Rise in rabies cases in Jammu region: A problem that requires urgent attention.

Context: Rabies is a fatal zoonotic disease that is endemic in India. Both forms of rabies, namely, encephalitic and furious, invariably lead to coma and death. Lack of awareness is the most critical barrier in accessing timely post-exposure prophylaxis that can prevent the progression to clinical disease. Aims: To report the case series of fourteen clinically suspected rabies cases. Settings and Design: We followed a retrospective study design. Data were collected from the Anti Rabies Section of Government Medical College, Jammu, which is a tertiary care hospital of Jammu Division. Methods and Material: We collected data of all patients over a period of three years, from 2017 to 2020, who were diagnosed as cases of clinically suspected rabies on the basis of classic signs and symptoms and who finally succumbed to the disease. Statistical Analysis Used: Descriptive statistics was used to describe the results of the study. Results: In the present description, the mean age of the patients was 31 ± 18.6 years. Out of 14 suspected cases, 9 had not received any post-exposure prophylaxis-neither vaccine nor serum-and instead visited spiritual faith healers. The remaining patients had history of either incomplete, unknown, or incorrect vaccination status. Median duration of presentation of symptoms after dog bite was 42 days, with a range of 15-180 days. Mean survival of patients after presentation of symptoms was around 1.8 days. Conclusions: Low level of awareness resulted in non-seeking of health-care services after animal bites.

The Use of Absorbable Plates to Treat Facial Fractures From Dog-Bite Injuries in Pediatric Patients: A Case Report.

Dog-bite injuries are common in the facial and neck areas of pediatric patients on account of their size. The incidence of dog-bite etiology for facial fractures in Mexico is unknown as they are underreported. We present a case of a pediatric patient with facial fractures due to dog-bite injuries. We describe the patient's surgical management with absorbable plates and its aftermath and engage in a literature review of dog-bite facial fractures. The patient demonstrated generally favorable results, with minimal postsurgical sequelae. The use of absorbable plates leads to positive outcomes in pediatric patients with dog-bite-related facial fractures.

Retrospective Analysis of Dog Bite Injuries in Children with Autism Spectrum Disorder.

PURPOSE: Children with autism spectrum disorder (ASD) may suffer a dog bite injury, but the frequency and its clinical impact is unknown. We sought to evaluate the (1) subject characteristics; (2) injury type; (3) clinical care provided; and (4) mortality in children with ASD who suffer a dog bite injury. We hypothesized that children with ASD have higher mortality and require more clinical care than children without ASD. METHODS: This is a retrospective observational cohort study utilizing the TriNetX ® EHR database of subjects aged 0 to 18 years with dog bite diagnostic codes. Data were analyzed for demographics, diagnostic, medication, procedural codes, and mortality. RESULTS: We analyzed 38,337 subjects (n, %) coded for a dog bite injury [619 (1.6%) with ASD and 37718 (98.4%) without ASD]. Children with ASD had a higher odds of a traumatic injury to the head [1.34 (1.15, 1.57), p < 0.0001] compared to those without. There was no difference in critical care services, hospitalization, mechanical ventilation, and rabies vaccine administration. All-cause mortality at 1 year was low with no deaths reported within the ASD cohort and 37 (0.1%) deaths reported within the no ASD cohort. CONCLUSIONS: Children with ASD that suffer dog bite injuries have similar clinical needs to children without ASD but are more likely to suffer a traumatic injury to the head. Future studies are needed to better understand inciting factors for injuries in this population.

Ambulatory Management of Bite Injuries to the Hand: A Safe and Cost-Effective Option.

