title: Dog bite injuries among American Indian and Alaska Native children.
abstract: OBJECTIVE
  To examine dog bites among American Indian (AI) and Alaska Native (AN) children visiting Indian Health Service and tribal health facilities.
  
  
  METHODS
  We retrospectively analyzed hospitalizations and outpatient visits with a diagnosis of dog bite between 2001 and 2008 in AI/AN children aged <20 years. Rates of dog bite hospitalizations and outpatient visits were estimated by age group, sex, region, and number and location of open wounds using Indian Health Service data. Analyses of hospitalizations for the general US population aged<20 years used the Nationwide Inpatient Sample.
  
  
  RESULTS
  The average annual dog bite hospitalization rate was higher among AI/AN children in Alaska (6.1/100,000 population) and the Southwest region (5.3/100,000) compared with the general US child population (3.1/100,000; 95% CI, 2.9-3.3/100,000). The average annual outpatient visit rate in AI/AN children was highest in the Alaska (596.4/100,000), Southwest (540.0/100,000), and Northern Plains West (537.6/100,000) regions. The hospitalization rate was highest in both AI/AN and US males aged<5 years, and outpatient visit rates were highest in AI/AN males aged 5-9 years. Open wounds diagnoses were most commonly seen on the head, neck, and face in hospitalized children (45.5% of open wounds in AI/AN children, 59.3% in US children; SE, 1.0%) and on the leg in AI/AN outpatients (35.6%).
  
  
  CONCLUSIONS
  Dog bites represent a significant public health threat in AI/AN children in the Alaska, the Southwest, and Northern Plains West regions of the US. Enhanced animal control and education efforts should reduce dog bite injuries and associated problems with pets and stray dogs, such as emerging infectious diseases.
authors: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA. abjork@cdc.gov
authors: Adam
authors: A
authors: Bjork
authors: Robert C
authors: RC
authors: Holman
authors: Laura S
authors: LS
authors: Callinan
authors: Thomas W
authors: TW
authors: Hennessy
authors: James E
authors: JE
authors: Cheek
authors: Jennifer H
authors: JH
authors: McQuiston
mesh_terms: D000293:Adolescent; D000413:Alaska / Q000453:epidemiology; D000818:Animals; D001733:Bites and Stings / Q000453:epidemiology*; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D004285:Dogs; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult