PU520 Unit 10 Child Dog Bite Epidemiologic Profile Example

Bitten at Home by a Dog They Knew: An Epidemiologic Profile of Dog Bite Injuries Among Children Aged 0 to 14 in a Composite County of 310,000, Describing the Burden by Person, Place and Time, Comparing Rates With the State and Ending on Determinants and Data Gaps

[Student Name]

Purdue University Global

PU520: Principles of Epidemiology

Unit 10 Epidemiologic Profile

[Instructor Name]

[Date]

The county, its data and every figure are composite and bracketed for the writer's own data; the national studies cited are real.

Case Definition and Population

Condition: emergency department visits, hospitalizations and deaths among county residents aged 0 to 14 with an external cause code for being bitten or struck by a dog, from the state's emergency department and hospital discharge data and death certificates. Years: the most recent three, pooled to stabilize rates, reported as annual averages. Population: [58,000] children aged 0 to 14.

Burden

Emergency department visits: [412] a year on average, a rate of about [710] per [100,000] children. Hospitalizations: [21] a year. Deaths: none in the three years; [one] in the past decade. For comparison, national surveillance of emergency department visits estimates more than [330,000] dog bite visits a year across all ages in the United States, with about [80] percent occurring at home (Loder, 2019).

Person

Age-specific rates per [100,000] a year: ages 0 to 4, [908]; ages 5 to 9, [788]; ages 10 to 14, [447]. Rates are highest among the youngest children. Boys account for [57] percent of visits. Young children are more often bitten on the head, face or neck, because of their height and how they approach dogs, and children aged four and under are more likely than older children to be admitted (Loder, 2019). The youngest children have the highest rates and the most serious wounds, because their faces are at a dog's height.

Place

Of visits with a recorded location, [78] percent occurred at home: the child's own home or a relative's or friend's. In [69] percent of reports to animal control involving children, the dog belonged to the family or a neighbor. Rates by ZIP code were highest in two lower-income neighborhoods, consistent with a study that found biting dogs more often lived in neighborhoods with lower median incomes (Shuler et al., 2008). The county's rural ZIP codes had rates near the county average.

Time

Visits peak from May through August and on weekends, and most occur in the afternoon and early evening, when children are home from school and outdoors.

Severity and Treatment

Most emergency visits involved puncture wounds and lacerations treated with cleaning, closure and antibiotics, and discharged the same day. The [21] yearly hospitalizations were mostly children under five with facial wounds needing repair under anesthesia, sometimes by a plastic surgeon, and a few older children with infected hand wounds. Rabies post-exposure prophylaxis was started in [6] percent of visits, almost always when the dog could not be identified or observed. Children with facial injuries often need follow-up for scarring, and some develop lasting fear of dogs or symptoms of traumatic stress, consequences that hospital data do not capture.

What Families Described

Interviews with [eight] families whose children were treated for dog bites found a common pattern. Nearly all knew the dog well, often their own or a grandparent's. Several described a child hugging, kissing or reaching for food near the dog moments before the bite. Parents said they had never considered the family dog a risk, and none had received information about dog safety at well-child visits. These accounts support the profile's focus on familiar dogs at home and suggest when and where prevention advice might reach parents.

Trends

Pooled rates for the most recent three years are similar to those for the three years before, so the problem appears stable rather than rising or falling over the period. Emergency visits fell during one pandemic year, when fewer families sought care for minor injuries, then returned to their earlier level.

Comparison With the State

The county's rate for children aged 0 to 14, [710] per [100,000], is above the state's [590]. The difference is concentrated in ages 0 to 4. Because the county's age structure among children is similar to the state's, age adjustment within this age range changes little.

Determinants

Child factors: age and height, unfamiliarity with dog body language and approaching dogs while they eat or sleep. Dog factors: research in one county found biting dogs were more often sexually intact males, and some breed groups were overrepresented, though breed information in reports is often unreliable (Shuler et al., 2008). Household factors: supervision, the presence of a dog in a home with young children and the dog's history of guarding food or toys. Community factors: licensing and spay-neuter access, which may be lower in lower-income neighborhoods, and the availability of affordable veterinary care.

Data Sources and Their Limits

Emergency department and hospital data capture injuries that reached care, but not minor bites treated at home. Animal control reports capture bites reported for rabies follow-up but are incomplete, and they include details, such as the dog's ownership, that hospital data lack. The two systems are not linked, so the profile cannot follow a single bite across both. Breed identification in reports is often guesswork. There are no local data on how many households with young children own dogs, which is the denominator a true risk calculation would need.

Data Gaps a Prevention Program Would Face

Without dog ownership data, the program cannot calculate risk per household with a dog. Without linked data, it cannot tell which bites led to animal control follow-up. Without information on the circumstances of each bite, such as whether an adult was present, it cannot target education precisely. A short standard questionnaire for emergency departments, asking where the bite happened, whose dog it was and what the child was doing, would close part of the gap.

What the Profile Suggests for Prevention

Programs should focus on young children and on familiar dogs at home, not on stray dogs. Education for parents of children under five about supervision and dog behavior, offered at well-child visits, fits the pattern. Expanding affordable spay-neuter and training services in the two neighborhoods with the highest rates would address dog factors.

Conclusion

Dog bites among children in this county are frequent, concentrated among the youngest children and at home, and higher than the state average. The data describe the burden well and the circumstances poorly, which is the first problem a prevention program would need to solve (Celentano & Szklo, 2019).

References

Celentano, D. D., & Szklo, M. (2019). Gordis epidemiology (6th ed.). Elsevier.

Loder, R. T. (2019). The demographics of dog bites in the United States. Heliyon, 5(3), e01360. https://doi.org/10.1016/j.heliyon.2019.e01360

Shuler, C. M., DeBess, E. E., Lapidus, J. A., & Hedberg, K. (2008). Canine and human factors related to dog bite injuries. Journal of the American Veterinary Medical Association, 232(4), 542-546. https://doi.org/10.2460/javma.232.4.542