Dog Bite Causes

Dogs are a part of life. Millions of people have dogs as pets, but no matter how small and cute they are, under certain conditions, they could hurt you. Even the nicest, most well-trained family dog may snap if it's startled, scared, threatened, agitated, angry, or hungry. You can respect a dog by giving it space and following certain rules. These rules not only keep your dog happier, they can protect your child from getting bit. Dog attacks are a major public health concern worldwide. Dogs bite over 4 million people a year resulting in the hospitalization of 6000 to 13000 people each year in the United States. 1,2

According to Larry Schmitt, author of "Injuries from dog bites", a child attacked by a dog and bitten above the shoulders is equivalent to an unarmed adult sustaining a bear bite. Findings suggest that eleven percent of the children reported prolonged emotional distress, including nightmares and subsequent augmented fear of dogs. Many of these children unnecessarily experience prolonged emotional distress in silence. Some reasons for this are that the child does not want to upset the parent; the parent exhibits emotion (anxiety, guilt) that the child observes whenever the attack is mentioned; and for boys, in particular, speaking about these fears is often considered unmanly, thus reinforcing the silent suffering. 5

Certain breeds are more aggressive than others. Male and unneutered dogs more likely to be aggressive compared with female and neutered dogs. In several countries, certain dog breeds are considered "fighting dogs" and are subject to legal regulations. In Germany, these breeds include mastiff, bull mastiff, bulldog, bull terrier, Tosa-Inu, and others. However, every breed poses the threat of dog bites; any dog may attack, even smaller dogs such as Jack Russell terriers inflict severe bites. 4,7 A CDC study on fatal dog bites lists the breeds involved in fatal attacks over 20 years - Breeds of dogs involved in fatal human attacks in the United States between 1979 and 1998.



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Severe dog bites in children occur most frequently in those younger than 5 years old and involve the head and neck. Large dogs that are familiar to the child are usually involved. Young children should be closely supervised when around any dog. 6

Dogs rarely, if ever, bite without reason, it is just that they see the world differently to us. What might seem innocuous or friendly to us might be seen as potentially threatening or intimidating to another which uses a different communication system.

It is important

  • not to leave child under 5 years of age alone with a dog
  • to teach your child not to tease a dog
  • to pet a dog only when the owner says it's all right
  • not to get between or try to separate dogs that are fighting
  • to be careful when feeding a dog by hand
  • to pet a dog without at first letting it sniff you
  • not to disturb a dog that is caring for puppies.

Remember: the highest rate of serious injury from dog bite is to children under 5 years of age.

Fatal Dog Attacks

Although statistically, fatal dog attacks are very rare, no loss of life should be trivialized. The root causes of fatal dog attacks has been fairly well established:

  • unsterilized dogs were involved in 97 percent of fatal attacks
  • reckless owners who abused, neglected, chained, and/or failed to properly supervise their dogs in 84 percent
  • guard dogs, yard dogs or fighting dogs in 87 percent 2

A European study described 20 fatal dog attacks in a 10-year period in Germany, Switzerland, and Austria. Half of the victims were children younger than 8 years old (median: 2 years, 7 months). Death was caused either by multiple trauma or by injuries to the head and neck.4

Causes of Dog Bites

A research team analyzed the circumstances surrounding 111 cases of dog bites involving 103 dogs over a period of 4 years. All 103 dogs involved had bitten children. Findings indicate that food guarding was the most circumstance involving children familiar to the dog; territory guarding was the most common involving children unknown to the dog. 2

In addition to well-known situations such as disturbing a dog while eating or pulling its tail, running or cycling past the dog without direct contact provoked several attacks. Small dogs attacked small children significantly more frequently than older children, presumably because small dogs are more likely to feel superior to little children. 4

Dog Bite Related Infections

Dog bite related infections are polymicrobial, predominantly Pasteurella and Bacteroides bacteria. Infected bites presenting less than 12 hours after injury are particularly likely to be infected with Pasteurella bacteria, whereas those presenting more than 24 hours after the event are likely to be predominantly infected with staphylococci or other bacteria.


Factors That Increase Risk of Infection

Patient factors

  • Alcoholism (increased susceptibility to Pasteurella infection). Pasteurella is present in >50% of dog bites that cause infection with severe consequences. It is associated with a mortality of 30% in blood poisoning cases. Infection with Pasteurella is likely to result in joint damage in hand bites especially, and may lead to irreparable damage and amputation. 7
  • Cirrhosis (liver damage)
  • Steroid therapy, rheumatoid arthritis, diabetes mellitus, and lymphoedema after radiotherapy (all increase risk of Pasteurella infection).

High Risk Patients (conditions)

  • Diabetes mellitus
  • Immunosuppression (people with transplanted organs)
  • Postmastectomy
  • Rheumatoid arthritis and prosthetic joints

References:

  1. Human Fatalities Resulting From Dog Attacks in the United States, 1979-2005. Ricky L. Langley, Division of Public Health, Raleigh, NC
  2. Joan Schaffner. A lawyer's guide to dangerous dog issues
  3. Dog bite and injury prevention-analysis, critical review, and research agenda
  4. Johannes Schalamon, MD, Herwig Ainoedhofer, Georg Singer, MD, Thomas Petnehazy, MD, Johannes Mayr, MD, PhD, Katalin Kiss, MD, Michael E. Höllwarth, MD, PhD. Analysis of Dog Bites in Children Who Are Younger Than 17 Years
  5. Schmitt RL. Injuries from dog bites. JAMA. 1998;279 :1174
  6. Thomas V. Brogan MD1, Susan L. Bratton MD, M. Denise Dowd MD, Mary A. Hegenbarth MD Severe Dog Bites in Children



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