of bites and deadly attacks is higher than in southern Canada, particularly in children. Thus, reducing at-risk interactions between children and dogs through prevention programs requires a strong understanding of the unique dog–child relationship in this particular setting. This study used quantitative and qualitative research methods to examine the characteristics of interactions that put children at risk in Kuujjuaq, an Inuit village in Quebec, Canada. Data were collected using 40 observational walks, 34 semi-structured interviews, and 31 conversational interviews. Seven types of at-risk child–dog interactions were identified: showing affection to the dog, ignoring the dog, playing with the dog, running away from the dog, intervening during a dog fight, attacking the dog, and untying the dog. According to interviewees, the last four types of interaction put children’s health directly at risk. All interactions were directly observed, though rarely, except for the untying of dogs. The interview analysis identified several determinants for these at-risk interactions at the child, family, socio-situational, and macro levels. As some of these determinants are modifiable, these findings advocate for a multifaceted educational intervention that targets children, parents, dog owners, and the whole community, while respecting the particular context of Kuujjuaq. This study offers specific insights that could guide the development of a socio-culturally sensitive education program aimed at improving the relationship between children and dogs in Inuit villages and thereby reducing the incidence of dog bites.
... Cyclists, long-distance athletes, marathon runners, recreational athletes, etc. are most often exposed to attacks, both during training and during competitions (24). ...
Athletes who train in public places in urban and rural areas are just as attacked and injured by dogs of known owners as they are by dogs with no owners, in a relatively equal proportion. The largest number of bites occurs in the summer, what makes up half of all bites, just when sports activity is most pronounced. Athletes who are most often exposed to potential attacks and bites are cyclists , long-distance athletes, marathon runners, recreational athletes , etc. both during training and competitions. Off-road cyclists are at a significantly higher risk of dog attacks because cycling takes place off-road, that is, away from urban areas. Dog attacks can adversely affect the psycho-physical readiness of athletes. In Bosnia and Herzegovina there have been no cases of injuries to athletes recorded by competent medical institutions or umbrella sports associations. It is necessary to work on more efficient administration (registration and recording of attacks and bites of dogs). It is of utmost importance to educate athletes on dog behaviour, the reasons for their aggressive behaviour and causal mechanisms of dog attacks as well as the first aid education, what can have a great impact on reducing further complications.
... An example of a developed country that produced similar results is a study of children in China where most attacks occurred within the home of the animal that bit it [74]. The same was evidenced in another study conducted in Philadelphia, where 52% of the incidents occurred indoors [78]. All these antecedents agree with what was stated by Caffrey [66], who proposed that the probability of a bite incident occurring at home was 8.17 times higher than in public places in Calgary, Canada. ...
Simple Summary
Dog bites are a major public health problem throughout the world. The main consequences for human health include physical and psychological injuries of varying proportions, secondary infections, sequelae, risk of transmission of zoonoses and surgery, among others, which entail costs for the health system and those affected. The objective of this study was to characterize epidemiologically the incidents of bites in Chile and the patterns of human-dog relationship involved. The results showed that the main victims were adults, men. The dogs most involved in these incidents were medium-sized, mixed-breed, and most of these were known to the victim. The greatest frequency of such episodes occurred inside the home. This characterization of the problem is essential for a comprehensive understanding of the topic to develop successful dog bite prevention and management programs.
Abstract
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.
... The majority of dog bite victims are among children (Abubakar & Bakari, 2012), mainly males aged below 15 years (Ghosh et al., 2016). Younger children also tend to be bitten by their family pet dog, which is familiar to them (Davis et al., 2012;Reisner et al., 2011). In addition, a study by Seligsohn (2014) discovered that family pet dogs were responsible for the majority of dog bite incidences as compared to stray and unfamiliar dogs. ...
Introduction: Rabies is a highly fatal disease that is mostly caused by a dog bite. The Dog Bite Prevention KAP scale is a 30-item scale that is designed to measure children's level of safety knowledge on dog's behaviour, precautionary behaviour around dogs, perceived vulnerability towards dogs and help-seeking behaviour following a dog bite. Therefore, this study aimed to determine the test-retest reliability and validity of outcome measures. Methods: This questionnaire was administered to samples of school student aged from 13 years to 14 years at a secondary school located in Bau District, Sarawak. They were purposively selected for a baseline interview (Time 1) and a ten-day follow-up (Time 2). This study was conducted within four months, which were from 10 April to 31 August 2018. Descriptive analysis, content analysis, Cronbach's alpha, intra-class correlation and exploratory factor analysis were performed in this study. Results: A total of 64 boys and 114 girls were involved in the study, whereby 79.2%, 10.1%, 7.9%, 2.2% and 0.6% of them were of Bidayuh ethnic, Chinese, Iban, Malays and other ethnic, respectively. The Cronbach's alpha was 0.796. The test-retest intra-class correlation was adequate, with 0.84 for perceived vulnerability towards dogs and 0.81 for precautionary behaviour around dogs. Principal components analysis with varimax rotation resulted in two factors, which explained 39% of the variance (perceived vulnerability towards dogs) and 49% of the variance (precautionary behaviour around dogs). Conclusion: The questionnaire is a valid and reliable tool for a dog-bite prevention survey.
