Downloaded from http://veterinaryrecord.bmj.com/ on June 9, 2015 - Published by group.bmj.com
Gazette Letters
Letters
One Health approach to dog bite prevention WE read with interest the recent Comment in Veterinary Record discussing ways in which the medical and veterinary professions could collaborate more ‘for everyone’s benefit’ (VR, January 25, 2014, vol 174, p 78). With recent Hospital Episode Statistics (HSCIS) showing a 550 per cent increase in the number of hospital admissions from 1989 to 2013 related to dog bites and dog strikes
(HSCIS 2013) and an estimated annual cost to the health service of £10 million (Anon 2013), we feel this is a subject that requires urgent attention and would benefit from a coming together of the two professions, and more. In a recent review of dog bite injuries (DBIs), seen over the course of one year at a tertiary referral hospital in the Yorkshire and Humber region, 626 patients presented (Mannion and Mills 2013). The results are summarised in Fig 1. Not only are the total numbers alarming, but so are the numbers of patients in the differing age group categories, especially children. The figure indicates a stark contrast between the differing age categories and the bite location. This raises interesting questions from a biological and psychological perspective about the point of view (and concurrent actions) of patient and ‘biter’. The sheer volume of these injuries will paint a familiar picture to any surgeon or accident and emergency doctor working in any hospital in the country. The massive scale of this problem requires both professions to act. Vets and medics should work together in a concerted attempt to develop educational programmes aimed at dog owners, schoolaged children, their parents and the wider adult population. As the majority of dog bite incidents are evidence of canine distress, however momentary, then creating and maintaining canine behavioural health must be taken seriously by the veterinary profession, in order to fully apply the One Health concept. A coordinated use of the media, highlighting prevention strategies
FIG 1: Total number of dog bite injuries attending a tertiary referral hospital in 2011-2012
February 8, 2014 | Veterinary Record | 151
Downloaded from http://veterinaryrecord.bmj.com/ on June 9, 2015 - Published by group.bmj.com
Gazette Letters and awareness of the signs of dog aggression and canine behavioural problems, should be undertaken; it should also provide advice on how to seek help and support. Professional cooperation and ‘joined up’ thinking must also address what happens after the injury, particularly in view of the finding/observation by one of us (CJM) that the same patient may attend with similar dog-related injuries on more than one occasion (Mannion and others 2011, De Keuster and Overall 2011). Designated veterinary specialists with a knowledge and interest in bite injuries and canine behaviour (Shepherd 2013) could be notified of any DBI presenting through the medical system for a particular county or region. Detailed analysis of the animal (ie, age, conformation of breed, medical and training history, etc), the specific details relating to the bite incident, and possible future requirements that might help both human and canine parties could be addressed and the data stored on a national database. Any further specialised aftercare could then be coordinated through this pathway with access to follow-up services being made available. This is a similar model to that used for safeguarding children in accident and emergency departments, where notification of protection agencies may occur. There can be no complacency in addressing this important area. Only with a truly preventive attitude towards bite injuries can we deliver significant rewards through a reduction of numbers and, in these austere times, marked financial savings for the NHS. We believe that collaboration is the key to this problem. Christopher James Mannion, Consultant Maxillofacial Surgeon, Leeds Teaching Hospitals NHS Trust, Leeds Dental Institute, Leeds, West Yorkshire LS2 9LU Kendal Shepherd, Veterinary Surgeon and Animal Behaviourist, 16 Church Street, Finedon, Wellingborough, Northamptonshire NN9 5NA e-mail: [email protected]
References
ANON (2013) Responsible Dog Ownership. www. publications.parliament.uk/pa/cm201213/cmhansrd/ cm130226/halltext/130226h0001.htm. Accessed February 3, 2014 DE KEUSTER, T. & OVERALL, K. L. (2011) Preventing dog bite injuries: the need for a collaborative approach. Veterinary Record 169, 341-342 HSCIS (2013) Provisional Monthly Hospital Episode Statistics for Admitted Patient Care, Outpatients and Accident and Emergency Data: April 2013 to May 2013. www.hscic.gov.uk/catalogue/PUB11550. Accessed February 3, 2014 MANNION, C. J., KANATAS, A. & TELFER, M. R. (2011) Preventing dog bite wounds in people. Veterinary Record 168, 594 MANNION, C. J. & MILLS, D. S. (2013) Injuries sustained by dog bites. British Journal of Oral and Maxillofacial Surgery 1, 368-369 SHEPHERD, K. (2013) Teaching dog owners new tricks. Veterinary Record 172, 583-584
doi: 10.1136/vr.g1371 152 | Veterinary Record | February 8, 2014
Downloaded from http://veterinaryrecord.bmj.com/ on June 9, 2015 - Published by group.bmj.com
One Health approach to dog bite prevention Christopher James Mannion and Kendal Shepherd Veterinary Record 2014 174: 151-152
doi: 10.1136/vr.g1371 Updated information and services can be found at: http://veterinaryrecord.bmj.com/content/174/6/151.2
These include:
References Email alerting service
This article cites 4 articles, 3 of which you can access for free at: http://veterinaryrecord.bmj.com/content/174/6/151.2#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