Introduction Animal or human hand bites are a common presentation to the emergency department. If hand bites are not treated adequately, they can give rise to significant local and systemic complications, potentially leading to functional deficits that impact patients' lives. Traditionally, hand bites require hospital admission for the administration of intravenous antibiotics and, in some cases, surgical intervention. A combination of the increasing incidence, hospital admission rates, and in-patient bed pressures prompted a change in our bite management protocol and a move toward ambulatory management of bite injuries. We found this new protocol to be safe, efficient, and cost-effective with a scope for wider implementation. Aim The primary outcome is to assess the feasibility of safely managing hand bites on an outpatient basis, by reviewing the local data before and after the change in practice. The secondary outcome is to compare the financial implications of treating hand bites with an outpatient approach. Material and methods All first-presentation adult consultations referred to Trauma and Orthopaedics from the emergency department over a three-month snapshot period were reviewed in 2017. This was repeated after the implementation of the updated handbite guidelines in 2023. Initial admission documentation as well as operation notes and clinic follow-up letters were each reviewed retrospectively.  Results  In 2017, 36 patients were identified over three months. The average time to surgery was 1.19 days with an average inpatient stay of 2.36 days. There were two re-operations and follow-up of two cases of osteomyelitis.  In 2023, 63 patients were identified over three months. The average time to surgery was 1.03 days with an average inpatient stay of 0.56 days. Thirty-seven surgeries were performed for 33 patients with 32% (20/63) of patients admitted directly from the emergency department. There were no documented cases of osteomyelitis on follow-up. The cost per patient episode decreased by 40% from 2017 to 2023, without accounting for inflation. Conclusions With the implementation of the new departmental guidelines, there has been a reduced average inpatient stay and reduced time to surgery without an increase in documented osteomyelitis. There is also a significant decrease in the average patient cost. This data suggests that without compromising patient safety it is possible to cost-effectively manage hand bites without the need for long inpatient stays.  However, it is imperative that there is close patient follow-up as well as prompt time to surgery to ensure patient safety. Our findings suggest a need for further research to strengthen the evidence supporting our conclusions.

Welsh hospital admissions due to dog bites and strikes (2014-2022).

OBJECTIVE: To describe the incidence and victim demographics of Welsh hospital admissions due to dog bites and strikes from 2014 to 2022. STUDY DESIGN: Descriptive analysis of Welsh hospital admissions data. METHODS: Residents of Wales admitted to a Welsh National Health Service (NHS) hospital for a dog bite or strike, were identified using ICD-10 codes. The annual incidence of dog bite and strike admissions between 2014 and 2022 was calculated and stratified by child-adult status, sex, and Local Health Boards. Trends over time were analysed using the Chi-square test for trends. RESULTS: Hospital admissions due to dog bites and strikes have significantly increased from 16.3 per 100,000 to 23.7 per 100,000 population in 2022. This was driven by an increase in non-geriatric adults and an increase in three Local Health Boards. The Swansea Bay area has the highest incidence in Wales (56.1 admissions per 100,000). CONCLUSIONS: Wales has a higher incidence of dog bites and strikes than England or the Republic of Ireland. Work in the communities where incidence is exceptionally high is needed to understand the reasons behind having the highest incidence of dog bites in the British Isles and to establish the most efficacious methods for bite prevention.

A Multidisciplinary Approach to a Complex Fatal Attack Due to a Pack of Maremma Sheepdogs: Is It Always an Accident?

Deaths due to dog attacks are a worldwide issue. Fatal dog attacks may occur in various environments, including the dog owner's property. A lot of difficulties emerge when the attack involves a pack of dogs, of different species and sizes. In this case, it becomes much more difficult for forensic investigators to evaluate the event, especially regarding the identification of the dog or dogs that caused the death as well as the identification of the owner and the reconstruction of the dynamics for forensic purposes. In this paper, we analyze a specific case of an attack by a herd of Maremma sheepdogs. A crime scene investigation has been carried out. In the first phase of this case, the victim interacted with dogs that had non-aggressive attitudes. Then, after an escape attempt, she was assaulted by about 20 Maremma dogs of different sizes, leading to multiple injuries all over her body. The greatest difficulty was precisely that of reconstructing the dynamics due to the numerous injuries and dogs involved in the attack. The dynamics were divided into several stages following the analysis of the injuries found on the victim. This case study highlights how the forensic multidisciplinary approach has made it possible to precisely reconstruct the event. The analysis of the dogs' state of malnutrition and their suddenly aggressive attitude towards the victim revealed profiles of responsibility of the owner attributable to improper management and training of the animals to defend their property.

Burden of dog bite injuries and wound management practices to prevent rabies among dog owners.

