Epidemiology of hospitalizations due to dog bite injuries in Israel, 2009-2016

Injury. 2018 Dec;49(12):2167-2173. doi: 10.1016/j.injury.2018.09.058. Epub 2018 Oct 3.


Background: Dog bites are a substantial public health concern. Rarely has hospitalizations resulting from dog bites been examined. We examined, at a national level, demographic and injury characteristics of dog-bites injuries requiring hospitalization to target prevention programs and policies for those who are at higher risk.

Methods: Data on hospitalizations due to dog-bite injuries with an ICD9-CM E906.0 coding were extracted from the Israeli National Trauma Registry between 2009-2016. We calculated the annual incidence of hospitalized dog-bite injuries and compared rates by Chi-squared test. Mantel Haenszel chi-squared test and Dickey-Fuller time-series analysis were used to test linear age and temporal trends, respectively.

Results: Overall 986 persons were hospitalized for dog-bite injuries between 2009-2016. An increasing significant trend over the 8-year-period in the proportion of hospitalized dog-bite injuries among all trauma hospitalizations was revealed among children between 0 and 14 years old (p = 0.01). Children had also approximately twice the risk for dog-bite injuries compared to persons aged between 15 and 94 years old (relative risk [RR] = 1.89, 95% confidence interval [CI] = 1.35-2.66, p < 0.0001); the 2016 (latest year) rate per 100,000 was significantly higher for boys than for girls (RR = 2.85, 95%CI = 1.57-5.19, p < 0.0001); no gender differences were detected in the other age groups. Injury in the face/head/neck was most common in children between 0 and 14 years old (49.7%), specifically among the youngers (<1, 1-3 and 4-5 year olds) compared with the 6-11 and 12-14 age groups (p < 0.0001), with 4-fold-risk compared with persons aged between 15 and 94 years old (RR = 3.78, 95%CI, 3.01-4.75). There was no overall significant temporal trend in the annual incidence rates (from 1.84 (95%CI = 1.54-2.15) in 2009 to 1.54 (95%CI = 1.28-1.81) in 2016 per 100,000 population.

Conclusions: Children younger than 15 years, with greater extent in boys than girls, represent the high-risk demographic group for dog bites. Prevention programs targeting at this group should be implemented and translated into an actual reduction in the incidence of dog-bites. In addition, an ongoing monitoring and reporting system specific for all dog-bites should be established in Israel, in order to better understand how to minimize the incidence of dog-bites and evaluate prevention efforts.

Keywords: Dog bite incidence in Israel; Dog bite injury; Epidemiology; Hospitalizations from dog bites; Prevention; Public health; Trauma injuries.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Bites and Stings / epidemiology*
  • Bites and Stings / prevention & control
  • Bites and Stings / therapy
  • Child
  • Child, Preschool
  • Dogs
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Incidence
  • Infant
  • Israel
  • Male
  • Middle Aged
  • Population Surveillance
  • Public Health*
  • Registries
  • Retrospective Studies
  • Young Adult