... 8 Those under the age of 9 years are disproportionately affected (17.6 per 100 000 population) and account for twothirds of admissions among <18 year olds. 6 Specifically, research has identified two age groups of children that are bitten most often: those under the age of 2 years, [9][10][11] and those aged 9-12. 9 12 The true incidence of dog bites is likely to be underestimated as studies have found that only a third of dog bite victims seek medical treatment and of those that do, not all will receive treatment in a hospital setting and therefore would not be included in the above figures. ...
Dog bite injuries are a significant public health problem and many are sustained by children. These injuries can be complex, both physically and psychologically, and in rare cases fatal. This paper will review current evidence-based approaches to treatment, explore identified patterns in biting incidents and discuss the effectiveness of prevention strategies. Safe management of these patients requires a comprehensive approach. Physical injuries need to be accurately assessed with a high index of suspicion for underlying injuries, particularly in younger children less able to communicate. Treatment depends on severity and location, but all bites must be irrigated to reduce the risk of infection but may not always require prophylactic antibiotic use. Careful exploration of the circumstances in which the bite occurred is essential to make safeguarding decisions and prevent future bites. Reducing the incidence of paediatric dog bites requires education of both children and parents that any dog can bite, regardless of breed, and all child–dog interactions must be highly supervised. However, education alone is unlikely to prevent dog bites. Policies that support environmental changes need to be developed such as provision of pet dogs less likely to bite (or bite as severely), through breeding for temperament and appropriate socialisation. Additionally, investment in psychological support for bite victims and their families is required to reduce the long-term impacts of being bitten.
... The concentration of nonfatal dog bite injuries from unfamiliar dogs among adolescents is often the result of negative interactions with dogs. 24,25 Male children, adolescents, and young adults aged 0-19 are more likely than their female counterparts to sustain any injury, and nonfatal dog bite injuries are no exception. 1 Among children and adolescents aged 10-14, the risk of nonfatal dog bite injuries was 49% higher among boys than among girls. ...
Objective
No studies using national data have evaluated changes in nonfatal dog bite injuries among children, adolescents, and young adults during the past 2 decades. We examined estimates of annual nonfatal dog bite injuries among persons aged 0-19 treated in US emergency departments (EDs) from 2001 through 2017.
Methods
We examined data from the Web-based Injury Statistics Query and Reporting System to compare estimates of the annual rates of nonfatal dog bite injuries in EDs among all persons aged 0-19, by age group (0-4, 5-9, 10-14, and 15-19), and by sex. We determined significance by comparing 95% confidence intervals (CIs), and we standardized rate calculations to the year 2000 population.
Results
During 2001-2017, an estimated 2 406 109 (95% CI, 2 102 643-2 709 573) persons aged 0-19 were treated in EDs for nonfatal dog bite injuries (age-adjusted rate of 173.1 per 100 000 persons aged 0-19). The estimated number of nonfatal dog bite injuries declined significantly, from 181 090 (95% CI, 158 315-203 864) in 2001 to 118 800 (95% CI, 97 933-139 667) in 2017. The highest rate was among children aged 5-9. Male children, adolescents, and young adults were significantly more likely than female children, adolescents, and young adults to be treated in the ED for nonfatal dog bite injuries, driven by male–female differences in children and adolescents aged 5-14.
Conclusions
Although the estimated number of nonfatal dog bite injuries among persons aged 0-19 declined significantly in the past 2 decades, additional regulatory and educational efforts specific to age and sex may lead to further reductions in nonfatal dog bite injuries.
... Although the ownership of pets showed benefits, including better child development, certain negative consequences, such as zoonotic infections [41], allergy and asthma [42], bites and other injuries [43], and the psychological and emotional costs due to loss of pet [44] have been noted. In addition, children are at a greater risk of animal bites from a household pet [45,46], and children under five years of age are most at risk of serious injury [47,48]. ...
Contact with companion animals has been suggested to have important roles in enhancing child development. However, studies focused on child development and pet ownership at a very early age are limited. The purpose of the current study was to investigate child development in relation to pet ownership at an early age in a nationwide prospective birth cohort study: the Japan Environment and Children’s Study. Associations between cat and dog ownership at six months and infant development at 12 months of age were examined in this study. Infant development was assessed using the Ages & Stages QuestionnairesTM (ASQ-3) at 12 months. Among participants of (Japan Environment and Children’s Study) JECS, those with available data of cat and dog ownership at six months and data for the ASQ-3 at 12 months were included (n = 78,868). Having dogs showed higher percentages of pass in all five domains measured by ASQ-3 (communication, gross motor, fine motor, problem-solving, and personal-social) compared to those who did not have dogs. Significantly decreased odds ratios (ORs) of developmental delays were observed in association with having dogs in all fix domains (communication: OR = 0.73, gross motor: OR = 0.86, fine motor: OR = 0.84, problem-solving: OR = 0.90, personal-social: OR = 0.83). This study suggested that early life dog ownership may reduce the risks of child developmental delays.
