Pet-associated injuries: the trouble with children's best friends

Children Today, May-June, 1989 by Phillip M. Wishon, Allen Huang

Pet-Associated Injuries: The Trouble with Children's Best Friends

In recent years, there has been considerable interest in the value of animals for human physical, mental, emotional and social health. In addition to the unquestionable instrumental (and intrinsic) value of pet animals, companion animals can also be tools for teaching children important values. As young children watch their parents stroke and cuddle a cat, they learn to be gentle. Give a child a role in caring for the family dog and the child learns responsibility. As children see their parents set rules for the family pet for its own safety, they learn that discipline is really an extension of love and caring.

More than 52 million dogs enjoy cohabitation with Americans. We also own more than 56 million cats, 25 million caged birds, 125 million small mammals and reptiles and over a billion fish--totaling more than 1.2 trillion pet creatures.(1) The importance of the pet-human bond is perhaps best illustrated by the fact that over one-half of all households in the English-speaking world keep them.(2) Notwithstanding the value of human-pet bonding, a sober note to our understanding is advanced in this article, which examines the nature and consequences of pet-associated injuries on children.

Companion Animal Attacks

Injuries from animal attacks--especially animal bites--are a major community health problem in the United States. While many bite injuries are minor, some are serious and a few, fatal. Psychological trauma can also occur. National estimates of animal bites range from 300 to 700 bites per 100,000 population each year.(3) However, since many incidents of animal bites go unreported, the true number of animal bites is certain to be considerably higher than the nearly two million reported annually.

Children five to nine years old are overwhelmingly the primary victims of animal bites: Better than five percent of that age group receive a reported bite every year--more than the combined annual reports of measles, mumps, chicken pox and whooping cough.(4) In other words, although children in this age group comprise less than nine percent of the population, they are the victims of nearly 30 percent of animal bites. Children nine to 14 years old are the group with the next most bites.

Dogs are by far the most common offender in animal bite incidents (approximately 79 to 90 percent of attacks), followed by cats (five to 20 percent), humans (yes, humans are animals, too), and rats. Several breeds of dogs have been reported to have higher bite rates, as well as higher relative risk values, than mixed breed dogs. The collie, German shepherd and cocker spaniel have the highest bite rates, and the sporting and working groups of dogs have higher rates and relative risks when compared with the toy group of dogs.(5) The sporting and working groups are also more likely to inflict more severe injuries. Across all categories of dogs, males and animals under four years are more likely than others to be biters.(6)

In the majority of animal bite cases, the offending animal belongs to the victim, a neighbor or a friend. Most reports of animal bites also indicate that the majority of the incidents occur in or around the victim's home. When closer to their home or when approached, loose pets are more aggressive than unowned strays. The most common behavior associated with being bitten by someone else's dog is simply entering the dog's territory when it is running loose. Nearly half of all bites occur on the street, sidewalk or alley adjacent to the dog owner's property.(7)

It has been noted that from one-third to one-half of dog bite incidents are provoked (whether intentionally or accidentally) by human activity.(8) While deliberate or unintentional provocation--touching a dog's puppies, untangling fighting dogs or even playing with the dog--does sometimes precede bites, this interaction occurs infrequently when compared to just being in the vicinity when the animal decides that its territory needs protecting.

Injuries

While most injuries from animal attacks are not severe, they can become infected, and fatalities do occur. A wide variety of organisms cause a multitude of clinical problems, and more frequently the injury is psychological rather than surgical. Bite wounds consist of lacerations, evulsions, punctures and scratches, and there is a growing awareness of the magnitude of infectious complications from bites.

Dog bites are one of the most common causes of severe facial laceration in children. Nationally, these rates yield approximately 44,000 facial bites sustained by children each year--16,000 of them severe enough to constitute a significant public health problem.(9) Morbidity associated with facial and craniocerebral injuries to small children from dog bites is of special concern. In addition to the facial injuries sustained by children, dogs bite--in the order of frequency--the legs, right arm and other areas of the head.

The potential for infection varies. Although less than five percent of dog bites become infected, up to 50 percent of cat bites do.(10) This increased rate is attributed to difficulty in effectively irrigating the puncture wounds that typically occur from these bites. Generally, animal bites have not been shown to be at high risk for tetanus contamination; very few cases of tetanus associated with animal bites or scratches are reported each year in the United States. However, this may be due in part to the high level of tetanus immunity in the general population.