Epidemiology of hospitalizations due to dog bite injuries in Israel, 2009–2016

Abstract

BackgroundDog bites are a substantial public health concern. Rarely has hospitalizations resulting from dog bites been examined. We examined, at a national level, demographic and injury characteristics of dog-bites injuries requiring hospitalization to target prevention programs and policies for those who are at higher risk. MethodsData on hospitalizations due to dog-bite injuries with an ICD9-CM E906.0 coding were extracted from the Israeli National Trauma Registry between 2009–2016. We calculated the annual incidence of hospitalized dog-bite injuries and compared rates by Chi-squared test. Mantel Haenszel chi-squared test and Dickey-Fuller time-series analysis were used to test linear age and temporal trends, respectively. ResultsOverall 986 persons were hospitalized for dog-bite injuries between 2009–2016. An increasing significant trend over the 8-year-period in the proportion of hospitalized dog-bite injuries among all trauma hospitalizations was revealed among children between 0 and 14 years old (p = 0.01). Children had also approximately twice the risk for dog-bite injuries compared to persons aged between 15 and 94 years old (relative risk [RR] = 1.89, 95% confidence interval [CI] = 1.35–2.66, p < 0.0001); the 2016 (latest year) rate per 100,000 was significantly higher for boys than for girls (RR = 2.85, 95%CI = 1.57–5.19, p < 0.0001); no gender differences were detected in the other age groups. Injury in the face/head/neck was most common in children between 0 and 14 years old (49.7%), specifically among the youngers (<1, 1–3 and 4–5 year olds) compared with the 6–11 and 12–14 age groups (p < 0.0001), with 4-fold-risk compared with persons aged between 15 and 94 years old (RR = 3.78, 95%CI, 3.01–4.75). There was no overall significant temporal trend in the annual incidence rates (from 1.84 (95%CI = 1.54–2.15) in 2009 to 1.54 (95%CI = 1.28–1.81) in 2016 per 100,000 population. ConclusionsChildren younger than 15 years, with greater extent in boys than girls, represent the high-risk demographic group for dog bites. Prevention programs targeting at this group should be implemented and translated into an actual reduction in the incidence of dog-bites. In addition, an ongoing monitoring and reporting system specific for all dog-bites should be established in Israel, in order to better understand how to minimize the incidence of dog-bites and evaluate prevention efforts.