Epidemiology of Dog Epidemiology of Dog Bite Injuries and Bite Injuries and Fatalities in Texas Fatalities in Texas and the United States and the United States Nancy Crider, MS, RN, CNAA Nancy Crider, MS, RN, CNAA University of Texas School of Public Health University of Texas School of Public Health June 11, 2007 June 11, 2007 57 57 th th Annual James H. Steele Conference Annual James H. Steele Conference Diseases in Nature Transmissible to Man Diseases in Nature Transmissible to Man Austin, TX Austin, TX
Transcript
Epidemiology of Dog Bite Epidemiology of Dog Bite Injuries and Fatalities in Texas Injuries and Fatalities in Texas
and the United Statesand the United States
Nancy Crider, MS, RN, CNAANancy Crider, MS, RN, CNAAUniversity of Texas School of Public HealthUniversity of Texas School of Public Health
June 11, 2007 June 11, 2007 5757thth Annual James H. Steele Conference Annual James H. Steele ConferenceDiseases in Nature Transmissible to ManDiseases in Nature Transmissible to Man
Austin, TXAustin, TX
AcknowledgementsAcknowledgements
Jim Schuermann,Jim Schuermann, Staff Epidemiologist, Zoonosis Control Branch, Texas Department of State Health Services Kent Robertson, Bureau Chief, City of Houston Health Kent Robertson, Bureau Chief, City of Houston Health & Human Service, Bureau of Animal Regulation & Care & Human Service, Bureau of Animal Regulation & Care (BARC) (BARC) Sameer Gokhale, MPH, UT School of Public HealthSameer Gokhale, MPH, UT School of Public HealthJanelle Rios, MPH, UT School of Public HealthJanelle Rios, MPH, UT School of Public HealthMichael Smolensky, PhD, Professor UT School of Michael Smolensky, PhD, Professor UT School of Public HealthPublic HealthKeith Burau, PhD, Associate Professor UT School of Keith Burau, PhD, Associate Professor UT School of Public HealthPublic HealthIrina Cech, PhD, Professor UT School of Public Health Irina Cech, PhD, Professor UT School of Public Health
Nancy Crider 7/1993
Why be Concerned about Dog Bites?Why be Concerned about Dog Bites?
10-year-old San Antonio girl, Amber Jones, was fatally 10-year-old San Antonio girl, Amber Jones, was fatally injured in January 2007injured in January 2007 by a neighbor's pit bull she was by a neighbor's pit bull she was trying to free after its collar got hooked on a chain-link trying to free after its collar got hooked on a chain-link fence. fence. Harris County 4-year-old Pedro Rios Jr. fatally mauledHarris County 4-year-old Pedro Rios Jr. fatally mauled in in November 2006 by two stray dogs.November 2006 by two stray dogs.Lillian Stiles, 76, attacked and killed by a neighbor's dogs in Lillian Stiles, 76, attacked and killed by a neighbor's dogs in the front yardthe front yard of her Thorndale home in November 2005 of her Thorndale home in November 2005Houston Houston woman killed by a pair of pit bulls and a woman killed by a pair of pit bulls and a Rottweiller on city streetRottweiller on city street in 2003 in 2003
By JANET ELLIOTT Copyright 2007 Houston Chronicle Austin Bureau
Recent Dog Attacks Texas 2007Recent Dog Attacks Texas 2007
Two Pit bulls enter San Antonio home and maul sleeping Two Pit bulls enter San Antonio home and maul sleeping 90-year-old man with Alzheimer's90-year-old man with Alzheimer's. Selestino Rangel was . Selestino Rangel was in critical condition after dogs pulled him from his in critical condition after dogs pulled him from his bedroom into the living room, leaving a trail of blood. bedroom into the living room, leaving a trail of blood. (May 14, 2007, Associated Press). (May 14, 2007, Associated Press). Golden retriever in Friendswood mauling to be put down. Golden retriever in Friendswood mauling to be put down. Pamela Rushing, 50, found mauled to death in her Pamela Rushing, 50, found mauled to death in her backyardbackyard in the Forest of Friendswood subdivision. in the Forest of Friendswood subdivision. (March 29, 2007, Ben Tinsley / Galveston County Daily (March 29, 2007, Ben Tinsley / Galveston County Daily News). News). Pit bulls attack girls leaving bus stop.Pit bulls attack girls leaving bus stop. A 7 year-old is A 7 year-old is dragged down the street before deputies kill dogs. dragged down the street before deputies kill dogs. 12 12 year-old describes terror of being chased, attackedyear-old describes terror of being chased, attacked. . (February 2007, Lindsay Wise / Houston Chronicle)(February 2007, Lindsay Wise / Houston Chronicle)
Dog Bite Related Fatalities Dog Bite Related Fatalities by state 1979-1996 by state 1979-1996
MMWR Vol146/No21 p465
Fatal Dog Bites 1989 to 1994 Fatal Dog Bites 1989 to 1994
109 dog bite-related fatalities (DBRF) 109 dog bite-related fatalities (DBRF) 57% in children < 10 years old57% in children < 10 years old22% involved unrestrained dog OFF the owner's 22% involved unrestrained dog OFF the owner's property. property. 18% involved restrained dog ON the owner's 18% involved restrained dog ON the owner's property, property, 59% involved unrestrained dog ON the owner's 59% involved unrestrained dog ON the owner's property. property. 10% of the dog bite attacks involved sleeping 10% of the dog bite attacks involved sleeping infants. infants.
