The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Original Article

When the Dog Bites: A 5-Year Retrospective on Canine Bite Encounters

Authors: Sara Elisabeth Rowell, BS, Michele Nichols, MD, Charli Cohen, MD, William King, MPH, RPh, DrPH, Jennifer McCain, MD, Kathy Monroe, MD, MSQI

Abstract

Objectives: This study addresses two objectives: to describe the epidemiology of dog bite-related emergency department (ED) visits and to evaluate changes in the rate of dog bite visits from 2019 to 2023.

Methods: Dog bite visit data from the Children's Injury Database were analyzed. Descriptive statistical and epidemiologic analyses were conducted using Epi Info 7 version 7.2.4.0. ED visits cases containing code W54, "bitten by dog," were retrieved and reviewed for inclusion.

Results: Between 2019 and 2023, our ED treated 1403 dog bite-related visits. There were 1252 initial visits and 151 return visits for follow-up care related to the same injury. Even though there were 34% fewer visits in 2020 than in 2019, the rate of dog bite injury visits increased by 70%. Nearly 12% (n = 165) of patients required admission, and the median length of stay for these patients was 40 hours. Injuries occurred to the head/neck/face (64%, n = 805). Patients were most often male (57%, n = 711), with an average age of 6.5 years old. Dog breeds were identified in 43% (n = 596) of cases.

Conclusions: Dog bites are commonly seen in a pediatric ED, with 12% of patients with this type of injury requiring admission. Frequently consulted specialties included facial surgery services and ophthalmology. Primary care physicians and parents share a crucial role in reducing this type of injury.

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References

1. McGuire C, Morzycki A, Simpson A, et al. Dog Bites in Children: A Descriptive Analysis. Plast Surg 2018;26:256-262.
2. Beck AM, Jones BA. Unreported Dog Bites in Children. Public Health Rep 1985;100:315-321.
3. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. WISQARS cost of injury. Number of injuries and associated costs. https://wisqars.cdc.gov/cost/?y=2023&o=TAR&i=0&m=3000&g=00&s=0&u=TOTAL&u=+AVG&t=COMBO&t=MED&t=LIFE&t=WORK&a=custom&g1=0&g2=199&a1=0&a2=18&r2=INTENT&r3=NONE&r4=NONE&c1=NONE&c2=NONE. Accessed January 20, 2025.
4. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. WISQARS cost of injury. Number of injuries and associated costs https://wisqars.cdc.gov/cost/?y=2023&o=HOSP&i=0&m=3000&g=00&s=0&u=TOTAL&u=AVG&t=COMBO&t=MED&t=LIFE&t=WORK&a=5Yr&g1=0&g2=199&a1=0&a2=199&r1=MECH&r2=INTENT&r3=NONE&r4=NONE. Accessed January 20, 2025.
5. Abraham JT, Czerwinski M. Pediatric Dog Bite Injuries in Central Texas. J Pediatr Surg 2019;54:1416-1420.
6. Dixon CA, Mistry RD. Dog Bites in Children Surge during Coronavirus Disease-2019: A Case for Enhanced Prevention. J Pediatr 2020;225:231-232.
7. American Veterinary Medical Association. Pet population continues to increase while pet spending declines https://www.avma.org/news/pet-population-continues-increase-while-pet-spending-declines. Accessed February 1, 2025.
8. Kohn MA, Senyak J. Sample Size Calculators. https://sample-size.net/confidence-interval-proportion. Accessed August 11, 2025.
9. Menk PT, Mahabee-Gittens EM, Ruest S, et al. Pediatric Dog Bite Injury Trends During the COVID-19 Pandemic. Pediatr Emerg Care 2025;41:509-513.
10. Plana NM, Kalmar CL, Cheung L, et al. Pediatric Dog Bite Injuries: A 5-Year Nationwide Study and Implications of the COVID-19 Pandemic. J Craniofac Surg 2022;33:1436-1440.
11. Royal Kennel Club. The COVID-19 puppy boom-one in four admit impulse buying a pandemic puppy. https://www.royalkennelclub.com/about-us/resources/media-centre/2020/august/the-covid-19-puppy-boom-one-in-four-admit-impulse-buying-a-pandemic-puppy/. Published August 17, 2020. Accessed February 1, 2025.
12. Schalamon J, Ainoedhofer H, Singer G, et al. Analysis of Dog Bites in Children Who Are Younger Than 17 Years. Pediatrics 2006;117:374-379.
13. Boyd LC, Chang J, Ajmera S, et al. Pediatric Dog Bites: A Review of 1422 Cases Treated at a Level One Regional Pediatric Trauma Center. J Craniofac Surg 2022;33:1118-1121.
14. Means O, Fernstrum C, Lucich E, et al. Management of Dog Bite Injuries Procedural Sedation, Infection, and Operative Indications at a Single-Institution Level 1 Pediatric Trauma Hospital. Ann Plast Surg 2023;90:71-75.
15. Kaye AE, Belz JM, Kirschner RE. Pediatric Dog Bite Injuries: A 5-Year Review of the Experience at The Children’ Hospital of Philadelphia. Plast Reconstr Surg 2009;124:551-558.
16. McLoughlin RJ, Cournoyer L, Hirsh MP, et al. Hospitalizations for pediatric dog bite injuries in the United States. J Pediatr Surg 2020;55:1228-1233.
17. Patterson KN, Beckmeyer A, Bourgeois T, et al. Legal epidemiology of paediatric dog bite injuries. Inj Prev 2023;29:142-149.
18. Fein J, Bogumil D, Upperman JS, et al. Pediatric dog bites: a population-based profile. Inj Prev 2019;25:290-294.
19. US Census Bureau. US Census Bureau QuickFacts-Jefferson County, Alabama
20. Bishai D, McCauley J, Trifiletti LB, et al. The Burden of Injury in Preschool Children in an Urban Medicaid Managed Care Organization. Ambul Pediatr 2002;2:279-283.
21. Santor LJ, Stocking CB. Safety practices and living conditions of low-income urban families. Pediatrics 1991;88:1112-1118.
22. Shen J, Rouse J, Manasvee G, et al. Systematic Review: Interventions to Educate Children About Dog Safety and Prevent Pediatric Dog-Bite Injuries: A Meta-Analytic Review. J Pediatr Psychol 2017;42:779-791.
23. Jakeman M, Oxley JA, Owczarczak-Garstecka SC, et al. Pet dog bites in children: management and prevention. BMJ Paediatr Open 2020;4:1-8.
24. Patterson KN, Horvath KZ, Minneci PC, et al. Pediatric dog bite injuries in the USA: a systematic review. World J Pediatr Surg 2022;5:1-8.
25. Dixon CA, Mahabee-Gittens EM, Hard KW, et al. Dog Bite Prevention: An Assessment of Child Knowledge. J Pediatr 2012;60:337-341.
26. Duncan-Sutherland N, Lissaman AC, Shepherd M. Systematic review of dog bite prevention strategies. Inj Prev 2022;28:288-297.
27. American Academy of Pediatrics. Tips for Choosing the Right Pet for Your Family https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Before-Choosing-a-Pet.aspx. Accessed August 1, 2025.
28. Peters V, Sottiaux M, Appelboom J, et al. Posttraumatic stress disorder after dog bites in children. J Pediatr 2004;144:121-122.
29. Boat BW, Dixon CA, Pearl E, et al. Pediatric Dog Bite Victims: A Need for a Continuum of Care. Clin Pediatr 2012;51:473-477.