AN ANALYSIS OF THE CHALLENGES AND POSSIBLE SOLUTIONS FOR DOG BITE INJURY SURVEILLANCE

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1 AN ANALYSIS OF THE CHALLENGES AND POSSIBLE SOLUTIONS FOR DOG BITE INJURY SURVEILLANCE Felicia Trembath, MPH International Society for Disease Surveillance Conference December 10, 2014

2 Background In the US, there are approximately 4.7 million dog bites per year 1 Dog bites: are the third leading cause of homeowner insurance claims 2 cost insurance industry at least 489 million dollars annually 2 have total societal costs upwards of 2 billion dollars 3

3 Challenges True impact remains unknown Discrepancies between data sources 4 e.g. hospital discharge data versus bite report forms Many bites go unreported 5

4 Importance Despite public health improvement in other areas of trauma, the number of dog bites has remained fairly constant over the last 20 years 6 However: medically attended dog bite injuries increased 36% between 1986 and hospitalizations due to dog bite injuries increased 86% between 1993 and Number of dog bite related fatalities has risen 966.7% between 1993 and 2013 Majority of bites are to children 9 majority of those effect the facial area 10

5 Study Objective Look further upstream to identify challenges in surveillance and data analysis for dog bite injuries

6 Methods Identify and research: data sources victim types Create a conceptual map of data sources and victim types Overlay the two to identify areas where surveillance fails, as well as where discrepancies occur in data sources

7 Results Data sources National Electronic Injury Surveillance System (NEISS) Hospital discharge Hospital records Insurance claims Bite data collected by local jurisdictions (animal control) Victim types Fatalities Seek medical care at hospital in outpatient setting Don t seek medical care Tribal resident Observational studies United States Post Office Death certificates

8 Conceptual Map of Sources for Dog Bite Data

9 Conceptual Map of Dog Bite Victims

10 Conclusions Hospital data considered gold standard for research fails to capture: some fatalities cases treated at urgent care or physicians offices cases not seeking medical care Current surveillance methods: miss many cases unable to compare data from different sources

11 Future Considerations Adoption of a nationwide standardized dog bite report form standardized dog bite trauma scale Develop Regional or National repositories for dog bite data Inclusion of dog bite injuries in current or developing disease surveillance systems

12 References 1. Centers for Disease Control and Prevention (CDC). Nonfatal dog bite-related injuries treated in hospital emergency departments United States, MMWR Morb Mortal Wkly Rep Jul 4;52(26): Insurance Information Institute. Average Number of Dog Bite Claims Falls in 2012; Claims Costs Still on the Rise. Press Release. [Internet] May 21 [cited 2014 Sept 9]. Available from: 3. Voelker R. Dog bites recognized as public health problem. JAMA (4): Lindsay, SR. Handbook of Applied Dog Behaviour and Training Vol 1, Adaptation and learning. Ames, Iowa: Iowa State University; p. 5. Beck, AM., Jones BA. Unreported dog bites in children. Public Health Rep May-Jun;100(3): Gilchrist J, Sacks JJ, White D, Kresnow MJ. Dog bites: still a problem? Inj Prev (5): Weiss HB, Friedman D, Coben JH. Incidence of dog bite injuries treated in emergency departments. JAMA : Holmquist, L, Elixhauser, A. Emergency department visits and inpatient stays involving dog bites, Agency for Healthcare Research and Quality 2010 November. 9. Shuler CM, DeBess EE, Lapidus JA, Hedberg K. Canine and human factors related to dog bite injuries. J Am Vet Med Assoc (4): Islam S, Ansell M, Mellor TK, Hoffman GR. A prospective study into the demographics and treatment of paediatric facial lacerations. Pediatr Surg Int (10):

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