Background: Despite members of dog-owning families being at a higher risk of dog bites owing to their proximity to dogs in their household, there are hardly any studies from India which focus on the burden of dog bites among them and their rabies control and prevention practices. This study aimed to estimate the burden of dog bites among dog owners and their wound management practices to prevent rabies. Materials and Methods: A cross-sectional study was conducted among pet dog owners in a high-end housing society of National Capital Region of Delhi. A pre-tested and pre-validated schedule was used to collect data by consecutive sampling through community survey. Data were analyzed using R software. The incidence of dog bites and the status of rabies prevention practices adopted by the participants are presented as proportions. Chi-square test was applied to compare proportions. Results: A total of 100 families were studied, which covered 355 family members. The incidence of dog bites in the past 1 year was found to be 44/355, 12.4% (95% confidence interval 9.2-16.3%). Pet dogs were responsible for 31/44 (70.5%) bites. Among 44 dog bite incidents, 30 (68.2%) reported taking any injection after the incident, and 10 (22.7%) reported receiving an anti-rabies vaccine. Only six out of 100 families reported at least one family member covered by rabies pre-exposure prophylaxis. Conclusion: The incidence of dog bites among the dog owners was high. The rabies pre- and post-exposure prophylaxis practices adopted by the participants were found to be inadequate.

Emergency department visits for dog bite injuries in Missouri municipalities with and without breed-specific legislation: a propensity score-matched analysis.

Breed-Specific Legislation is a type of law that bans or restricts ownership of specific dog breeds. Some local governments - including over seventy municipalities in the state of Missouri - have enacted Breed-Specific Legislation to prevent injuries from dog bites. Several studies from the peer-reviewed literature have found that aggressive behavior is not associated with any particular dog breeds and, since 2018, at least a dozen municipalities in Missouri have repealed these laws. To evaluate the impact of Breed-Specific Legislation on public safety, the 2010-2015 rates of emergency department visits for dog bite-related injuries in Missouri municipalities with and without Breed-Specific Legislation were compared. Propensity-score matched negative binomial regression models were used to assess the effect of breed restrictions on injury rates while balancing the samples on population characteristics and estimates of dog ownership. After matching the sample on population, housing and dog ownership estimates, no association was found between emergency department visits for dog bite injuries and whether the municipality enacted Breed-Specific Legislation. However, the incidence rate ratio of emergency room visits for dog bite-related injuries increased by 13.8% for every 1% increase in the percentage of males aged 5 to 9 in the population (p < 0.01). This study has found breed discriminatory laws have not reduced the risk of emergency department visits for injury from dog bites in Missouri. There appears to be no greater risk to public safety as local governments move to repeal existing breed bans.

Domestic dog attacks on livestock referred to a Veterinary Teaching Hospital.

Losses and the economic impact of dog attacks (DAs) on livestock are often overlooked and include factors such as decreased production, expenses for treatment and handling, and death of injured animals. This study evaluated the epidemiological, therapeutic, and pathological findings of DAs on livestock over an 11-year survey using the records of farm animals referred to a Veterinary Teaching Hospital. Livestock attacked by dogs included 31 sheep, 11 horses, 3 cattle, 3 goats, and 2 pigs, totaling 50 animals. Anatomical locations injured by dog bites were identified as head/neck, thoracic/pelvic limbs, abdomen/flank, rump/tail, and multiple affected regions (two or more bite sites). Additionally, the severity of the injuries was classified into four degrees adapted from the classification of dog bite injuries in children. Most livestock presented Grade 1 (26%) and Grade 2 (28%) injuries, while Grade 3 and Grade 4 injuries were observed in 46% of DAs. Furthermore, 35 animals (70%) were discharged, 9 (18%) died, and 6 (12%) were humanely euthanized. DAs may represent a significant cause for referring livestock species to clinical care, severe injuries, and a considerable number of deaths. In this study, we provide information regarding DAs on livestock for the first time in Midwestern Brazil.

