Dog bites are a public health concern that also implicates animal welfare, with negative outcomes such as rehoming or euthanasia for the animals responsible. Previous research has shown that the severity of dog-bite injuries reflects multiple factors, including the degree of inhibition exhibited by dogs and how people behave towards dogs. This study utilizes an objective dog bite injury assessment tool: The Dunbar aggression scale. Trained officers employed by The City of Calgary systematically use the Dunbar scale whenever investigating dog-bite complaints. We analyzed The City of Calgary’s administrative data on confirmed dog-bite injuries in people, 2012–2017, with a multivariable generalized ordered logistic regression model. Severe dog-bite injuries occurred more frequently in the family home than in any other setting. Young children, youths and older adults were at higher risk of more serious bites than adults. There has been a decreasing trend in the probability of a high or medium severity bite, and an increasing trend in the probability of a low severity bite since 2012. These results indicate that greater public awareness regarding dog-bite injuries is needed. Consideration should be given to campaigns targeted towards different demographics, including older adults, to provide an understanding of dog behaviour and to emphasize the need to supervise children closely in the presence of all dogs at all times, including family dogs in the home environment. Given that dog-bite injuries are not just a public health issue, but also an animal welfare issue, we endorse One Health responses in educational campaigns, policy development, and professional practice.

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Background Dog-bite injuries remain a perennial problem, especially in pediatric emergency services. Nonetheless, few researchers have examined how local-level policies may contribute to primary prevention. We do so with qualitative research and an emphasis on implementation. This study highlights the potential benefit of coordination in Alberta between municipalities and emergency health services.  Implementation This study mainly took place in the City of Calgary, which has earned a sterling reputation, in Canada and internationally, for the results of its animal-control policy in reducing dog-aggression incidents. We attribute part of this achievement to the high compliance of licensing in Calgary. The City estimates 80-90% of all dogs in Calgary have been licensed (by comparison, the City of Toronto estimates 35% compliance with mandatory licensing for dogs). The City of Calgary earmarks revenue from licensing for human-animal services, including public education, assessment of dogs’ behavior, and a state-of-the-art shelter oriented towards rehoming. Here, we frame the City of Calgary’s dog-aggression policy as a ‘One Health’ issue. This concept refers to human-animal-environment interdependencies as the basis for health. Whereas most One Health research has focused on preventing zoonotic infections or environmental toxins, our approach emphasizes health promotion, in which ‘caring for one’s self and others’ as the foundation for improving longevity and quality of life. Over the years, we have informed and learned from the City of Calgary’s implementation of its dog-aggression policy framework. Evaluation Methods Related research (Caffrey et al., 2019) has analyzed the City of Calgary’s administrative data on dog-bite incidents, statistically and spatially. Previously our team partnered with the Emergency Services Strategic Clinical Network on an analysis of emergency services utilization for dog-bite injuries across Alberta (Jelinski et al., 2016). We have also highlighted risks to occupational health and safety amongst officers who enforce dog-aggression policies, in Alberta and worldwide (Rault et al., 2018). In this presentation, we delve into how these officers act on municipal data when investigating dog-aggression incidents in the City of Calgary. Our main sources of information were semi-structured interviews and participant-observation. Results High compliance with dog-licensing bylaws in Calgary assists officers in efficiently locating dogs following a dog-aggression complaint. In turn, citizens lodge complaints because they view the City of Calgary’s human-animal services as effective and humane. References Caffrey, N., Rock, M., Schmidtz, O., Anderson, D., Parkinson, M., Checkley, S.L. Insights about the epidemiology of dog bites in a Canadian city using a dog aggression scale and administrative data. Animals, 9(6). doi: 10.3390/ani9060324.   Jelinski, S.E., Phillips, C., Doehler, M., Rock, M. (May, 2016). The epidemiology of emergency department visits for dog-related injuries in Alberta. Canadian Journal of Emergency Medicine, 18(S1). doi: 10.1017/cem.2016.68   Rault, D., Nowicki, S., Adams, C., Rock, M. (2018). To protect animals, first we must protect law enforcement officers. Journal of Animal and Natural Resource Law, XIV, pp.1-33.

Background Throughout the SARS-CoV-2 pandemic, there have been many questions about how COVID-19 affects patients living with HIV (PLWH). We examined the clinical courses of 45 PLWH who required hospitalization with SARS-CoV-2 infection. Methods This is a retrospective cohort study in which ICD-10 codes were used to identify PLWH who were admitted to three large hospital systems in Memphis, TN with COVID-19. We included all patients ≥ 18 years of age with HIV and a documented positive SARS-CoV-2 PCR test. After manual abstraction from the electronic health records, chi-squared and T-tests were performed to evaluate associations between patient-level factors and outcomes. Results A total of 45 patients with HIV who tested positive for SARS-CoV-2 were admitted to Memphis, TN area hospitals between March 2020 and October 2020. 18 (40%) were female, 43 (95.6%) were Black, and the average age was 50.3 years (SD 12.6). The average BMI was 30.2 (SD 8.6). 40 (88.9%) patients admitted had at least one comorbidity with the most common being hypertension (28 patients, 62.2%) and diabetes (14 patients, 31.1%). 24 (46.7%) patients had a Charlson Comorbidity Index > 3. 15/43 (48.4%) patients had a CD4 count < 200, and 35 (77.8%) were on ART. 30 (66.7%) patients met SIRS criteria within 24 hours of admission, and 27 (60%) required some form of oxygen supplementation during hospitalization, including 4 (8.9%) who required intubation. The average length of stay was 10.4 days (SD 12.5). 9 (20%) patients required an ICU stay, and 3 (6.7%) died. BMI > 30, CD4 count < 200, and viral load > 1000 were not associated with worse outcomes. Both a Charlson Comorbidity Index > 3 and the absence of ART were associated with need for ICU-level care. Conclusion Viral load, CD4 count, and BMI were not correlated with differences in mortality or oxygen use in our study. Patients with higher Charlson Comorbidity Indices and patients who were not on ART at presentation were significantly more likely to require the ICU. Further study is needed to definitively determine factors affecting the outcomes of PLWH with SARS-CoV-2 infection. Disclosures All Authors: No reported disclosures

In recent solid organ transplant recipients, acute febrile illness is usually a source of grave concern and a diagnostic dilemma, especially if no response is noted after initiation of broad antimicrobial therapy. Human Monocytic Ehrlichiosis (HME) is a tick-borne illness caused by Ehrlichia chaffeensis and is not considered an opportunistic infection in immunocompromised patients such as solid organ transplant patients. Ehrlichiosis in immunocompromised patients can be life-threatening, and a strong index of suspicion is needed, especially in patients who live in endemic areas, for proper treatment initiation with doxycycline. We report a case of a 40-year-old male who received an orthotopic liver transplant six months earlier secondary to primary sclerosing cholangitis, on chronic immunosuppressive medication, who presented with complaints of sudden onset fever associated with nausea, vomiting, and diarrhea. Initial extensive infectious workup was negative and no response to empiric antimicrobials. There was suspicion for ehrlichiosis prompting empiric doxycycline use. Subsequently, E. chaffeensis polymerase chain reaction (PCR) was positive, and the antibiotic regimen was de-escalated to only doxycycline with complete resolution of his symptoms and progressive improvement in previously abnormal biochemical indices.