"Dog bites man" is news-how pediatricians can spread the word to parents and patients

DR. MELNICK is professor of pediatrics at the Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale, Fla. He recently retired as executive vice chancellor and provost of the NSU Health Professions Division. He has nothing to disclose in regard to affiliations with, or financial interests in, any organization that may have an interest in any part of this article.

Before you begin reading, take a moment for this preliminary self-assessment:

They say it's news when man bites dog. That also means that dog biting man is so common it's not news. But how common is it? And how important is this problem for pediatricians?

Children are the most frequent victims. Of those bitten, twice as many children (26%) require medical care for their bites than do adults (12%). And most of those who die from bites-17 people, on average, each year-are children.²

Although cats and other animals also bite, the magnitude of the problem is not as great, nor is the expense. The estimated annual cost to the insurance industry of the dog-bite problem is about $2 billion.³ Of concern is that, even though the number of dogs in the US has increased by only 2% in the past decade, the number of dog bites has increased by 33%.² The reason for this disproportionate increase is unclear.

Despite the statistics on dog bites, few people-pediatricians included-are aware of the scope of the problem, or the fact that dog bites are among the most frequent causes of injury to children. Becoming informed about dog-related injuries is the first step toward educating families and preventing children from being bitten.

Owning a dog: rewards and risks

By one estimate, 68 million dogs are household pets in the US.⁵ That means millions of children (and adults) are happy with the companionship, friendliness, playfulness, love, and security of dogs. The National Center for Infectious Diseases notes that pets have physical as well as psychological benefits: They can decrease an owner's blood pressure, cholesterol level, triglyceride level, and feelings of loneliness.⁶ At the same time, they provide an opportunity for exercise and outdoor activity and the chance for socialization. And, the fact is, most dogs never bite.

The advantages of pet ownership make it difficult to convince satisfied dogs owners-parents, children, and physicians-that preventive measures are extremely important. Yes, dogs are great pets. Yes, dogs are potential dangers. We must live with both aspects of companion dogs-with conscious understanding and alertness.

Which children get bitten most?

More than half of all dog bite victims are children younger than 14 years. The rate of dog bites is highest among children 5 to 9 years old, followed closely by children from birth to 4 years of age and those between ages 9 and 14.⁷ From age 14 on, the rate of bites decreases rapidly.⁷ More boys are bitten than girls, although this gender difference disappears after age 14.

And where on the body?