... 5,6,21 Males are more likely to suffer traumatic injury due to higher risketaking behaviors. 4,5,19,22 Young children lack knowledge on how to behave around animals. 6,11,23 Head/neck injuries in the youngest age group are associated with short stature, inquisitive behavior, and predisposition for crawling and playing on the floor. ...
Background:
An estimated 800,000 dog bites require medical attention every year. The purpose of this study is to review the characteristics of dog bite injuries in children and examine temporal trends.
Methods:
The Kids' Inpatient Database was used to identify pediatric patients with dog bite injuries over a 10-y period. Demographic data, primary payer, injury characteristics, length of hospitalization, and treatments were recorded. Statistical analysis was performed in SAS 9.3 (SAS Institute Inc, Cary, NC).
Results:
A total of 6308 patients were identified. Average age at time of injury was 6.4 ± 4.3 y. Children under age 5 y were the most affected subgroup (39.3% in 2000 versus 44.7% in 2009, P < 0.001). Most bites were to the head/neck and significantly increased from 53.9% in 2000 to 60.1% in 2009. Cellulitis complicated many injuries (33.7% in 2000 versus 44.8% in 2009, P < 0.001). Overall, 50% of patients underwent a procedure; 31% had an invasive surgical procedure; and 5.1% of patients required skin grafts or flaps.
Conclusions:
Dog bites are a common cause of pediatric injuries and are a significant burden on families and the health care system. Evaluating the characteristics of these injuries can guide educational efforts.
... Indeed, fear and anxiety, along with environmental and social stressors likely to cause frustration are associated with irritability and aggressive displays in dogs (27)(28)(29). For instance, although children often love to be physically close to, and tactile with a dog (30), dogs do not always share the enjoyment of this contact, as evidenced by their body language, and it is these types of child-initiated interactions which can often lead to dog bites (31,32). Physiological studies suggest that even with adults, some dogs may find certain close contact interactions (e.g., kissing, petting) stressful, as evidenced by increases in cortisol (33,34). ...
There has been little investment in exploring the impact of the child-dog relationship on the dog. Since child-dog interactions can pose potentially serious threats to a dog's physical and psychological health, as well as the wider satisfaction of the owner with their dog, we describe the development and validation of an owner-completed pet dog quality of life scale (Lincoln P-QOL), to enable professionals and families to monitor dog well-being and employ suitable interventions as required. Four-hundred and two dog-owners (194 lived with a neuro-typically developing child; 208 lived with a child with a neuro-developmental disorder) responded to an online survey. Respondents recorded whether they had observed their dog displaying any of the 22 behavioral responses which have been identified as being common in 11 child-dog interactions. These behavioral responses appeared to group into three categories of behaviors (i.e., behavioral constructs), representing Excitability, Calmness, and Fearfulness in the dog. To assess convergent validity of the quality of life scale respondents completed additional measures including, dog body condition score, health issues (incorporating psychological factors such as anxiety and physical proxies of well-being, such as skin irritations) and dog-owner relationship satisfaction. Excitability and Fearfulness constructs were associated with a negative impact on dog health and the owner-dog relationship. Calmness was associated with a positive impact on the dog-owner relationship. A range of interactions, including carefully expressed child-dog physical affection and spending quiet time together appear to had a beneficial impact on dog quality of life, whereas rough contact, child meltdowns, and grooming/bathing had a negative effect. We found little evidence to support a difference in the overall quality of life of dogs living with neuro-typically developing children compared to those with a neuro-developmental disorder. However, parents and practitioners need to be aware of the potential increased risk to dog well-being when meltdowns, grooming/bathing, and quiet time involve a child with a neuro-developmental disorder. This is the first validated scale for the assessment of dog well-being around children, additionally, the behavioral constructs identified may form the rational basis of a more general dog behavior/stress assessment tool in social situations.
... The largest number of bites to children occur during their outdoor activities (cycling, playing with a ball, running). The location of the bite is often associated with the age of the child, where younger children are more likely to have head injuries, while in the older children, lower extremities are mainly involved (44). The same data were obtained from a study conducted in Italy (45). ...
... The first is the rapid change in anatomic location of the bite by age (Fig. 4a). Several authors [14,21,32,33] have noted that children are more likely to sustain bites to the head and neck, while adults are more likely to sustain bites to the extremities. However, a breakdown of anatomic location by detailed age groups has not been described until now. ...
Dog bites are a significant public health issue. There is no comprehensive study of dog bite demographics. It was the purpose of this study to perform such an analysis across the US. The National Electronic Injury Surveillance System All Injury Program data for the years 2005 through 2013 was accessed; dog bite injuries were extracted and analyzed. Statistical analyses were performed with SUDAAN 11.0.01™ software to account for the weighted, stratified nature of the data. Incidence values were calculated using population data from the US Census Bureau. A P < 0.05 was considered significant. There was an average 337,103 ED visits each year for dog bites. The average age was 28.9 years; 52.6% were male and 47.4% female. The bites were located on the upper extremity in 47.3%, head/neck in 26.8%, lower extremity in 21.5%, and trunk in 4.4%. Younger patients had more bites involving the head/neck, while older patients the upper extremity. More occurred in the summer and on weekends and 80.2% occurred at home. Hospital admission occurred in 1.7%. Logistic regression analysis demonstrated that the odds of admission was solely dependent upon the age group. The OR for admission was 11.03 [4.68, 26.01] for those >85 years of age, 4.88 [2.89, 8.24] 75–84 years, and 2.79 [1.77, 4.39] those ≤4 years of age, with the 10–14 year age group the reference group. The average annual incidence was 1.1 per 1,000, and was slightly higher in males (1.18 vs 1.02 per 1,000). The estimated cost was at least 400 million US$ per year. Potential prevention strategies are educational programs directed at both children and parents/caretakers outlining the responsibilities of owning a dog. This information can be disseminated in health care facilities, radio/TV/Internet venues, and dog kennels/shelters.
