Global Health Vet – A One Health approach to public health

The scope of the problem

Every dog can bite (Photo source)

Much of the reaction to dog bites have been the implementation of breed-specific legislation with the intent to reduce the number of large dog breeds such as Pit bull-type dogs or Rottweilers (breeds most often targeted by such legislations). While it is logical that bigger dogs can inflict more severe bites, research has shown that such legislations do not address the underlying causes of dog bites – managing and understanding dogs’ behaviors. As it turns out, every dog can bite, and a special report from the Journal of the American Veterinary Medical Association (JAVMA) from 2000 has linked about 30 different dog breeds to about 200 fatal dog attacks between 1979 & 1998. These included Dachshunds, a Yorkshire terrier and a Labrador retriever. The authors further mention that breed-specific legislations do not address the fact that a dog of any breed can become dangerous when trained to be aggressive. Another limitation of such legislations is that identifying dog breeds is not as easy as one may think. In fact, experts can often disagree on what makes up a specific breed and due to extended cross-breeding, DNA testing can yield a myriad of results that does not necessarily reflect the animal it came from, as shown by this study. For example, some of the most commonly targeted dogs include “Pit bulls”. As it turns out, “Pit bull” does not officially refer to a breed but rather a loose description of characteristics that a dog may have, which is why the official term is: “Pit bull-type breed”.

Breed-specific legislation do not address the underlying issues of dog aggression – mismanagement of dogs behaviors. This dog is a former victim of dog fighting. (Photo source)

In fact, the 2001 AVMA’s Canine Aggression Task Force warns that isolating and targeting a few breeds deemed dangerous can lead to a false sense of accomplishment when it comes to reducing severe dog bites, because it does not address the reasons behind dog aggression. Other experts such as the American Humane Association argue that breed-specific legislations are difficult and costly to enforce and can have unintended consequences such as black-market or indiscriminant breeding of affected dogs (after all, breeds most involved in bites are the most popular ones). So what should we do to reduce dog bites to people? In order to provide an appropriate alternative to breed-specific legislation, let’s take a closer look at the problem.

The situation in the USA

The first piece of data to consider is that the United States, as of 2001, is the country with the most pet dogs/people, with 53 million pet dogs nationally. This creates an environment where there is a high rate of contact between people and dogs, which can be a risk factor for being bitten.

In fact, the CDC reports that about 4.5 million Americans are bitten every year, and 1/5^th of these injuries require medical attention. These numbers reflect the scope of the problem in the countries like the USA. However, in order to properly address this issue, it is important to look at the populations at risk. Is everyone equally affected by dog bites or are there specific groups that public health officials need to focus their attention on? A closer analysis of the problem shows that half of bite victims are children under 12 years old. Another group particularly at risk is the elderly, specifically those 70 years old and over; even if they represent only 10% of those bitten, almost a 4^th of these bites can be fatal.

Kids are at higher risk of being bitten by dogs. Proper dog training and monitoring children’s interaction with dogs is essential to prevent bites. (Photo source)

Another important variable to look at is the background of the bite itself. It is indeed interesting to see in the previously mentioned JAVMA study that 58% of the people involved were bitten by an unrestrained dog in their own property.  What stands out from this study is that a great majority (75%) of dog bites were done by dogs that victims knew and inside their owner’s homes. Finally, the cost of dealing with dog bites can be significantly high, and the insurance industry in the USA has paid more than $ 1 billion in dog-bite claims annually.

Furthermore, bite statistics also show that the great majority of dogs involved in fatal attacks were males (about 92%), of which 94% were intact (not neutered). This suggests an important behavioral component that relates adult intact male dogs to the tendency of biting.

Los Angeles County is a county of about 10 million residents, there is a high rate of interaction between people and dogs. In fact, dog bites to people have increased between 2006 and 2009 in one report and LA County is one of the US’ top locations for dog bites. This is why bites are one of the main focus area of the 2020 Healthy Pets Healthy Families initiative (Stay tuned! – I will talk about this program and my involvement with it in further detail in an upcoming post).

