Dog Bite Research Articles

Rabies epidemiology in the central of Tunisia: A Call for a One-Health Approach

Abstract Background Advocating for a One-Health approach is crucial for ensuring effective rabies surveillance in Africa, including Tunisia. Collecting information is essential to evaluate the prevalence of dog bites and rabies in Tunisia. To address this, we conducted an analysis of reported incidents in the central region of Tunisia from 2019 to 2022. This analysis aimed to generate valuable insights that can inform strategies for rabies elimination in Tunisia, highlighting the importance of the One-Health approach. Methods We carried out a descriptive study using surveillance data from Monastir governorate in Central Tunisia. All humans exposed to animals, residents in Monastir Governorate and declared to the regional directorate of primary health care from January 1, 2019 to December 31, 2022 were included in our study. Data were entered, cleaned, and analyzed using Excel. Results During the studied period, 7789 cases of human exposures to animals were reported with an annual average of 1969 ± 207 exposures per year. The annual incidence rate of exposure to animal bites was 324 per 100,000 population. The sex-ratio was 2.07 and almost one third of exposed humans were aged less than 15 years-old. The most listed offending animals were dogs (65.2%), followed by cats (24.4%). The number of exposures by unvaccinated dogs increased significantly during our study period. Post-exposure prophylaxis (PEP) was applied among 99% (n = 7772) of declared exposures. Among them, 2.5% (n = 202) did not complete the PEP recommended protocol. During our study period, rabies was confirmed in 39 animals. Two fatal human rabies cases were declared respectively in 2021 and 2022. Conclusions Rabies remains a worrying health problem in Tunisia with a high percentage reported among youth and males. Targeting children and adolescents by education and information campaigns about preventive measures and mass dog vaccination are the key to ending this scourge. Key messages • It is crucial to reinforce preventive strategies, such as mass dog vaccination programs. • Public awareness about rabies prevention should be enforced in order to decrease Human rabies risks.

Unwanted Feeding and Other Interactions Between Passers-By and Horses: Owners’ Views During the COVID-19 Pandemic

ABSTRACT Interference events, such as unwanted feeding of horses by passers-by and removal of equipment, can compromise equine health and pose a risk to human safety (e.g., from equine bites). With altered exercising behavior during COVID-19 restrictions came reports of an increase in such events. Our study’s main purpose was to estimate the extent of these and, as a secondary aim, gauge whether their frequency changed during COVID-19 lockdowns. We used two surveys: one aimed at UK horse owners (n = 1,017) and the other open to owners worldwide (n = 2,747). Unwanted feeding was a common event, reported by 77% of UK-based owners, representing a real source of welfare concern: 28% of horses fed suffered aftereffects and 16% of these later died. Globally, interference events, including feeding, are similarly common – 80% of owners reported events ranging from stroking through to more serious situations (e.g., dog attacks). Perceptions of how COVID-19 affected interference events were mixed. Going forward, we suggest that improved public education and, ultimately, behavior change toward animals belonging to others is required. Owners have some responsibility in achieving this; for example, with improved physical barriers like hedgerows between public spaces and their horses (whilst ensuring rights of way remain unobstructed).

Psychological Sequelae of Dog Bites in Children: A Review.

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. 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. 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. 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.

Evaluation of Emergency Admissions Due to Animal-Related Incidents Based on Prehospital Emergency Medicine Data: A Retrospective Study.

Animal injuries, especially dog bites, are a major public health problem in both developed and developing countries. The majority of these injuries lead to emergency healthcare visits and may have serious consequences such as infection risk and organ injuries. There is a limited number of studies on the demographic and operational characteristics of animal-related 112 emergency visits in Turkey. In this study, we aimed to conduct research to fill this gap. This retrospective study included animal-caused cases received by Ankara 112 Emergency Health Services Emergency Health Automation System (ASOS) between January 1, 2019 and December 31, 2023. A total of 3457 cases were analyzed. Data were evaluated using theIBM SPSS 27.0 program. There was an overall decreasing trend in animal-related emergency admissions between 2019 and 2023. Most cases were recorded during the summer season, especially in July. Male patients predominated (61.2%), with the majority of cases (81.7%) occurring in urban areas. Dog bites were the most common cause, accounting for 49.3% of cases. In the majority of cases, transportation time was below the Ministry of Health quality standards. Dog bites account for the majority of animal-related emergency admissions. The increase in cases during thesummer months emphasizes the importance of social awareness and preventive strategies. The findings of the study provide an important reference for improving emergency health services and developing strategies to prevent such cases.

The effects of the COVID-19 pandemic on pediatric dog bite injuries

Background/objectiveShortly after the onset of the COVID Pandemic, when many schools and outside activities were suspended, dog adoption rates increased. It is unknown if increased dog adoption rates along with stay-at-home orders resulted in changes to pediatric dog bite injuries. The objective of this study was to examine the incidence and characteristics of dog bites in children seen in a pediatric emergency department (PED) during the pandemic compared to before.MethodsA retrospective review of children evaluated in the PED of a level 1 pediatric trauma center and its satellite PED from March 2018 through February 2022 who had a discharge diagnosis of dog bite (ICD-10 W54.0XXA) was conducted. Pre-pandemic cases, March 2018 through February 2020, were compared to those that occurred during the pandemic, March 2020 through February 2022.ResultsThere were 2,222 patients included in the study. Compared to pre-pandemic cases, the incidence for the first 12 months of the pandemic was 1.5 times higher than the pre-pandemic 12-month periods but returned closer to the pre-pandemic rates during the second 12 months of the pandemic. More patients were admitted during the pandemic (6.1% vs. 3.7%, p < 0.05). Facial and multiple injuries occurred more frequently during the pandemic (face 35.9% vs. 33.5%: multiple 18.5% vs. 15.6% p < 0.05).ConclusionsThere was a higher incidence of PED visits, higher admission rates, and an increase in multiple body part and facial injuries in children with dog bite injuries during the COVID pandemic compared to pre-pandemic. Pediatric providers should emphasize safe dog interactions with anticipatory guidance.

Surgical Management of Pediatric Dog Bites: A Systematic Review and Treatment Guideline

IntroductionDog bites are a unique and unusual injury in children, associated with atypical bacterial species, high infection rates, and controversial surgical treatment. Expert recommendations currently guide management and no surgical evidence-based guidelines exist. We conducted a systematic review to answer three management questions: (1) What are the best practices for wound management? (2) In what circumstances should prophylactic antibiotics be administered? (3) In what circumstances should rabies prophylaxis be given? MethodsA structured review was performed using a keyword search querying “pediatric” “dog bite” “management”. Results were reported according to the PRISMA methodology. The quality of nonrandomized studies was evaluated according to Methodological Index for Non-Randomized Studies (MINORS). Qualitative analysis was performed. ResultsA total of 803 studies were identified and 53 studies were included in the final analysis. Current literature suggests that primary closure of bites which are well irrigated and sharply debrided within 8 h of injury, is not associated with increased infection. While dog bites are associated with an overall high rate of infection (6–25 %), routine antibiotic prophylaxis in low-risk wounds does not lower that risk. Postexposure prophylaxis for rabies is indicated for all dog bites where the rabies status of the dog cannot be determined, or the animal cannot be quarantined for 10 days. ConclusionHigh-quality evidence regarding the surgical management of pediatric dog bites is limited. Trial data have demonstrated improved outcomes in wound healing and infection rates with a focus on copious irrigation and diligent wound debridement, although independent validation is needed. Level of EvidenceLevel II – systematic review.

