By Bruce Taylor Seeman
NEWHOUSE NEWS SERVICE
March 19, 2000
Perhaps Josiah Holden pestered his dog while it ate. Maybe he tripped over its chain. Or accidentally stepped on a paw as the pair romped on the freshly fallen snow.
Whatever ignited the dog's wrath, 5-year-old Josiah of suburban Cleveland paid an awful price. On Feb. 18, he was mauled to death in his own yard.
Fatal dog attacks remain a rarity, each year killing about 15 Americans, most often children, federal statistics show. But the incidents, according to a growing chorus of experts, nonetheless represent the worst possible consequences of dog bites, a public health problem in full bloom.
The American Veterinary Medical Association, mindful that dogs nip, pierce or rip the flesh of an estimated 4.7 million Americans each year, has assembled a landmark task force to address the problem.
The national Centers for Disease Control and Prevention is embarking on a new effort to count bites and to get a fuller picture of America's dog population -- its size, breed distribution and gender proportions.
Increasing interest is aimed at Nevada, where public health officials say dog bites are declining because school nurses are teaching first-graders that not every dog is a cuddly friend.
But while those steps represent new efforts to measure and avoid the threat posed by dogs, analysts have delivered an intimidating portrait of the problem:
About 800,000 Americans seek medical treatment for dog bites each year, according to the CDC. Of those, about 40 percent go to emergency rooms.
More than half the injured are children, a fact widely attributed to kids' innate tendency to be impulsive, trusting or agitated. Because their necks and faces are closer to the ground, kids get hurt worst.
Dog bite victims are collecting about $250 million a year through lawsuits. That doesn't include medical treatment, lost work and other costs believed to raise the overall economic impact to about $1 billion.
Solutions are elusive. Outlawing specific breeds is unrealistic, most experts agree, even if scientists could say which dogs bite most. Leash laws and other local strategies are often inadequate or too costly to enforce.
A 10-year-old boy killed by Rottweilers in September in New Orleans was the first dog-related death in that city in years, said Catherine Olivier, community affairs director of the Louisiana Society for the Prevention of Cruelty to Animals. But the incident was among 405 bites reported to authorities in New Orleans last year.
"The attacks that are taking place are much more serious," Olivier said. "There was a little girl last year who was mauled by a pit bull in a relative's living room. About half of her face was ripped off. It was supposedly an unprovoked attack. But the dog's name was Satan. When you have people who want pets like that, it gets frightening."
Dog bites don't top the public health agenda. While death by dog attack is among the most horrible, such events are statistically insignificant compared to other accidental deaths.
More attention is given, for example, to drownings, which kill about 4,000 Americans annually, or to bicycle-related head injuries, which claim about 500, or to accidental poisonings, which claim about 100.
Until they're bitten or their child is bitten, experts say, most Americans regard dog bites as a random and remote possibility, much like a broken leg.
Meanwhile, the right to keep a dog, even one that has displayed a dangerous temper, is often claimed with the same passion as maintaining private property or owning a hunting rifle.
"I'm from Texas," said Leslie Sinclair, a consultant and former director of veterinary issues for companion animals at the Human Society of the United States. "In Texas, you better not tell anyone they don't have a right to have a dog in the back yard."
In truth, no one knows how many bites to blame on America's 60 million dogs.
The number of bite-related deaths remains relatively constant at about 15 a year. Most often responsible, reports the CDC, are pit bulls, Rottweilers, German shepherds, Alaskan malamutes, huskies, Doberman pinschers and chow chows.
But the data on bites is less certain.
About 580,000 people sought medical treatment for bites in 1988, according to the CDC. The agency's estimate rose to about 800,000 for 1994, the most recent figure available.
But many injuries get patched up over the bathroom sink rather than mended by a physician. And when bites are properly treated, there is no universal requirement to report it.
Even the CDC's upcoming estimates on the dog population and bites will fall short in some areas. It will not, for example, reveal which breeds are most dangerous. Nor will it measure how many Americans are acquiring larger, more aggressive dogs for protection.
Regardless, numerous experts are convinced bites are on the rise.
"It's a consistent upward trend, that's my guess," said Dr. Julie Gilchrist, a CDC epidemiologist who is guiding the agency's upcoming effort to estimate dog bites. "Unless it's a mauling, some tragedy, it doesn't make the news."
Gilchrist and others believe more bites are occurring because more dogs are being kept in an increasingly urbanized society.
"But there are two other important factors," she said. "First, our reasons for having dogs have changed. It used to be the family pet, something to play with. Now, dogs are more for protection. The dogs are bigger.
"The other thing is our time commitments are changing. People have two jobs, they work 12 hours a day, they come home and want to lay on the couch. The commitment to play with the dog, exercise the dog, supervise your children with the dog, has changed."
In Nevada, public health officials claim dog bites are dropping because nurses are lecturing first-graders.
Ronald Anderson, veterinary diagnostician for the animal disease lab at the Nevada Department of Agriculture, said he decided to tackle the problem because dog bite reports suggested the incidents were avoidable.
"They took the bowl away when the dog was eating, they jumped the dog when it was sleeping, they pulled the dog's ear. This was the type of thing that the kids were doing," Anderson said. "Silly stuff that shouldn't happen."
Under the education effort, children get a 40-minutes lesson on dog behavior, watch a video and take home coloring books donated by an insurance company.
In 1997, the program's first year, the state recorded 2,058 dog bites. In 1999, even after populations of both people and dogs increased more than 10 percent, reported dog bites dropped to 1,948.
School nurse Gail Pickren, who teaches about 1,200 first-graders a year, comes to class in street clothes and carrying a pair of stuffed dogs. "Kids tend to be sucked in when you have props," she said.
Pickren covers the basics: Why do dogs bite? How do you know if a dog is friendly? How do you avoid a bite? And what should you do if a dog attacks?
"Stop and stand still," Pickren tells her pupils. "Cross your arms over your chest and put your fists under your chin. Don't look at the dog. Don't scream and run. If you get knocked down, get on your knees, bend over to protect face and ears. If there's a car accessible or a tree, use it."
Insurance companies are following the issue closely.
MetLife Auto & Home, a Rhode Island-based insurer, red-flags any applicant who has a dog with a history of aggression or one that fits the insurance company's definition as a high-risk breed.
"The agent will say, 'OK, we'll take the application, but I will have to submit this to our home office, we want to take a closer look,' " said Richard Berstein, a vice president and general counsel for MetLife. "We're just trying to exercise care. Frankly, if you have an aggressive dog with a history of biting, no price will match the risk."
State Farm Fire and Casualty Company, which promotes dog bite safety, reported that payments for dog bites -- both medical and liability -- rose from $57 million in 1994 to $80 million in 1997.
The amount dropped to $76 million in 1998, and the company hopes a slight drop in the number of claims will continue, said Dan Hattaway, an underwriting consultant.
But the size of a typical payout, Hattaway said, is rising. "We're seeing more attorney involvement," he said. "The personal injury attorneys didn't used to be so interested."
The costs of treating a dog bite can be high. Rather than merely piercing flesh, an angry dog often bites the face, neck, arms or legs, clamps down and violently shakes its prey.
In the worst cases, "the wounds tend to be large, with tearing and ripping of tissues," said Dr. M. Douglas Baker, director of pediatric emergency medicine at Yale-New Haven Children's Hospital in Connecticut and a member of the task force.
As with burns, infection is a concern. Multiple surgeries are common. A CDC study estimated annual medical costs for dog bites to be about $165 million for emergency room visits and hospitalizations.