Gazette Letters
Letters
One Health approach to dog bite prevention WE read with interest the recent Comment in Veterinary Record discussing ways in which the medical and veterinary professions could collaborate more ‘for everyone’s benefit’ (VR, January 25, 2014, vol 174, p 78). With recent Hospital Episode Statistics (HSCIS) showing a 550 per cent increase in the number of hospital admissions from 1989 to 2013 related to dog bites and dog strikes
(HSCIS 2013) and an estimated annual cost to the health service of £10 million (Anon 2013), we feel this is a subject that requires urgent attention and would benefit from a coming together of the two professions, and more. In a recent review of dog bite injuries (DBIs), seen over the course of one year at a tertiary referral hospital in the Yorkshire and Humber region, 626 patients presented (Mannion and Mills 2013). The results are summarised in Fig 1. Not only are the total numbers alarming, but so are the numbers of patients in the differing age group categories, especially children. The figure indicates a stark contrast between the differing age categories and the bite location. This raises interesting questions from a biological and psychological perspective about the point of view (and concurrent actions) of patient and ‘biter’. The sheer volume of these injuries will paint a familiar picture to any surgeon or accident and emergency doctor working in any hospital in the country. The massive scale of this problem requires both professions to act. Vets and medics should work together in a concerted attempt to develop educational programmes aimed at dog owners, schoolaged children, their parents and the wider adult population. As the majority of dog bite incidents are evidence of canine distress, however momentary, then creating and maintaining canine behavioural health must be taken seriously by the veterinary profession, in order to fully apply the One Health concept. A coordinated use of the media, highlighting prevention strategies
FIG 1: Total number of dog bite injuries attending a tertiary referral hospital in 2011-2012
February 8, 2014 | Veterinary Record | 151
Downloaded from http://veterinaryrecord.bmj.com/ on June 9, 2015 - Published by group.bmj.com
Gazette Letters and awareness of the signs of dog aggression and canine behavioural problems, should be undertaken; it should also provide advice on how to seek help and support. Professional cooperation and ‘joined up’ thinking must also address what happens after the injury, particularly in view of the finding/observation by one of us (CJM) that the same patient may attend with similar dog-related injuries on more than one occasion (Mannion and others 2011, De Keuster and Overall 2011). Designated veterinary specialists with a knowledge and interest in bite injuries and canine behaviour (Shepherd 2013) could be notified of any DBI presenting through the medical system for a particular county or region. Detailed analysis of the animal (ie, age, conformation of breed, medical and training history, etc), the specific details relating to the bite incident, and possible future requirements that might help both human and canine parties could be addressed and the data stored on a national database. Any further specialised aftercare could then be coordinated through this pathway with access to follow-up services being made available. This is a similar model to that used for safeguarding children in accident and emergency departments, where notification of protection agencies may occur. There can be no complacency in addressing this important area. Only with a truly preventive attitude towards bite injuries can we deliver significant rewards through a reduction of numbers and, in these austere times, marked financial savings for the NHS. We believe that collaboration is the key to this problem. Christopher James Mannion, Consultant Maxillofacial Surgeon, Leeds Teaching Hospitals NHS Trust, Leeds Dental Institute, Leeds, West Yorkshire LS2 9LU Kendal Shepherd, Veterinary Surgeon and Animal Behaviourist, 16 Church Street, Finedon, Wellingborough, Northamptonshire NN9 5NA e-mail: [email protected]
References
ANON (2013) Responsible Dog Ownership. www. publications.parliament.uk/pa/cm201213/cmhansrd/ cm130226/halltext/130226h0001.htm. Accessed February 3, 2014 DE KEUSTER, T. & OVERALL, K. L. (2011) Preventing dog bite injuries: the need for a collaborative approach. Veterinary Record 169, 341-342 HSCIS (2013) Provisional Monthly Hospital Episode Statistics for Admitted Patient Care, Outpatients and Accident and Emergency Data: April 2013 to May 2013. www.hscic.gov.uk/catalogue/PUB11550. Accessed February 3, 2014 MANNION, C. J., KANATAS, A. & TELFER, M. R. (2011) Preventing dog bite wounds in people. Veterinary Record 168, 594 MANNION, C. J. & MILLS, D. S. (2013) Injuries sustained by dog bites. British Journal of Oral and Maxillofacial Surgery 1, 368-369 SHEPHERD, K. (2013) Teaching dog owners new tricks. Veterinary Record 172, 583-584
doi: 10.1136/vr.g1371 152 | Veterinary Record | February 8, 2014
Downloaded from http://veterinaryrecord.bmj.com/ on June 9, 2015 - Published by group.bmj.com
One Health approach to dog bite prevention Christopher James Mannion and Kendal Shepherd Veterinary Record 2014 174: 151-152
doi: 10.1136/vr.g1371 Updated information and services can be found at: http://veterinaryrecord.bmj.com/content/174/6/151.2
These include:
References Email alerting service
This article cites 4 articles, 3 of which you can access for free at: http://veterinaryrecord.bmj.com/content/174/6/151.2#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