Adherence to post-exposure prophylaxis and associated socio-demographic characteristics of dog bite patients visiting selected health facilities in Kisii County, Kenya

Background: Dog bites have proven to be a significant public health concern among African and Asian countries that report 95% of human mortalities. Rabies is a deadly viral disease spread by a rabid animal that invades the CNS and is 100% fatal. The main objective of the study was to assess adherence to rabies post-exposure prophylaxis and associated socio-demographic characteristics among dog bite patients. Methods: This was a hospital-based cross-sectional study with 289 dog bite patients from selected health facilities in Kisii County, Kenya. Simple random sampling technique was adopted in the selection of participants, while the health facilities were purposively selected. Data was analysed using SPSS software version 25. Results: More than a half (57.8%) of the dog bites were females as compared to their male counterparts (42.2%). Level of education (p=0.001), age (p=0.012), marital status (p=0.001), income (p=0.001) were significant determinants of adherence to rabies PEP treatment, preferred rabies PEP regimen acquired (p=0.001). Over 68.2% of the patients adhered to rabies PEP treatment, adherence to individual dosage of ARV regimen with 67.2% of dog bite patients completed the PEP regimen, ZAGREB regimen had 95.6% of dog bite patients likely to complete their treatment compared to ESSEN regimen. Conclusions: Dog bites were prevalent among females. The study further revealed that as the level of education increased the odds of rabies PEP adherence treatment improved. Dog bite patients preferred ZAGREB rabies PEP regimen.

An unsuspected extracranial internal carotid pseudoaneurysm following dog bites: a case report and review of literature

BackgroundExtracranial internal carotid artery (ICA) pseudoaneurysm is a rare condition that can be caused either by penetrating or blunt trauma, including dog bites, which is an uncommon occurrence. Together with the possibility of no symptoms or nonspecific ones such as cervical pain, hematoma, swelling, or mass, considering ICA pseudoaneurysm following a dog attack is of paramount importance to avoid life-threatening complications.Case presentationWe present a rare case of a 17-year-old male with a history of dog bites three months prior, who presented to the emergency department with left-sided neck pain, dizziness, and several episodes of blurred vision and diplopia. On physical examination, a palpable mass measuring approximately 20 × 30 millimeters was identified in the left neck region and multiple superficial lacerations were observed in this area. Laboratory tests yielded normal results. Doppler ultrasound revealed a pseudoaneurysm in the left internal carotid artery. Because the great saphenous veins were insufficient, the patient was successfully treated with synthetic graft patch arterioplasty, and no complications were seen in his one-year follow-up with computed tomography (CT) angiography.ConclusionsThis report emphasizes the significance of thorough initial evaluation and imaging in cases of dog attacks, even without apparent significant trauma, to rule out hidden arterial injuries.

Epidemiological Profile and Awareness Regarding Animal Bite Management in an Urban Area.

The most common way for people to contract the deadly zoonotic disease rabies is through animal bites. This study was designed because there is a shortage of community-based data to determine the true extent of rabies infection and a lack of understanding regarding patient misconceptions in urban areas. The objective was to determine the scope of the issue and the epidemiological features of animal bite incidents. This was a facility-based cross-sectional study conducted at the field practice area (Urban Health Training Centre) under the Department of Community Medicine, Government Medical College. The study duration was one year (May 2023 to April 2024). Consecutive patients (accompanied by an attendant) attending the Urban Health Training Centre were included in the study. A purposive sampling technique was used, and around 400 animal bite cases were recorded in one year at the Urban Health Training Centre. Out of 1503 male cases at the Urban Health Training Centre, around 255 were dog bite cases (50.6%), whereas out of 1302 females visiting the Urban Health Training Centre, around 145 were dog bite cases (48%). The majority (35%) belonged to the age group of 11 to 20 years for both males and females. The mean age of the cases was 19.4 ± 3.4 years. The study found a male preponderance (64%), with females constituting 36%. The right lower limb (49.5%), left lower limb (39%), and upper limb were the most frequently bitten sites. Fifty-one percent of the cases fell into Category II. According to local data, the most popular home management practices were ghee oil and cold treatments. Although Category III is the most severe bite, only 35% had taken the anti-rabies vaccine (ARV), and 8.75% had received rabies immunoglobulin. The public and medical community need to be made aware of the importance of wound care and the prudent use of the anti-rabies vaccine.

Role of prophylactic antibiotics in treating patients presenting to emergency care with dog bites.

