Tiny De Keuster

Prevalence of dog bites in children: a telephone survey

The prevalence of non-medically attended dog bite accidents in children is unknown. Dog bite frequencies have been estimated between 9 and 18 per 1000 subjects [1, 2,4]. These figures include both adults and children. As children are at least 3 to 5 times more likely to experience dog bites than adults [2,4], it could be expected that the prevalence of dog bites is significantly greater in children. The data could be useful to set goals for local prevention programmes, as child victims of dog bites may suffer physical and emotional complications [1,3]. A telephone survey was conducted between August and November 2002 in the French-speaking community of Belgium. From an initial anonymous list established by the telephone company Belgacom, the telephone numbers of 8000 families were randomly selected. Families entered the study if they included at least one child under 15 years of age and if parents agreed to answer a questionnaire about family characteristics. If a child had been bitten by a dog during the last 12 months preceding the enquiry, additional questions were asked about the circumstances of the accident and type of medical intervention. The questionnaire had been pretested on 20 families and some questions modified or omitted for lack of clarity. The university ethics committee had approved the study. Of the 8000 telephone numbers randomly selected, 1184 families (14.8%) were included in the study. The other families could either not be contacted (16%) or did not meet the selection criteria. A dog was owned by 398 of the 1184 families (33.6%). Of the 1184 families, 26 reported that a child had been bitten by a dog during the preceding 12 months. The annual prevalence of dog bite was thus 2.2% (CI 1.4-–3.0). Among the 26 children bitten by a dog, 10 presented to a general practitioner, 5 to a hospital emergency department and one child was hospitalised. No child had been bitten on a second occasion during the preceding 12 months and no child died following a bite accident. An annual frequency of 22 bites was determined per 1000 children under the age of 15 years. The findings also support previous observations that far less than 50% of dog bites were reported to medical or legal authorities [2]. The actual incidence of dog bites could still be greater than reported in this survey. Younger families with only portable telephones might not have been reached, while bites from family pets could have been underreported [2,3]. It can, however, be concluded that dog bites represent a significant and underreported portion of accidents in children.

Dogs in society can prevent society going to the dogs

An editorial comment on the importance of dogs to society, to counter the emphasis given to the risks they pose.

Preventing dog bite injuries: the need for a collaborative approach

Prevention of dog bites injuries in people requires an open-minded multidisciplinary approach that recognises the interaction between the dog, the human and the environment in which they interact, say Tiny de Keuster and Karen L. Overall AS specialists in veterinary behavioural medicine with a commitment to promoting safe and humane interactions between dogs and people, we read with interest the recent letters by Mannion and others in Veterinary Record (June 4, 2011, vol 168, p 594) and in the British Journal of Oral and Maxillofacial Surgery (Mannion and others 2011) discussing recurrent dog bite injuries in people. We wholeheartedly agree that the human and veterinary medical communities must work more closely in truly collaborative relationships to provide accurate, data-based advice and education that will mitigate the risk for both dogs and their owners. The data cited by Mannion and others from Stefanopoulos and Tarantzopoulou (2005) are for catastrophic bites involving surgically attended facial wounds. As such, these are atypical dog bite wounds in adults (Gershman and others 1994, Weiss and others 1998). In contrast, dog bites to young children often result in facial or neck injuries (Beck and others 1975, Wiseman and others 1983, Brogan and others 1995, Weiss and others 1998, Overall and Love 2001, Bernardo and others 2002, Kahn and others 2003, Hoff and others 2005). Older children are more commonly bitten on the extremities, as are adults (Guy and others 2001). The incidence of facial bites in children appears unrelated to the size of the dog but correlates with the age of the child (Bernardo and others 2002, Kahn and others 2003), emphasising the role for oversight when young children interact with dogs. Mannion and colleagues note that the catastrophic bite that prompted their letter was from the …

Aggression toward familiar people and animals

Dog bites pose a serious problem to humans, and the incidence appears to be increasing. This suggests that current preventive interventions are inadequate. The causes of bites are multifactorial, and more research is needed on the epidemiology of bites to help identify the most appropriate prevention strategies. This chapter covers evaluation of the patient, diagnosis, treatment of aggression, prognosis and follow-up, prevention, teaching owners how to interact safely with their pet.

Preventing dog bites: risk factors in different cultural settings.

Dog bites are a serious public health hazard (Weiss et al., 1998). Scientific evidence from Europe suggests the majority of bites occur in children, usually in their own home and inflicted by their own pet (Kahn et al., 2003; Morgan and Palmer, 2007). The paper by Messam et al. (2008), published in this issue of The Veterinary Journal, highlights two important factors associated with research into dog bite prevention strategies. Firstly, the source of the data may influence the results and, secondly, a consideration of human-canine environmental risk factors is essential. In addition, the findings underline the point that the frequency of bite incidents is not associated with the socalled ‘dangerous breeds’ (Kuhne and Struwe, 2006; Kahn et al., 2003). Historically, the incidence of dog bites has been investigated using hospital data from emergency departments. However, it has been suggested that of the estimated 0.74–1 per 100 people bitten each year, only a minority seek medical attention (Morgan and Palmer, 2007). Other authors estimate that >50% of bites are not reported to the medical authorities (Beck and Jones, 1985). Results from hospital-based studies are at variance with those obtained by questioning clients in veterinary clinics (Guy et al., 2001). In hospital-based studies, children were found to be victims of dog bites twice as often as other age groups (Kahn et al., 2004), whereas in veterinary-based studies, it has been reported that 73% of bites involved adults (Guy et al., 2001). Children more often suffer severe injuries to the face and neck, and may be over represented in hospital-based studies (Weiss et al., 1998). Reliance on hospital-based data can be criticised in that only ‘biting dogs’ are considered and the information relating to risks from specific breeds may be inaccurate (Overall and Love, 2001). The study of Messam et al. (2008) used data obtained from clients at veterinary clinics. The questionnaires specifically excluded play bites (although some researches may argue that such bites can cause harm), but included bites that did not break the skin. Since this study included data from ‘non-biters’ and ‘biters’, as well as information relating to minor injuries, it provides potentially valuable clues to help design prevention programmes.