PEDIATRICS (Vol.97 No. 6, 891-5), Jeffrey J. Sacks, M.D. and associates
Nancy Crider 11/2006 data source http://fataldogattack.com
Texas Dog Bite Related Fatalities By Year 1980 - 2007
3 3
2 2 2
1
2
1
0
2
4
1 1 1
0 0
3 3
0
2
3
0
3
1
4
3
7
2
0
1
2
3
4
5
6
7
8
1980 1983 1986 1989 1992 1995 1998 2001 2004 2007
Year
Fre
qu
en
cy
Series1Linear (Series1)
Nancy Crider 5/2007: Source data Zoonosis Division DSHS Severe Animal Bites
Nancy Crider 5/07: Source data Zoonosis Control Branch DSHS
Fatal Dog Bites: Texas 1980-2007Fatal Dog Bites: Texas 1980-2007
Total number of Total number of deaths 56deaths 56 – 16 DBRF 2004 – 2007 16 DBRF 2004 – 2007
Jim Schuermann, Staff Epidemiologist, Zoonosis Control Branch, Texas Department of State Health Services
Most Commonly Reported Dog Most Commonly Reported Dog Breeds Involved in DBRFBreeds Involved in DBRF
US 1979 – 1998US 1979 – 1998
Pit bull (24 deaths)Pit bull (24 deaths)
Rottweiller (16 deaths) Rottweiller (16 deaths)
German shepherd (10 German shepherd (10 deaths)deaths)
25 breeds involved in DBRF
Many other breeds also Many other breeds also involved in dog bite involved in dog bite injuries but less likely to injuries but less likely to inflict fatal woundinflict fatal wound
Texas 1980 -2007Texas 1980 -2007
Pit Bull 17Pit Bull 17
Rottweiller 7Rottweiller 7
Mixed/Cross 7Mixed/Cross 7
Chow 3Chow 3
Other breeds: Boxer, Other breeds: Boxer, Great Dane, German Great Dane, German Shepherd, St. Bernard, Shepherd, St. Bernard, Husky, MalamuteHusky, Malamute
Not recorded 12Not recorded 12
PEDIATRICS (Vol.97 No. 6, 891-5), Jeffrey J. Sacks, M.D. and associates;September 2000 study JAVMA (Vet Med Today: Special Report)
Jim Schuermann, Staff Epidemiologist, Zoonosis Control Branch, Texas Department of State Health Services
Non Fatal Dog Bite Injuries in the Non Fatal Dog Bite Injuries in the United States 2001United States 2001
Estimated 368,245 persons treated for dog bite--Estimated 368,245 persons treated for dog bite--related injuries (rate: 129.3 per 100,000 related injuries (rate: 129.3 per 100,000 population)population)
Injury rate highest for children aged 5--9 years; Injury rate highest for children aged 5--9 years; rate decreased with increasing age. rate decreased with increasing age.