Dog bites account for 250,000 attendances for urgent and emergency care each year. They pose risks including infections with potentially life-threatening complications. This article scrutinises the evidence underpinning the use of prophylactic antibiotics in dog bite wounds. A focused literature review involving four databases specialising in peer-reviewed healthcare literature was conducted to identify the highest quality evidence, which was then systematically appraised. The use of antibiotics in treating dog bite wounds to reduce the risk of infection is largely supported by the evidence. However, significant limitations exist in the research, with patient-specific criteria for administering prophylactic antibiotics and the associated risks and financial costs not addressed. Further research into antibiotic treatment for dog bites would help to support clinicians, nurse practitioners and the wider nursing and allied health professional team in urgent and emergency care by informing safe practice and in turn improving patient care, cost-effectiveness and antimicrobial stewardship.

Species of Nepenthes (Pitcher Plant) in Selected Areas of San Isidro, Northern Samar

Nepenthes is a genus in the Nepenthaceae family of the order Nepenthales that is also known as a carnivorous plant. Thus, a study was conducted to identify the diversity of Nepenthes species in nine (9) areas of San Isidro, Northern Samar. The descriptive method of research was applied in this study. A total of nine (9) species were identified in the sampling sites. These species mostly grow in forest and woodland areas. In terms of economic importance, residents used Nepenthes species as ornamental plant, for barter with any goods, and an albolaryo used Nepenthes pitchers to treat snake and dog bites, “kulam”, and “usog”. Furthermore, habitat destruction, cultivation, and overexploitation of Nepenthes species were identified as anthropogenic activities. Results implied that the gathered environmental conditions data were normal and optimal for the growth and development of Nepenthes species in the sampling sites. Further study on the plant will be helpful for future conservation, more economic value, and possible pharmaceutical applications. Moreover, DENR may coordinate with LGU and strictly implement ordinances against habitat destruction, cultivation, collection, and trading of Nepenthes species to assist conservation.

Factors associated with the rabies vaccination status of dogs in households in Beni City, D.R. Congo.

Human rabies transmitted by dogs still kills thousands of people each year worldwide. Dog bites are common in the city of Beni (Democratic Republic of Congo), which shows low rabies vaccination coverage. This study aimed to determine the factors associated with the rabies vaccination status of dogs. A cross-sectional analytical study was conducted in the town of Beni among dog owners, during a household survey selected using a multistage sampling. The information sought concerned the knowledge and characteristics of the dog owners as well as the vaccination status of these dogs. Logistic regression was used to investigate associations between the vaccination status of the dogs and the main independent factors. Rabies vaccination coverage in Beni was 26% (95% confidence interval [CI]: 22% - 30%). The main factors associated with the rabies vaccination status of the dog were primary education level of household head (adjusted odds ratio [aOR]:4.8; 95% CI: 1.2- 19.8); university education level of household head (aOR: 5.9; 95% CI: 1.6-22); perceived rabies severity (aOR: 44. 4; 95% CI: 10.4-188), having more than one dog in the household (aOR: 2.6; 95% CI: 1.6-4.3); age range 7-12 months (aOR: 0.2; 95% CI: 0.1-0.6) and confined dog breeding (aOR: 3.9; 95% CI: 1.1-14.9). The low vaccination coverage in Beni requires mass vaccination campaigns against canine rabies targeting the dog owners with low education levels, those raising more than one dog, with stray dogs or dogs less than 12 months old.

Pain, inconvenience and blame: defining work-related injuries in the veterinary workplace.