This chapter highlights the importance of veterinary psychiatry in all consultations with the general practitioner veterinarian and throughout the life of the dog. Thus, preventive medicine consultations are reviewed, followed by general medicine consultations. Euthanasia, this ultimate and particularly emotional act, is also discussed. Finally, this chapter describes the particularities of behavioral assessment of dangerousness as required by the French legislation.
Pediatric scalp avulsions represent a reconstructive challenge because of the unique features of scalp tissue. When microsurgical reimplantation is not feasible, alternative approaches such as skin grafting, free flap transfer with latissimus flap, or tissue expansion are considered. Generally, there is no consensus regarding management of this trauma, and, oftentimes, multiple reconstructive techniques may be needed for definitive coverage. This case study describes the reconstruction of a pediatric subtotal scalp avulsion using a dermal regeneration template and novel autologous homologous skin construct. This case was complicated by the absence of original tissue for reimplantation, excessive size of the defect relative to body habitus, and family concerns for future hair-bearing function. The reconstruction successfully provided definitive coverage and significantly reduced the size of the donor site and associated compilations. However, the hair-bearing potential of the tissue has yet to be determined.
OBJECTIVE
To describe the clinical and epidemiologic features of persons with dog and cat bite injuries who presented to emergency departments.
SAMPLE
Records of 648,492 dog and cat bite–related emergency department visits in California from 2005 to 2019.
PROCEDURES
Visits were selected by standardized International Classification of Diseases, Ninth or Tenth Revision, Clinical Modification codes that indicated a bite as an external cause of injury in the medical record. Incidence rates were calculated for patient demographics, location and month of bite incident, characteristics of bite injury, infection, patient outcome/disposition, and expected source of payment. Cross-sectional descriptive analysis was performed.
RESULTS
The average annual incidence of dog bites was highest in children aged < 10 years and males, while that of cat bites was highest in adults aged ≥ 80 years and females. Bites were more likely to occur in rural settings, in private residences, and during the summer. The median household income for zip codes in which animal bite patients resided was lower than the statewide median household income. Both dog and cat bite injuries were more likely to occur to upper limbs. Bacteria were isolated from 3% of dog bite injuries and 21.5% of cat bite injuries at initial presentation.
CLINICAL RELEVANCE
Epidemiologic findings about persons presenting to emergency departments for animal bite injuries can inform bite prevention efforts by identifying at-risk populations. Effective animal bite prevention demands an ongoing multisectoral program of veterinarians and other health professionals, collaborating with community and governmental organizations, to develop and implement integrated strategies within the context of other socially contributory factors.
This study aimed to describe the incidence and characteristics of dog-bite injury hospitalizations (DBIH) in the largest administrative region of Italy (Sicily) over the 10-year period: 2012-2021. Four hundred and forty-nine cases were analyzed. Patients were divided into seven age groups: preschoolers (0–5 years), school-age children (6–12 years), teenagers (13–19 years), young adults (20–39 years), middle-aged adults (40–59 years), old adults (60–74 years), and the elderly (≥75 years). Association among categorical variables (age, gender, principal injury location) was evaluated using chi-square tests, and mean differences for normally distributed variables were assessed using one-way analysis of variance. Finally, a Poisson regression general linear model (GLM) analysis was used to model incidence data. The results revealed that the incidence of DBIH per 100,000 population increased from 0.648 in 2012 (95%CI 0.565–0.731) to 1.162 in 2021 (95%CI 1.078–1.247, P < 0.01). Incidence for both male and female victims also increased over the studied period (P < 0.05). We found an increasing trend of incidence in young and middle-aged adults (P < 0.05 and P < 0.005 respectively). Moreover, the most frequently injured age group by dogs was the preschooler group and, whilst we found a lower risk of being injured for males older than 20 years, no difference with females was observed. The location of lesions depended on the age group (P < 0.001). The number of days of DBIH increased significantly with age (P < 0.01). The increase of DBIH represents a public health problem that requires the development of preventive approaches.
Our relationship with dogs runs thousands of years deep. Today, we might know dogs intimately as members of our human family, but we can also know and consider dogs on their own terms, as members of Canis familiaris , with a unique evolutionary history and species‐specific characteristics and needs. This chapter is a resource for all types of dog knowers and caretakers. It relies heavily on empirical research to anchor readers in the foundations of canine behavior—such as dog behavioral development, normal dog behavior, factors influencing behavior, and relationships with people—and considers how these topics affect dogs of all ages and backgrounds who find themselves in the shelter environment.