Approximately 154,625 (42.0%) bites among Approximately 154,625 (42.0%) bites among children aged children aged <<14 years 14 years
80% of bites in persons aged 80% of bites in persons aged <<18 years inflicted 18 years inflicted by a family (30%) or a neighbor's dog (50%)by a family (30%) or a neighbor's dog (50%)
Severe Dog Bites Reported to Zoonosis Control Division Texas DSHS by Year 1992 - 2004
196154
229
536
686
621 630597
522
420486
454
650
0
100
200
300
400
500
600
700
800
Year
Do
g B
ite
s
1992
1994
1993
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
Nancy Crider 5/2007: Source data Zoonosis Division DSHS Severe Animal Bites
Non Fatal Dog Bite Injuries in the Non Fatal Dog Bite Injuries in the United States 2001United States 2001
Rate significantly higher for boys (293.2 Rate significantly higher for boys (293.2 per 100,000 population) than for girls per 100,000 population) than for girls (216.7) (p = 0.037)(216.7) (p = 0.037)Difference between the rate for males Difference between the rate for males (102.9) and females (88.0) was not (102.9) and females (88.0) was not statistically significant for persons aged statistically significant for persons aged >>15 years15 years
Age of Dog Bite Victims Texas - 2004Age of Dog Bite Victims Texas - 2004
0
20
40
60
80
100
120
140
<66-
1011
-15
16-2
021
-25
26-3
031
-35
36-4
041
-45
46-5
051
-55
56-6
061
-65
66-7
071
-75
76-8
081
-85
86-9
0>9
0
Janelle Rios 5/2007: Age distribution of the reported 670 severe animal attacks or bites that occurred in Texas in 2004.
Non Fatal Dog Bite Injuries Treated Non Fatal Dog Bite Injuries Treated in US Emergency Rooms by Body in US Emergency Rooms by Body
Part and Age 2001Part and Age 2001
Most common injury sites: arm/hand (45.3%), Most common injury sites: arm/hand (45.3%), leg/foot (25.8%), and head/neck (22.8%). leg/foot (25.8%), and head/neck (22.8%). The majority (64.9%) of injuries among children The majority (64.9%) of injuries among children aged aged <<4 years were to the head/neck; this 4 years were to the head/neck; this percentage decreased significantly with age percentage decreased significantly with age (p<0.01) (p<0.01) Injuries to the extremities increased with age Injuries to the extremities increased with age (p<0.01) and accounted for 86.2% of injuries (p<0.01) and accounted for 86.2% of injuries treated in EDs for persons aged treated in EDs for persons aged >>15 years. 15 years. Overall, 98.2% of patients were treated and Overall, 98.2% of patients were treated and released from the ED. released from the ED.
When the site of injury is categorized by age, the proportion of victims When the site of injury is categorized by age, the proportion of victims experiencing trauma to the head decreases with increase in victim’s experiencing trauma to the head decreases with increase in victim’s age. Children less than 11 years of age were victims of only 33% of age. Children less than 11 years of age were victims of only 33% of the severe attacks; however, they sustained most (80%) of the head the severe attacks; however, they sustained most (80%) of the head injuries. injuries.
Janelle Rios 5/2007: Distribution of sites (n=755) of injury location of severe animal bites of Janelle Rios 5/2007: Distribution of sites (n=755) of injury location of severe animal bites of 691 victims in Texas in 2004.691 victims in Texas in 2004.
Dog Bite Related Injuries in the Dog Bite Related Injuries in the United States - 2001United States - 2001
Approximately 16,526 (4.5%) dog bite injuries Approximately 16,526 (4.5%) dog bite injuries were work-related (e.g., occurred to persons were work-related (e.g., occurred to persons who were delivering mail, packages, or food; who were delivering mail, packages, or food; working at an animal clinic or shelter; or doing working at an animal clinic or shelter; or doing home repair work or installations). home repair work or installations). For persons aged For persons aged >>16 years, approximately 16 years, approximately 16,476 (7.9%) dog bite injuries were work-16,476 (7.9%) dog bite injuries were work-related. related. Houston ranked first and second in the past two Houston ranked first and second in the past two years for number of mail carriers attacked.years for number of mail carriers attacked.