Infección tras mordedura de perro por Neisseria weaveri / Infection after dog bite by Neisseria weaveri / Infecção após mordedura canina por Neisseria weaveri

Resumen Las infecciones por mordeduras de perros y gatos presentan una etiología bacteriana mixta con microorganismos aerobios y anaerobios que provienen de la cavidad oral del agresor y, en menor medida, de la piel del agredido y el medio ambiente. Con mayor frecuencia se aíslan Pasteurella multocida, Pasteurella canis, Streptococcus spp., Staphylococcus spp., Corynebacterium spp., Capnocytophaga canimorsus y anaerobios. Si bien las infecciones por mordeduras de animales no son infrecuentes, algunos de los microorganismos implicados son excepcionales. Neisseria weaveri forma parte de la microbiota orofaríngea de perros y gatos; sin embargo, los casos comunicados debidos a mordeduras son escasos.

Abstract Infections caused by dog and cat bites have a mixed bacterial etiology with aerobic and anaerobic microorganisms that come from the mouth of the offender and, to a lesser extent, from the skin of the victim and the environment. Pasteurella multocida, Pasteurella canis, Streptococcus spp., Staphylococcus spp., Corynebacterium spp., Capnocytophaga canimorsus and anaerobes can be frequently isolated. Although animal bite infections are not uncommon, some of the microorganisms involved are rare. Neisseria weaveri is part of the oropharyngeal microbiota of dogs and cats; however, reported cases due to bites are rare.

Resumo As infecções causadas por mordeduras de cães e gatos têm etiologia bacteriana mista com microrganismos aeróbicos e anaeróbicos que provêm da cavidade bucal do agressor e, em menor grau, da pele da vítima e do meio ambiente. Pasteurella multocida, Pasteurella canis, Streptococcus spp., Staphylococcus spp., Corynebacterium spp., Capnocytophaga canimorsus e aneróbios podem ser isoladas mais frequentemente. Embora as infecções por mordeduras de animais não sejam incomuns, alguns dos microorganismos envolvidos são raros. A Neisseria weaveri faz parte da microbiota orofaríngea de cães e gatos, porém são escassos os casos relatados como consequência de mordeduras.

An Infected Dog Bite With Neisseria canis: A Case Report and Review of the Literature.

Neisseria is a common bacteria that colonizes in humans. Of the 11 species, only two, N. meningitidis and N. gonorrhea, are pathogenic. Although sparse, there are case reports of other Neisseria species causing infections in humans. Neisseria canis, which is a part of normal flora in the mouths of dogs and cats, has been shown to have potential to be pathogenic in humans. The standard treatment for dog and cat bites is oral amoxicillin/clavulanic acid (Augmentin) or IV ampicillin/sulbactam (Unasyn). However, in cases where the patient has multiple antibiotic allergies, careful antibiotic selection must be made to ensure resolution of infection.

How the forensic multidisciplinary approach can solve a fatal dog pack attack.

The authors present the case of a 61-year-old man found dead in an agricultural plot. The first investigation of the scene revealed the corpse laid face up in a spot of partially dried blood, next to an olive tree. His face, arms, legs, and abdomen showed signs of severe contusion and laceration of dogs' bite wounds. Next to the victim, an olives bin had been found overturned on the ground. A multi-disciplinary approach, including crime scene analysis, autopsy findings, veterinary animals review, odontologist bite mark study, and forensic genetics DNA correlations, was performed. The present case is a documented watchdogs lethal pack attack and provides an example of how to recognize the more active participants thanks to their odontological alterations. It could be considered the first described dog pack attack case solved by dysgnathia alteration. Comparisons between the dental casts obtained from the dogs and the inflicted wounds were made, resulting in positive correlations between the injuries and the dental arches from two of the six involved dogs, thanks to dental abnormalities and DNA founding. The victim's clothes were also compared with the dogs' dental casts, confirming that they were the most active participants during the pack attack. Dogs' DNA was finally matched with saliva traces found on victim's clothes and skin bite marks.

Barriers and opportunities for improving dog bite prevention and dog management practices in northern Indigenous communities.