Dog bites are a serious public health concern internationally and children are often at particular risk of them. Because bites to children often occur during apparently benign interactions with a parent present, the need for dog-bite prevention approaches to address adults’ awareness of, and supervision of, child–dog interactions has been highlighted. The aim of this study was to evaluate a hazard perception test of potential dog-bite hazards within a home setting. Six hazards were incorporated in a 2-minute 41-second video, which was embedded into a web-based interface that enabled respondents to identify hazards by clicking the mouse button or tapping the screen of a tablet computer as the video played. The 268 volunteer respondents also completed a short questionnaire. These respondents were predominantly female and appeared more likely to have undertaken higher education and have greater experience with dogs than the general population. Almost one-third (31.8%) of respondents identified all six hazards, and a further quarter (24.5%) missed only one; a quarter (25.2%) identified 3 or fewer; and 43.8% identified 4 or fewer hazards. No one scored zero, and 5.5% and 6.9% identified 1 and 2 hazards, respectively. A range of factors was associated with the identification of specific hazards. Participants with professional or long-term experience with dogs and those with higher educational attainment were more likely to detect some hazards. Older respondents were less likely to identify several of the hazards, and those living with children were less likely to identify cuddling a dog as a hazard. We find that hazard perception testing could be a useful tool for the assessment of knowledge regarding dog-bite risk situations and potentially an educational tool for increasing knowledge and changing practices around dogs.
Athletes who train in public places in urban and rural areas are just as attacked and injured by dogs of known owners as they are by dogs with no owners, in a relatively equal proportion. The largest number of bites occurs in the summer, what makes up half of all bites, just when sports activity is most pronounced. Athletes who are most often exposed to potential attacks and bites are cyclists, long-distance athletes, marathon runners, recreational athletes, etc. both during training and competitions. Off-road cyclists are at a significantly higher risk of dog attacks because cycling takes place off-road, that is, away from urban areas. Dog attacks can adversely affect the psycho-physical readiness of athletes. In Bosnia and Herzegovina there have been no cases of injuries to athletes recorded by competent medical institutions or umbrella sports associations. It is necessary to work on more efficient administration (registration and recording of attacks and bites of dogs). It is of utmost importance to educate athletes on dog behaviour, the reasons for their aggressive behaviour and causal mechanisms of dog attacks as well as the first aid education, what can have a great impact on reducing further complications.
Keywords: aggression; animals; first aid; marathon running; sports.
Copyright© by the Medical Assotiation of Zenica-Doboj Canton.
The current study aimed to investigate the extent to which young children’s risk of being bitten by a dog is explained by their inability to recognize the dog’s emotion and to behave appropriately around dogs. One hundred and seventeen children, aged 4 to 7 years, were shown 15 images and 15 video clips of happy, angry, and frightened dogs. After each image or clip, questions were asked to assess children’s accuracy and confidence in recognizing the emotional state and their inclination to approach the dog. Results indicate that children were least accurate when presented with frightened dogs, with only just over half of 4- to 5-year-olds accurately recognizing them. Children were inclined to approach frightened and happy dogs, but not angry ones, and this was true regardless of whether they had correctly identified the emotion or not. Therefore, the results suggest that although some children struggle to recognize when a dog is frightened, the more concerning issue is their lack of understanding of how to behave appropriately around dogs, especially those that are frightened. Learning how to behave appropriately around dogs should be key in any dog bite prevention program aimed at young children.
Accidents involving dog bites to humans have high incidence worldwide. According to studies conducted in different countries, dogs are responsible for 60%-95% of all bites. This type of incident is a growing public health issue in Chile and an important economic burden for health systems. The problems that arise from bites include physical injuries, psychological trauma, and zoonosis. The objective of the present study was to characterize epidemiologically all bite incidents in Chile that were recorded in 11 public emergency services and analyze the information provided in health care forms from 5195 bites recorded in six regions of Chile. Our results show that dogs were responsible for 91.6% of bite incidents. The victim knew the offending dog in most cases (63.7%). The highest percentage of people bitten was between ages 5 and 9 years, with a rate of 125 bites per 100,000 inhabitants (P ≤ 0.05). 86.6% of the cases in the study were single bites. Although the national health system has records of bite-related incidents, few studies provide relevant information on animal bites. This is a public health issue and we should know the magnitude of the problem, the species responsible for the bite, and the context in which accidents occur. The information obtained from the analyses performed in this study can contribute to develop prevention and control programs for bites, both in Chile and in other countries with similar sociocultural characteristics.
The prevalence and the incidence of dog bite studies are mainly based on hospital records. However, in this study, the information about dog bites to children was obtained by searching Serbian online newspapers, between January 2008 and May 2018. Sixty-nine articles from Serbian online newspaper report dog bites to 79 children between January 2008 and June 2018. Children over 6 years old (school class) constituted 65% of the sample and 51% were boys. Most commonly, children were bitten by dogs of known owners (59%). Stray dogs were involved in fewer bites to children (41%; P < 0.05). Children sustained the greatest number of dog bites during the spring months (37%) and the lowest in the summer (14%). Mongrels were involved in 37% of all bites followed by terriers in bull type (21%). Head, face, and neck (32%) were the most common individual site of injury from dog bites. Most children (68%) sustained bites without previous interaction with dogs. Data collected from newspapers on dog bites to children cannot provide a real insight into the scale and severity of the problem. However, these data can be the trigger for further studying of this problem by health workers, veterinarians and scientists, and a warning to local authorities to tackle the problem of irresponsible dog ownership.