Table 1. Reported Canine breeds involved in 601 reported severe animal Table 1. Reported Canine breeds involved in 601 reported severe animal attacks or bites that occurred in Texas in 2004 attacks or bites that occurred in Texas in 2004
City of Houston 2006
Sex & Reproductive StatusSex & Reproductive Status
1997 study by Texas DSHS of 25,000 dogs 1997 study by Texas DSHS of 25,000 dogs revealedrevealed– 3756 (31%) of female dogs were spayed3756 (31%) of female dogs were spayed– 2788 (23%) of male dogs were neutered2788 (23%) of male dogs were neutered
1998 – 2002 study of 1520 dogs involved in 1998 – 2002 study of 1520 dogs involved in severe bites concluded severe bites concluded – Spayed and intact females bite at about the same Spayed and intact females bite at about the same
proportion as prevalenceproportion as prevalence– Intact males bite at 2X the rate of neutered males Intact males bite at 2X the rate of neutered males
Texas DSHS Zoonosis Control Division 2002 Severe Animal Attack Summary
Texas Dog Bites – 2004Texas Dog Bites – 2004Sex & Reproductive StatusSex & Reproductive Status
181
86
6447
0
20
40
60
80
100
120
140
160
180
200
Intact Neutered
Males
Females
Sex and reproductive status of 555 canines involved in severe animal attacks or bites that occurred in Texas in 2004 .(The animal’s sex was specified in 555 of the 650 reports (85.4%), and the reproductive status of the animals was specified in 380 (69%)
Medical & Liability CostsMedical & Liability Costs
Estimated 5 million dog bites/year in the Estimated 5 million dog bites/year in the United StatesUnited States
Approximately 400,000 bites/year in TexasApproximately 400,000 bites/year in Texas
$250 million a year in medical and liability $250 million a year in medical and liability claimsclaims
1/3 of all liability claims against 1/3 of all liability claims against homeowners policieshomeowners policies
Texas DSHS –Infectious Disease Control Unit 10/1/2005
““Toddler mauled by neighbor's dog”Toddler mauled by neighbor's dog”
Three-year-old Breanna Webster may have Three-year-old Breanna Webster may have scars for the rest of her life. Her neighbor's scars for the rest of her life. Her neighbor's dog attacked her Tuesday evening when she dog attacked her Tuesday evening when she apparently stepped on the dog's paw. apparently stepped on the dog's paw. Little Breanna Webster was playing with a Little Breanna Webster was playing with a dog most people would consider family-dog most people would consider family-friendly, a golden retriever.friendly, a golden retriever.The attack took off most of Breanna's upper The attack took off most of Breanna's upper lip. lip. The owner admitted that wasn't the first time The owner admitted that wasn't the first time the dog had attacked a child. She said she the dog had attacked a child. She said she always tells children under the age of 10 to always tells children under the age of 10 to stay away from him, "because he'll bite you." stay away from him, "because he'll bite you."
Friday, March 23, 2007, By Friday, March 23, 2007, By BOB GREENE / WFAA-TV
Legal CostsLegal Costs
Jury awards Dog bite victim $1 millionJury awards Dog bite victim $1 million
Jury awards $3.7 million to woman Jury awards $3.7 million to woman maimed in Delray Beach dog attackmaimed in Delray Beach dog attack
Jury grants teen $228,000 for dog-Jury grants teen $228,000 for dog-bite injuriesbite injuries
Dog Attacks are Dog Attacks are not Accidents! not Accidents! They are They are terrifying brutal terrifying brutal physical physical assaults.assaults.
http://www.dogbitelawsuits.com/
Prevention Strategies to Decrease Prevention Strategies to Decrease Dog Bite Related Injuries & FatalitiesDog Bite Related Injuries & Fatalities
Targeted education for childrenTargeted education for children
Public education about dogs and dog Public education about dogs and dog ownershipownership
Animal control at the community levelAnimal control at the community level
Bite reporting and investigationBite reporting and investigation
Legislation (Texas House Bill 1355)Legislation (Texas House Bill 1355)
Community involvementCommunity involvement
Limitations of StudyLimitations of Study
Unknown number of actual dog bitesUnknown number of actual dog bitesIncomplete victim demographics Incomplete victim demographics Missing injury diagnosesMissing injury diagnosesIncomplete/absent dog owner informationIncomplete/absent dog owner informationLimited information re circumstances of biteLimited information re circumstances of biteIncomplete information regarding prior or concurrent Incomplete information regarding prior or concurrent attacks on other animalsattacks on other animalsUnable to calculate bite rate per breed (unknown Unable to calculate bite rate per breed (unknown denominator)denominator)Inaccurate or absent ID of dog breedInaccurate or absent ID of dog breedAnalysis did not account for exposureAnalysis did not account for exposure
ConclusionsConclusions
Most of the 52 million dogs in the US never bite Most of the 52 million dogs in the US never bite or kill anyone or kill anyone Most factors contributing to dog bites are related Most factors contributing to dog bites are related to the actions of dog owners. to the actions of dog owners. There is a seasonal trend to dog bites There is a seasonal trend to dog bites In general more DBRF occur in the SouthIn general more DBRF occur in the SouthImproved reporting and investigation of dog bites Improved reporting and investigation of dog bites is needed to establish a baseline and target is needed to establish a baseline and target limited resources effectivelylimited resources effectivelyPrevention strategies are needed to decrease Prevention strategies are needed to decrease dog bite related injuries & fatalities in Texasdog bite related injuries & fatalities in Texas