The veterinary workplace carries a high risk of staff accidents and injuries, yet there is scant research exploring it in comparison with other comparable fields, such as human medicine. To understand how veterinary professionals define injuries and to understand what injuries they do, or do not, deem reportable. A cross-sectional survey comprising demographic questions and open-text questions was shared with veterinary practice staff across the UK. Data were analysed descriptively and using an inductive content analysis. There were 740 respondents, who were broadly representative of the veterinary profession. There were differences in how injuries were defined; for example, small animal veterinarians expected injuries to involve blood, while equine and production animal veterinarians were more likely to expect injuries to reduce their ability to perform work and require medical treatment. Many suggested that 'all' workplace injuries should be reported; however, 'minor' injuries were often overlooked, for example, needlestick injuries did not always meet the criteria of being an 'injury'. Injuries caused by staff themselves (e.g. trips) were less likely to be reported than injuries that could be blamed on an external factor (e.g. dog bite). Collectively, the data suggest a wide-ranging perception of risk of injury in practice, with some harms seen as 'everyday norms'. Veterinary practices should interpret their injury statistics with a high degree of caution. They should explore the microcultures within their practices relating to worker perception of risk, injury and barriers to reporting.

Retrospective Analysis of Dog Bite Injuries in Children with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) may suffer a dog bite injury, but the frequency and its clinical impact is unknown. We sought to evaluate the (1) subject characteristics; (2) injury type; (3) clinical care provided; and (4) mortality in children with ASD who suffer a dog bite injury. We hypothesized that children with ASD have higher mortality and require more clinical care than children without ASD. This is a retrospective observational cohort study utilizing the TriNetX ® EHR database of subjects aged 0 to 18 years with dog bite diagnostic codes. Data were analyzed for demographics, diagnostic, medication, procedural codes, and mortality. We analyzed 38,337 subjects (n, %) coded for a dog bite injury [619 (1.6%) with ASD and 37718 (98.4%) without ASD]. Children with ASD had a higher odds of a traumatic injury to the head [1.34 (1.15, 1.57), p < 0.0001] compared to those without. There was no difference in critical care services, hospitalization, mechanical ventilation, and rabies vaccine administration. All-cause mortality at 1 year was low with no deaths reported within the ASD cohort and 37 (0.1%) deaths reported within the no ASD cohort. Children with ASD that suffer dog bite injuries have similar clinical needs to children without ASD but are more likely to suffer a traumatic injury to the head. Future studies are needed to better understand inciting factors for injuries in this population.

Immunisation of koalas against Chlamydia pecorum results in significant protection against chlamydial disease and mortality

In 2022, the Australian Government listed the koala as endangered in several states due to habitat destruction, traffic strikes, dog attacks, and Chlamydia pecorum disease. This study evaluates a 10-year assessment of a Major Outer Membrane Protein-based vaccine’s effectiveness against chlamydial disease in wild koalas from Southeast Queensland. Over a decade, 680 koalas were tracked, with five vaccine trials involving 165 koalas. While prior studies only offered up to two years of data, this study’s extended period allowed a thorough evaluation of vaccine efficacy. Results showed that vaccinated koalas had significantly lower disease incidence, with a 64% reduction in chlamydial mortality. This vaccine demonstrated positive impacts on both male and female koalas, highlighting its crucial role in conserving the Australian koala population and mitigating the threats they face.

Case Reports on Reconstruction of Injuries on the Face and Scalp after Dog Bite

Case Reports on Reconstruction of Injuries on the Face and Scalp after Dog Bite

A public health campaign to increase awareness of the risk of dog bites in South Australia

Dog bites are a serious public health problem. A campaign by the Dog and Cat Management Board of South Australia was launched to increase awareness that any dog can bite as a first step in reducing the incidence of dog bites. The aims of this study were to 1) evaluate changes in attitudes to dog bites following the media campaign, and 2) provide baseline data on dog bites and attitudes to interactions with dogs to help target future campaigns. The media campaign ‘Good Dogs Have Bad Days’ was run from July to October, 2023, using TV, radio, billboards and social media. A cross-sectional survey was conducted pre- and post-campaign, including demographics and questions relating to interactions and attitudes to dogs. A total of n = 402 to the pre- and n = 404 responses to the post-campaign surveys were received, with most having owned a dog, living in metropolitan areas, and an equal split of males and females. Over one third (36–37 %) of dog owners and 25–29 % of non-dog owners had been previously bitten by a dog, although most did not require medical attention. Respondents were more likely to agree that any dog can bite if they recalled seeing the campaign, and less likely if they were male and had poor knowledge of the scenarios in which a dog might bite. Older respondents and those from lower socioeconomic areas believed dog bites were a more serious community issue than younger respondents from higher socioeconomic areas. Approximately 70 % of dog owners believed it was safe for strangers to approach their dog, 34–37 % allowed children or other people to pat their dog without permission and less than half separated their dog from visitors or delivery people. In contrast few of the non-dog owners allowed their children to pat a dog without the owner’s permission and only 2 % allowed them to play with dogs without supervision. The results demonstrate a relatively short campaign was associated with increased agreement any dog can bite. The proportion of respondents who had been bitten by a dog affirms the importance of public health campaigns targeting dog attacks. Some behaviours, such as supervising dogs around children and keeping dogs separate from delivery people, had relatively low agreement from dog owners and may be targeted in future campaigns. Public awareness campaigns and ongoing education will help to increase safer interactions with dogs, but it will take time and commitment to achieve a result.

Replantation dilemma: lessons learned from managing a dog bite forearm amputation in a sixteen-year-old girl.

Bite injuries, particularly those involving the hands, present a significant medico-legal challenge, often leading to complications and frequent emergency department visits. Dog and cat bites, especially among children, are major contributors to infections due to the complex anatomy of the hand, which predisposes it to severe infections even from minor bites. Capnocytophaga canimorsus, found in the oral cavity of dogs and cats, is particularly concerning due to its potential to cause severe infections. Prompt and appropriate treatment is essential to mitigate these risks. Managing such injuries poses significant challenges, necessitating clear guidelines for reporting and safety measures. This article highlights the urgent need for additional research, support, and education, particularly focusing on children, along with the development of international guidelines to improve outcomes for patients. A case study of a sixteen-year-old girl who had her left forearm amputated due to a rottweiler bite is presented. Despite initial attempts at replantation, complications led to the decision for amputation. This case underscores the challenges in managing severe dog bite injuries, emphasizing the importance of prompt assessment, thorough debridement, and proper wound management to minimize complications. Additionally, psychological evaluation and treatment are crucial for patients and parents following such traumatic events. From a medical standpoint, this case highlights the importance of monitoring inflammatory markers, appropriate surgical priorities, and the need for psychological support. Prevention of dog bites is crucial, requiring increased awareness among public authorities and dog owners. Clear guidelines for reporting dog bites are essential, but further research is needed to improve their comprehensiveness and effectiveness.

Who let the dogs out? A 10-year review of maxillofacial dog bite injuries

Dog bites are common within the United Kingdom, with their incidence increasing over recent years. Bites to the head and neck region can have substantial and multifactorial implications for victims, and can provide a challenge to maxillofacial departments. This study is a 10-year retrospective review of head and neck dog bites that required input from the maxillofacial team within the Cwm Taf Morgannwg University Health Board. Data collected included demographics of the patients involved, relationship with and breed of dog, nature of the injury, treatment received, and nature of any complications. In total, 168 records matched our inclusion criteria. The median age of our cohort was 12 years, with 57.1% of patients being younger than 15. Of the patients, 52.4% were female. Eighty-three per cent of cases involved a known dog, with Jack Russells being the breed most commonly involved. The upper lip was the most commonly affected area (30.3%), followed by the cheek (24.5%). Twenty-eight per cent of patients were admitted for management in theatre, with 8% of the total patients experiencing a complication. In conclusion, head and neck dog bites most commonly affect children and the upper lip.

Dog Bite to the Hand: Infectious Disease Considerations

Myocarditis was recently described as one of the complications secondary to COVID-19 vaccination. We present a 38-year-old lady diagnosed with vaccine-related myocarditis a few days after receiving the mRNA-1273 vaccine. We also summarize what is reported in the literature about the association between COVID-19 vaccination and myocarditis. In conclusion, COVID-19 immunization appears to be associated with significantly fewer adverse outcomes than COVID-19 infection among all age groups.