The experiment investigated whether there would be a difference in behaviour between the effects of long-term tethering without exercise, long-term tethering with exercise and group pen housing on sled dogs. Siberian husky sled dogs from a commercial sled-dog kennel (n=9), were exposed to four different housing conditions and filmed to record behaviours for analysis. Filming took place at the sled dog kennel. The conditions consisted of six-months with no-exercise/tethered (Condition A), exercise (daily running)/tethered (Condition B), four weeks no-exercise/tethered (Condition C) and no exercise/un-tethered in group pens with 3 dogs per pen (Condition D). The dogs were returned to baseline (Condition A) after three months in group pen housing to control for order effects. Subjects were then filmed after a two-week habituation period. The tethered housing conditions (A,B and C) produced evidence of more repetitive behaviours and fewer social behaviours than the un-tethered housing condition. Although un-tethering subsequently reduced rebound and repetitive behaviours, the variable of tethering without exercise (conditions A and C) revealed the greatest difference in behaviour. Long term tethering with no exercise produced agonistic behaviours indicative of frustrative non-reward heightened by the intermittent delivery of the reward of exercise. Increased aggression vigorously directed at neighbouring dogs and an overall increase in vigilance was the direct consequence of the frustration of non- reward. Un-tethering significantly reduced interdog aggression (p=.05), but the dogs remained vigilant. Therefore, long-term tethering without exercise or with the intermittent reward of exercise produces an increase in frustrative maladaptive behaviours such as aggression and increased vigilance.
The authors attempted to remedy the current lack of empirically evaluated dog-bite prevention programs for children under 7 by assessing children's learning success with the "Blue Dog" CD.
Ninety-six 3-, 4-, 5-, and 6-year-old children used the interactive CD in an initial exposure phase, a training and a testing phase. Half received verbal feedback, and the other half additional practice with parents. All children were re-tested after 2 weeks.
There were significant increases in safe choices after the training phase at all ages, with older children performing better than younger children. Children still retained their ability to make safe choices after 2 weeks. Interestingly, children practicing with parents performed better than others when under 6 years. Verbal feedback did not play a role, the CD is equally effective without.
Children learned successfully about safe behavior with dogs; thus, the CD can help educate children about dog-bite prevention.
As a result of a perceived increase in pit bull injuries, all children who presented to The Children's Hospital of Philadelphia during 1989 for evaluation of dog bite injuries were prospectively studied. Epidemiologic information was collected from parents, either at the time of visit or by phone on the following day. A total of 168 children were enrolled; the mean age was 8 years. Males outnumbered females 1.5:1. Most (61%) injuries occurred in or around the home and involved dogs known to the patient (77%). Types of injuries included abrasions (33%), punctures (29%), and lacerations (38%). Thirteen bites had associated complications; nine developed infection. Twelve (7%) children required admission to the hospital. More than 12 different purebreeds or cross-breeds were identified as perpetrators, including German shepherds (n = 35), pit bulls (n = 33), rottweilers (n = 9), and Dobermans (n = 7). Most (54%) animals were contained (ie, leashed, fenced, in-house) at the time of injury. Fewer (46%) were provoked prior to biting. Significantly more pit bull injuries (94% vs 43%, P less than .001) were the consequence of unprovoked attacks and involved freely roaming animals (67% vs 41%, P less than .01). Children aged 5 or younger were more likely to provoke animals prior to injury than were older children (69% vs 36%, P less than .001). It is recommended that families with young children be the target of pet safety education and that measures be sought that would lead to early identification of a potentially dangerous dog and restrict ownership.
Dog bites are a major cause of injury, particularly in children.1 2 Guidelines on prevention are generally unevaluated and include controls on high risk breeds, keeping dogs on a leash, animal training, and educating dog owners.3 4 However, there are no evaluations of interventions designed to teach people how to avoid being attacked by a dog.
“Prevent-a-Bite” is an educational programme designed for primary school children.5 The programme aims to instil precautionary behaviour around dogs, assuming that this might reduce the incidence of attacks. A randomised controlled trial of the efficacy of the intervention was conducted in Australian children aged 7-8 years who were presented with an unsupervised opportunity to approach a strange dog.
Eight primary schools in metropolitan Sydney were randomly selected to participate in the trial. All agreed. The schools were cluster randomised into intervention and non-intervention control schools (four in each group), and two classes in each …
To characterize behavioral circumstances of bites to children by dogs presented to a veterinary behavior clinic.
Retrospective case series examining medical records of dogs presenting by referral to a university veterinary hospital for aggression and which had bitten a child <18 years old. Behavioral data included age of victim, familiarity with dog, and circumstances of bites.