This work consists of managing bite reports sent by bite victims or clinicians, which serves several purposes. The 1^st reason why it’s crucial to report all dog bites to local Department of Public Health is to get a better understanding of the issue in the county. As I’ve mentioned previously, dog bites in LA County have increased. Does this mean that more dogs are biting people or that more people are reporting bites? Only with the most complete data can officials truly understand the scope of the issue and focus their attention on specific groups or areas that are at higher risk.

The 2^nd reason why reporting bites is crucial is for rabies prevention. The veterinary staff at VPH puts a lot of effort in following through on each bite report to make sure the animal is properly quarantined and monitors if there are any signs of the disease. While rabies in dogs has become very rare in LA county, the severity of the disease warrants extreme precautionary measures to make sure people are not exposed (For more information about rabies, check out my previous post).

Recommendations

If breed-specific legislation show mixed results in protecting people from dog bites, what are actual recommendations that can help address the problem? Looking beyond such legislation, the most significant factor to look at is addressing behavioral factors…of the dog but most importantly people. Indeed, it is the belief of many experts that many bites occur from our lack of understanding of dog behavior, especially fear, and our inability to recognize warning signs that a dog is about to bite.

This dog exhibits typical fear behavior and may bite if approached. (Photo source)

There are many recommendations on how to avoid dog bites, but most of them revolve around a couple of main themes: being aware of the dog’s language and appropriate dog training and ownership.

Teaching pets submissive behaviors like rolling over are great ways to establish the owner as dominant and reduce dog aggressivity. (Photo source)

Such recommendations include:

–          Consult a veterinarian or professional before getting a dog – Many dogs have different personalities or needs. For example, a dog with a lot of energy can become frustrated and have unpredictable behavior if that need is not met. For these dogs, frequent exercise or outdoor activities is recommended.

–          Socialize & don’t abuse pets – Owners that don’t train their dog are not in control when a risky situation arises. Also, puppies who engage in “play bite” can grow up to become biters as they have not been taught otherwise. Furthermore, a dog that is abused will be afraid and this fear of people will translate into aggression.

Puppies often engage in play-biting. However, it is the owner’s responsibility to properly suppress such behaviors as the dog gets older (Photo source).

–          Supervise children when around dogs – As previously mentioned, children are highly affected by dog bites. Kids should be taught appropriate petting behaviors and be monitored during interactions with dogs.

–          Remain calm around an unfamiliar dog – Running away or trying to challenge an unknown dog can cause the dog to attack.

–          Do not try to touch a dog when it’s eating, sleeping or looks injured – Many dogs will feel threatened by people approaching them if they are injured. It’s not aggression; the dog is simply scared and trying to protect itself.

–          Spay/neuter dogs – As demonstrated by the figures above, a large number of fatal bites were inflicted by intact male dogs. These dogs have higher levels of testosterone and are more prone to dominant behaviors such as aggression. Likewise, intact females can attract roaming male dogs and may also bite when protecting their young.

Note: Impact in developing countries

The situation in developing countries is somewhat different and the threat of rabies is still very present. In fact, two of the most recent rabies fatalities (as of this post’s publication date) came from individuals exposed to rabid dogs in India and the Philippines. However a dog bite can be fatal in other ways, as not everyone in developing countries have access to appropriate medical facilities where bites can be treated aggressively. In this context, additional focus should be on stray dog spay/neuter & vaccination programs.

Stray dog in Peru.

For more information & recommendations on dog bites:

American Humane Association – KIDS: Kids Interacting with Dogs Safely

American Veterinary Medical Association – Dog Bite Prevention

Los Angeles County Departmen of Public Health, Veterinary Public Health – Dog bite Prevention

National Canine Research Council – Breed and Behavior

Veterinary Partner – Defensive Dog Behavior, Child Safety with Dogs,

Voelker R. 1997. Dog bites recognized as public health concern. Journal of the American Medical Association. Volume 277, Issue 4, pp.278-280.