Globally, people living in northern Indigenous communities are at higher risk of dog bites than the rest of the population living in North America, with annual incidence ranging from 0.61 to 59.6/10,000 inhabitants. Considering that rabies is endemic in wild canid populations in certain regions of the Arctic, the prevention of dog bites and the management of dog populations are of crucial importance for public health in these contexts. Most northern communities lack access to veterinary services, mainly due to their remote geographical location and to limited financial resources. Currently, northern Indigenous communities are using different approaches and strategies to prevent dog bites and manage dog populations, but the effectiveness of these approaches sometimes lacks evidence, and their low acceptability may affect their implementation. This study aims to describe (1) the current access and uses of veterinary services, and (2) the perceived barriers and opportunities related to dog population management practices currently implemented, or that could be implemented, in a Naskapi community and an Innu community located in northern Quebec (Canada). Quantitative data were collected through a survey to inhabitants on veterinary services (n = 122). Qualitative data were collected using individual interviews to inhabitants and health professionals to describe how dog population management measures were perceived, and to identify barriers and opportunities related to their implementation (n = 37). Descriptive and inferential analysis (quantitative data) and thematic analysis (qualitative data) were performed. Results show that the two main measures implemented at the time of the study - dog culling and short-duration veterinary clinics - were not perceived as fully acceptable and sustainable. Reinforcing access to veterinary services and other dog-related services, such as shelters and training programs on dogs, was identified as a need to improve dog bites prevention and dog population management in remote Indigenous communities. The implementation of animal health measures should be decided by concerned Indigenous communities to follow decolonial practices. It includes ensuring informed consent of dog owners, improving communication before, during and after interventions, separating veterinary services from rehoming and, most importantly giving back to Indigenous communities the complete leadership over animal health in their communities.

A Retrospective Observational Study of Facial Dog Bite Injuries and Its Management in a Tertiary Care Center.

Background : Facial dog bite injuries result in significant emotional, psychological, and physical trauma to the victims involved and should be considered a significant health issue. The purpose of this study is to share our experience in the management and to add to the existing medical literature regarding the epidemiological patterns of facial dog bite injuries. Materials and Methods : This is a single-center retrospective observational study conducted at Dr. RML Hospital, New Delhi, from January 2021 to January 2022. A total of 105 patients were included. The wounds were managed according to the recommendations made by the national rabies control program and surgical intervention was performed in the form of primary suturing or flap cover. Results : Children of age group 0 to 10 years are most commonly affected. Pet dogs are the cause in 61% of cases and 57.1% of bites were provoked. Midface is most commonly affected and modified Lackmann's class 3A and 3B are the most common wounds. Conclusion : In view of raising incidence of dog bites with pet dogs, the general public needs to be educated regarding the practices to prevent these injuries. Postexposure prophylaxis should be given to all affected individuals irrespective of the vaccination status of the dog. Immediate surgical intervention gives better results.

Microbial Complexity of Oral Cavity of Healthy Dogs Identified by Mass Spectrometry and Next-Generation Sequencing.

The high complexity of the oral microbiota of healthy dogs and the close exposure of humans to companion animals represent a risk of the transmission of potential zoonotic microorganisms to humans, especially through dog bites, including multidrug-resistant ones. Nonetheless, a limited number of comprehensive studies have focused on the diversity of the microorganisms that inhabit the oral cavities of healthy dogs, particularly based on modern molecular techniques. We investigated bacterial and fungal organisms in the oral cavities of 100 healthy dogs based on a combination of conventional and selective microbiological culture, mass spectrometry (MALDI-TOF MS), and next-generation sequencing. In addition, in vitro antimicrobial susceptibility patterns of isolates and mecA resistance gene were assessed. A total of 213 bacteria and 20 fungi were isolated. Staphylococcus pseudintermedius (40/100 = 40%), α-hemolytic Streptococcus (37/100 = 37%), and Pasteurella stomatis (22/100 = 22%) were the most prevalent bacteria diagnosed by microbiological culture and MALDI-TOF MS, whereas Aspergillus (10/100 = 10%) was the most common fungi identified. Based on next-generation sequencing of selected 20 sampled dogs, Porphyromonas (32.5%), Moraxella (16.3%), Fusobacterium (12.8%), Conchiformibius (9.5%), Bergeyella (5%), Campylobacter (3.8%), and Capnocytophaga (3.4%) genera were prevalent. A high multidrug resistance rate was observed in Staphylococcus pseudintermedius isolates, particularly to azithromycin (19/19 = 100%), penicillin (15/19 = 78.9%), and sulfamethoxazole/trimethoprim (15/19 = 78.9%). In addition, the mecA resistance gene was detected in 6.1% (3/49) of coagulase-positive staphylococci. Here, we highlight the microbial complexity of the oral mucosa of healthy dogs, including potential zoonotic microorganisms and multidrug-resistant bacteria, contributing with the investigation of the microbiota and antimicrobial resistance patterns of the microorganisms that inhabit the oral cavity of healthy dogs.