Records of bites to 111 children were examined. Children <6 years old were most commonly bitten in association with resource guarding (44%), whereas older children were most commonly bitten in association with territory guarding (23%). Similarly, food guarding was the most common circumstance for bites to familiar children (42%) and territory guarding for bites to unfamiliar children (53%). Behavioral screening of the 103 dogs examined revealed resource guarding (61%) and discipline measures (59%) as the most common stimuli for aggression. Anxiety screens revealed abnormalities in 77% of dogs. Potential contributory medical conditions were identified/suspected in 50% of dogs. When history before presentation was known, 66% of dogs had never previously bitten a child, and 19% had never bitten any human. Most dogs (93%) were neutered, and 66% of owners had taken their dogs to obedience training classes.
Most children were bitten by dogs with no history of biting children. There is a high rate of behavioral abnormalities (aggression and anxiety) in this canine population. Common calming measures (neutering, training) were not routinely effective deterrents.
A method for comparing death rates of groups of injured persons was developed, using hospital and medical examiner data for more than two thousand persons. The first step was determination of the extent to which injury severity as rated by the Abbreviated Injury Scale correlates with patient survival. Substantial correlation was demonstrated. Controlling for severity of the primary injury made it possible to measure the effect on mortality of additional injuries. Injuries that in themselves would not normally be life-threatening were shown to have a marked effect on mortality when they occurred in combination with other injuries. An Injury Severity Score was developed that correlates well with survival and provides a numerical description of the overall severity of injury for patients with multiple trauma. Results of this investigation indicate that the Injury Severity Score represents an important step in solving the problem of summarizing injury severity, especially in patients with multiple trauma.
To assess the effects of gender and parental status of dog owners on knowledge of and attitudes toward factors associated with dog aggression directed toward children.
Prevalence survey.
804 dog owners.
A questionnaire was distributed to owners of all dogs examined at a university veterinary hospital between January and April 2007. Respondents were asked to indicate whether they agreed or disagreed with 37 statements regarding dog behavior and safety practices for dog-child interactions. Responses were compared between women and men and between parents and nonparents.
Of 804 questionnaires that were completed, 421 (52%) were completed by parents and 598 (74%) were completed by women. There was a general lack of knowledge regarding dog behavior and safety practices for dog-child interactions. Women were more knowledgeable than men, regardless of parental status. Mothers were more knowledgeable than fathers and female nonparents regarding interactions with young children and had greater awareness than female nonparents and males (regardless of parental status) regarding interactions with infants and toddlers.
Results suggested that dog owners frequently had only limited knowledge of dog behavior and often were unaware of factors that increased the risk of dog bites to children. The veterinary examination presents an important opportunity for education of dog owners regarding dog behavior, including body language, social signals, resource-guarding, and self-defense, and the risks of dog bites to infants and young children.
A method for comparing death rates of groups of injured persons was developed, using hospital and medical examiner data for more than 2,000 persons. The first step was determination of the extent to which injury severity as rated by the Abbreviated Injury Scale correlates with patient survival. Substantial correlation was demonstrated. Controlling for severity of the primary injury made it possible to measure the effect on mortality of additional injuries. Injuries that in themselves would not normally be life threatening were shown to have a marked effect on mortality when they occurred in combination with other injuries. An Injury Severity Score was developed that correlates well with survival and provides a numerical description of the overall severity of injury for patients with multiple trauma. Results of this investigation indicate that the Injury Severity Score represents an important step in solving the problem of summarizing injury severity, especially in patients with multiple trauma. The score is easily derived, and is based on a widely used injury classification system, the Abbreviated Injury Scale. Use of the Injury Severity Score facilitates comparison of the mortality experience of varied groups of trauma patients, thereby improving ability to evaluate care of the injured.
Few situations are more anxiety provoking than that of a small child being attacked by a dog. On occasion dogs have been known to save human lives. Conversely, dogs have actually been known to kill (references 1 and 2; Chicago Sun-Times, March 31, 1980). Unfortunately, the incidence of dog bites has increased in recent years, and more than 1 million Americans are bitten by dogs every year.3-5 In addition, children are the most frequent victims.1,4-8 With the rising crime rate, more citizens are buying or even renting large and sometimes vicious dogs to protect their family or property. (Chicago Sun-Times, March 31, 1980, and reference 5).
Approximately one million dog bites occur yearly in the United States, and 60% to 70% of these are to children. Although the majority of dog bites are not serious, some are disfiguring or, on rare occasions, fatal. Bites are disruptive and stressful but also are preventable. This paper reviews the epidemiology of dog bites, examines the conditions under which bites occur, and discusses behavioral factors related to the dog and to the child that determine whether a bite will occur. Dog bites then are compared with other childhood injuries, and strategies for intervening both before and after a dog bite occurs are discussed.