Biosecurity and management practices in different dog breeding systems have considerable margin for improvements

To investigate the current management and biosecurity practices and identify possible differences between different types of breeders, a cross-sectional study was carried out in 102 Belgian dog breeding facilities ranging from small (less than 10 dams on site) to large-scale (more than 50 dams on site or at least 500 puppies sold yearly) breeders. Veterinary prophylactic protocols (ie, vaccination, endoparasite control, ectoparasitic treatments) were highly implemented (91.5 per cent, 92.6 per cent, 42.7 per cent, respectively) across all breeder categories. 13.8 per cent of all visited breeders reported to administer antimicrobials to each female post partum and 10.3 per cent reported to treat all puppies, or at least of one breed, systematically with antimicrobials. Large-scale breeders reported to employ staff more frequently (p<0.01), and appeared to be more familiar with the principles of biosecurity. They reported to apply disinfection (p<0.01) and hygienic measures (p=0.03) across all parts of the facility, and to quarantine newly acquired dogs (p<0.01) more often compared with small-scale breeders. Nonetheless, a moderate knowledge of and use of disinfection was recorded, as was the presence of pet dogs, breaking the compartmentalisation. Results of this study indicate that there is substantial room for improvement in hygiene and disease management across all categories of breeders. The characterisation of different types of dog breeders with respect to biosecurity and management practices is a first step towards improvement of dog husbandry and biosecurity measures. Tailored guidelines should permit breeders to further improve the health of breeding animals and puppies while reducing the risk of infectious disease outbreaks and associated expenses.

Human-directed aggression: are we barking up the wrong tree?

The impact of dog bites on human health has been extensively documented in the literature and risk factor analysis has been very useful in the search for causal mechanisms of dog bite accidents, by identifying human-, dog- and context-related risk factors. In this way, epidemiological studies have contributed to a better understanding of specific triggers of dog bites in a given context (Reisner and others 2007, Gilchrist and others 2008, Rezac and others 2015) and have helped to tailor more adequate prevention strategies; that is, for a household setting and a familiar dog (Meints and De Keuster 2009, Schwebel and others 2012, Dixon and others 2013, Shen and others 2016), or for a human-dog encounter in public places with an unfamiliar dog (Chapman and others 2000, Hornisberger 2015, Lakestani and Donaldson 2015). At the same time, a number of conclusions proved to be a major point of disagreement between studies worldwide, especially those relating to the dog’s characteristics, the dog-owning household, and also to the type of education and training methods used. Even though decades of research have stressed the importance of avoiding interpretation bias in studies (Parrish and others 1959, Overall and Love 2001, Cornelissen and Hopster 2010), the frequent lack of …

Behaviour problems: a brief guide

Behavioural problems may be a reason for presentation by the owner or may be noted during a consultation for another reason. In either event it is important to investigate them. As well as affecting the dog itself, behavioural problems can threaten the human-animal bond, and society itself: a behaviour problem in an otherwise healthy animal may result in rehoming or euthanasia of the dog, social stress for owners, and even injury to third parties. This chapter looks at canine body language, puppy development and behaviour, a clinical approach to behaviour problems and clinical approach to some common presentations.

Re: Mannion CJ, Kanatas A, Telfer MR. One dog bite too far [Br. J. Oral Maxillofac. Surg. 49 (2011) 159, doi:10.1016/j.bjoms.2010.12.008]

As specialists in veterinary behavioural medicine with a ommitment to promote safe, humane interactions between ogs and people, we read with interest the letter by Mannion t al.1 The data cited are for catastrophic bites involving surically attended facial wounds. These are atypical dog bite ounds in adults. Dog bites to young children often result in acial or neck injuries, correlating with age of child, emphaizing the need for oversight.2 The discussed case involved a family dog who had earlier itten this same 28 year old female on the face. Data show hat >60% adults recognize triggers for bites and 90% of dog ites in the home are triggered by an action from the human owards the dog. At the first sign that any dog may bite or injure, advice hould be sought from competent veterinary and medical rofessionals. While the majority of veterinary schools lack pecialist programs in veterinary behavioural medicine, there re sufficient data that allow veterinary surgeons to play a ajor role in dog bite prevention by teaching owners to accuately interpret dog behaviour within the context in which ehaviours occur. Primary and secondary prevention of dog bites requires: