Public health implications of dog bite injuries in Greece

Dog bite injuries pose substantial traumatic and zoonotic risks worldwide. Surveillance remains insufficient globally. This study assessed the epidemiology of dog bites in Greece with the aim to identify risk factors relevant for broader public health strategies. A nationwide cross-sectional study was conducted in 2023, analyzing dog-bite injuries reported by public hospitals and primary health units. Demographic, clinical, and exposure data were collected and examined alongside dog ownership patterns. A total of 2,820 dog-bite injuries were reported, corresponding to an annual frequency of 26.9 cases per 100,000 residents. The incidence of medically attended dog bite injuries varied among regions ranging from 3.1 to 72.6 cases per 100,000 population $$\:{(\chi\:}^{2}\left(12\right)=1019.96,\hspace{1em}p<0.001)$$ . Bite frequency was positively associated with stray-to-owned dog ratio $$\:{(R}^{2}=0.696,\hspace{1em}p<0.001)$$ . Lower limbs were the most commonly affected site (50.9%), while head and neck injuries predominated in children aged 0–9 years $$\:\left({\chi\:}^{2}\right(32)=226.50,\:\:p<0.001)$$ . Tissue loss was documented in 9.3% of cases, with phalangeal amputation recorded in 0.9%. Hospitalization was required in 4.9% of cases. Dog bites represent a significant but underrecognized public health issue. Stray dog populations were identified as a key driver affecting local bite frequencies. Integrating dog bite surveillance into routine health information systems is a critical public health priority globally.