Dog bites as a zoonotic risk in Ecuador: Need for the implementation of a One Health approach.

Rabies is a viral zoonotic disease that can infect all mammals and the main route of transmission to human is attributed to dog bites. Due to the limited information available about the rabies vaccination coverage, although Ecuador is supposed to be free of rabies, we conducted a retrospective study of the epidemiological surveillance records on the notification of dog attacks to humans in Guayaquil, the most populated city in Ecuador. The results showed an annual incidence rate of 105.6 dog bites per 100,000 inhabitants, where the most affected anatomical parts are the lower extremities; individuals from 1 to 14 years of age were the most affected age group (IC95% 1.42-1.92; p < 0.001). As for the severity of the wounds, most of them (65%) were mild. Moreover, 25% of the dogs were free roaming ones, and only 43% of the dogs with owner had a complete vaccination scheme against rabies virus. We found a important dog attack rate in Guayaquil city and more than half of the dogs involved were not vaccinated against rabies. Under a potential scenario of rabies circulation in canine population, there would be a serious risk for rabies transmission to humans. Hence, it is important to reinforce rabies surveillance and vaccination programs aligned to the One Health concept to manage this public health issue.

One Health Approach on Dog Bites: Demographic and Associated Socioeconomic Factors in Southern Brazil.

Despite being an important public health issue, particularly due to rabies, dog bites and associated risk factors have rarely been assessed by health services from a One Health perspective. Accordingly, the present study aimed to assess dog biting and associated demographic and socioeconomic risk factors in Curitiba, the eighth-largest Brazilian city with approximately 1.87 million people, based on the post-exposure prophylaxis (PEP) rabies reports between January/2010 and December/2015. The total of 45,392 PEP reports corresponded to an average annual incidence of 4.17/1000 habitants, mainly affecting white (79.9%, 4.38/1000 population), males (53.1%, 4.81/1000 population), and children aged 0-9 years (20.1%, 6.9/1000 population), with severe accidents associated with older victims (p < 0.001) and mainly caused by dogs known to the victims. An increase of USD 100.00 in the median neighborhood income was associated with a 4.9% (95% CI: 3.8-6.1; p < 0.001) reduction in dog bites. In summary, dog biting occurrence was associated with victims' low income, gender, race/color, and age; severe accidents were associated with elderly victims. As dog bites have been described as multifactorial events involving human, animal, and environmental factors, the characteristics presented herein should be used as a basis to define mitigation, control, and prevention strategies from a One Health perspective.

Accidentes vinculados a la Cirugía Plástica Pediátrica durante el confinamiento voluntario en Uruguay por SARS-CoV-2 / Accidents related to Pediatric Plastic Surgery during voluntary confinement in Uruguay due to SARS-CoV-2

Introducción y objetivo: Epidemiológicamente se esperaban cambios en los patrones de consulta en emergencia durante la pandemia por SARS-CoV-2. La permanencia dentro del hogar de todos los integrantes de la familia, la suspensión de la actividad deportiva, recreativa y social, sumadas al temor por concurrir a emergencia y contraer COVID-19 podían generar la interrogante en cuanto a la incidencia de accidentes. Material y método: Analizamos las historias clínicas de las consultas en emergencia de 3 instituciones en Uruguay, país en el cual el confinamiento durante la pandemia por COVID-19 fue voluntario desde el 13 de marzo de 2020 al 29 de junio del mismo año. Incluimos todos los motivos de consulta vinculados a Cirugía Plástica Pediátrica en nuestro medio en pacientes menores de 16 años. Resultados: Obtuvimos datos de 166 pacientes. Durante el mismo período del 2019 se recabaron datos de 268 pacientes. Conclusiones: Nuestro trabajo evidencia menos accidentes vinculados a Cirugía Plástica Pediátrica durante el confinamiento. Los pacientes de sexo masculino fueron los más afectados durante el confinamiento y fuera de él. Hubo una disminución de accidentes en pacientes de 6 a 16 años, siendo la franja más afectada la de los pacientes de edad prescolar. Aumentaron las mordeduras de perro, disminuyeron las consultas menos graves junto con los procedimientos más sencillos y no se evidenció aumento en los ingresos hospitalarios ni en las cirugías por accidentes. (AU)