Communication occurs when one individual, the sender, produces a signal that alters the behavior of another individual, the receiver. The signal can provide broadcast information about species and individual identity or transmitted information, in which the sender effects a change in the receiver's behavior. To reduce ambiguity, signals have evolved to be conspicuous, redundant, and stereotypic. These features allow communication signals to be produced by senders and perceived and acted upon appropriately by receivers, both conspecific and heterospecific. The modality of the communication signal can be visual, olfactory, or acoustic. Visual signals can be adjusted rapidly for response during interactions between individuals at close or medium range. Examples include displays of relative dominance or submission. Olfactory signals can be used for individual, sex, or group identity at close range during greetings and assessments of individuals. Excretory products can be used for olfactory communication over long distances and for long periods of time. Acoustic signals can be adjusted rapidly for close- and far-range communication. They do not persist in the environment. For dogs, communication is fundamental to maintaining affiliations, reducing competition, and identifying individuals. These factors are critical to the highly developed social behavior of dogs. In an ultimate sense, dogs have been selectively bred for positive interactions with humans; in a proximate sense, many dogs spend their lives in close social association with humans. For these reasons, many of the signals used by dogs in dog-dog communication are also used in dog-human communication. Veterinarians act as receivers for communication signals when greeting dogs as patients. The information obtained is used to assess the state of arousal and probability of future behavior of the dog so that handling of the animal can be facilitated. The goals are to minimize stress and injury, to successfully complete the treatment program, and to promote the health of the animal.
Pets, present in more than half the households in the United States, provide emotional and physical benefits to their owners.1,2 However, pet-associated human illnesses and injuries cause significant morbidity and mortality, incurring substantial economic costs for owners and insurance companies. The most costly pet-associated health hazards, Salmonella gastroenteritis, congenital toxoplasmosis, and animal bites,3,4 are potentially preventable with appropriate knowledge and precautions.5- 8 We hypothesize that there is a lack of awareness of pet-associated health risks among parents, and that pediatricians do not educate their patients about the health risks involved in owning a pet. This study assesses parents' and pediatricians' knowledge of specific pet-related risks, identifies the sources of this information, and examines pediatricians' attitudes regarding education about pet-associated health risks.
Dog bite injuries in children are a preventable health problem. To characterize this type of injury, we have undertaken to define demographic criteria and patterns of injury inflicted by dogs in our pediatric population. A retrospective chart review was conducted of pediatric patients with dog bite injuries admitted to a Level I pediatric trauma center from January 1986 through June 1998. Patient demographics, canine characteristics, and hospital patient data were collected and analyzed using the Excel program and appropriate statistical methodology. There were 67 patient records reviewed. Thirty-eight (57%) of the patients were male, and 29 (43%) were female. There were 43 (64%) white children, 22 (33%) African-American children, and 2 (3%) Hispanic children. The average age of the children was 6.2 +/- 4.2 years, with an average weight of 23.3 +/- 13.7 kg. More than half the attacks occurred in the afternoon and 55 per cent of these attacks were documented as "unprovoked" attacks. Thirty-one (46%) of these attacks involved family pets, and 30 (45%) dogs were known to the attacked child. The head and neck was involved in greater than 67 per cent of these injuries. Pit bulls caused 25 per cent of the bite injuries. Large dogs were responsible for 88 per cent of the attacks. Forty-four (66%) patients required operative intervention. Twenty-eight of these patients had multiple anatomical areas injured. There were 44 procedures involving the head and neck, 21 involving extremities, and 6 involving other areas of the body. All patients 5 years of age and under had head and neck injuries. Dog bite injuries requiring admission occur more in male children. Caucasian and African American children were the majority of children affected. The children under 5 years of age suffered the most devastating injuries. More than half of these attacks were not provoked. More than two-thirds of the injuries to these children involved the head and neck. We conclude that effective prevention strategies must stress careful supervision of young children and the family or neighbor's dog, a scenario that may easily lead to complacency and set the stage for a severe injury.
Dog bites account for a significant number of traumatic injuries in the pediatric population that often require medical treatment. Although agent, host, and environmental characteristics of dog bites have been well documented, no attempt has been made to compare these characteristics by patient age group. The purpose of this study is to determine if differences exist in agent, host, and environmental characteristics among younger (< or =6 y) and older (>7 y) patients treated in a pediatric emergency department (ED) for dog bites. Findings from our study could be used to develop age-specific strategies for dog bite prevention.
The epidemiologic triad of agent/host/environment formed the theoretical framework.
The study setting was the ED at Children's Hospital of Pittsburgh. Patients were enrolled between 1999 and 2000 and were identified through a review of ED records (n = 386) of children sustaining dog bites. Records were abstracted with a researcher-designed and validated form for agent (eg, breed, number of biting dogs, owner, rabies status), host (eg, age, gender, number and location of bites, treatment), and environmental (eg, bite month and time, bite location, events leading to the bite, ZIP code) characteristics. Data were analyzed using descriptive and inferential statistical tests.
Children younger than 6 years constituted 52.8% (n = 204) of the sample. As compared with older children, a higher proportion of younger children were bitten by their family dog (chi2 = 27.64, P = 0.001) whose rabies shots were up to date (chi2 = 12.08, P = 0.034). A higher proportion of younger children were bitten on the face (chi2 = 49.54, P = 0.000) and were bitten in their own homes (chi2 = 16.075, P = 0.013).
Young children frequently sustain dog bites from their family dog in their own homes. Injuries typically involve severe lacerations to the face. Prevention strategies for young children include close supervision of child-dog interactions.
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.
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