Background and objective: Changes in the epidemiology at the emergency department during the SARS-CoV-2 pandemic were expected. Confinement of all family members, the suspension of sports, and social activity, in addition to the fear of attending an emergency and contracting COVID-19 could change the incidence of accidents. Methods: The medical records of the emergency department of 3 institutions in Uruguay, country in which confinement during the COVID-19 pandemic was voluntary from March 13, 2020 to June 29 of the same year. All the consults related to Pediatric Plastic Surgery in patients under 16 years of age were included. Results: Data was obtained from 166 patients during the period of voluntary confinement. During the same period of 2019, data from 268 patients were collected. Conclusions: In our study, fewer accidents related to Pediatric Plastic Surgery were present during confinement. Male patients were the most affected in both periods. A decrease in accidents was evidenced in patients aged 6-16 years, with preschool-age patients being the most affected group. Not severe consultations decreased along with the simplest procedures and there were no increases in hospital admissions or surgeries due to accidents. (AU)

Dog-related deaths registered in England and Wales from 2001 to 2021.

OBJECTIVE: This study aimed to describe the incidence and demographics of fatal dog bites or strikes, as defined in English and Welsh mortality data (2001-2021). STUDY DESIGN: A descriptive analysis of the Office for National Statistics registered deaths data set. METHODS: Individuals whose cause of death was defined as 'bitten or struck by a dog' were identified. The average annual number of dog-related deaths and trends in incidence were calculated. Age and sex demographics of victims were described. RESULTS: In total, there were 69 registered deaths, a mean of 3.3 (95% confidence interval 0.3-6.3) dog-related deaths per year, and a mean annual incidence of 0.59 (95% confidence interval 0.06-1.11) deaths per 10 million population. There was no year-on-year change in incidence. Of victims, 59% were male, 10% were <5 years, and 30% were ≥75 years. CONCLUSIONS: Dog-related deaths are rare in England and Wales and have not increased between 2001 and 2021. Further contextual information about the incidents is needed to be able to develop public health strategies and interventions.

Spatial patterns and risk of aggression of dogs and cats in a central township of Mexico City.

Dog and cat aggressions are public health concerns associated with rabies transmission to the human population. The social and environmental conditions of marginalized and urban areas stand a risk due to people's contact with dogs. This study aimed to identify spatial patterns related to dog and cat aggression in a densely populated area in the center of Mexico City, analyzing the risk of aggression at the census unit level in the 2018-2020 triennium. This cross-sectional study was carried out in Coyoacán, in the south-central area of Mexico City's urbanized region. The total number of cases (n = 1,078) was obtained from monthly records of aggressions by dogs and cats, from the Control and Prevention of Zoonoses-Rabies Program of the Coyoacán Sanitary Jurisdiction. The information collected was related to the victims and the aggressors. Associations between the occurrence of bites and the characteristics of the victim were evaluated using a geographic information system (GIS), as well as the spatio-temporal distribution of the aggressions to the census unit level. Out of 1,078 cases reported, 977 (90.6%) were caused by dogs and 101 (9.4%) by cats, 55.1% (n = 587) occurred within the same household, and 13.7% (n = 148) were categorized as severe injuries. Adult men were the most affected group. Attacks on the street had a higher risk of resulting in a severe injury, compared to those that occurred at home (OR 1.63, 95CI 1.15 - 2.31, p <0.006). According to the standardized rate of the triennium, the values ​​ranged between 54.1 and 619 aggressions per 100,000 inhabitants, and summer was the season with a higher probability of occurrence. These results provide a basis for the analytical investigation of the spatial patterns of dog and cat aggression, highlighting the need to implement efficient surveillance systems and public health strategies.