Do animals bite more during a full moon? Retrospective observational analysis

English hospital episode data analysis (1998-2018) reveal that the rise in dog bite hospital admissions is driven by adult cases

Dog bites are a global health issue that can lead to severe health outcomes. This study aims to describe the incidence and sociodemographics of patients admitted to English National Health Service (NHS) hospitals for dog bites (1998-2018), and to estimate their annual direct health care costs. An analysis of patient level data utilising hospital episode statistics for NHS England, including: temporal trends in annual incidence of admission, Poisson models of the sociodemographic characteristics of admitted patients, and direct health care cost estimates. The incidence of dog bite admissions rose from 6.34 (95%CI 6.12-6.56) in 1998 to 14.99 (95%CI 14.67-15.31) admissions per 100,000 population in 2018, with large geographic variation. The increase was driven by a tripling of incidence in adults. Males had the highest rates of admission in childhood. Females had two peaks in admission, childhood and 35-64 years old. Two percent (2.05%, 95%CI 0.93-3.17) of emergency department attendances resulted in admission. Direct health care costs increased and peaked in the financial year 2017/2018 (admission costs: £25.1 million, emergency attendance costs: £45.7million). Dog bite related hospital admissions have increased solely in adults. Further work exploring human-dog interactions, stratified by demographic factors, is urgently needed to enable the development of appropriate risk reduction intervention strategies.

Role of bioclimate conditions on cerebral aneurysm rupture in the Brittany region of France

INTRODUCTION

Subarachnoid hemorrhage (SAH) from intracranial aneurysm rupture is an unpredictable event responsible for significant morbidity and mortality. Despite inconsistencies, some studies suggest a potential role of climate conditions in SAH onset. The purpose of this study was to determine the impact of climatic and lunar factors on onset of SAH in an oceanic climate such as that of Brittany, France.

METHODS

All adults with SAH admitted to the neurosurgery department and intensive care unit of the University Hospital of Rennes (France) between January 1st, 2011 and December 31st, 2012 were included. Meteorological variables, their variations, lunar phases and tidal coefficients were compared between days with and without SAH.

RESULTS

We retrospectively included 295 patients with SAH. Mean minimum temperature was significantly lower during days with SAH (7.7±4.7°C versus 8.3±4.6°C; P=0.039); temperature variation between 2 successive days was significantly greater for days with SAH (8.6±4.1°C versus 7.9±3.8°C; P<0.01). Multivariate analysis showed that a 2-day temperature drop greater than or equal to 8°C was associated with 35% increased risk of SAH (odds ratio 1.35 [1.03-1.77]). There were no significant effects of other meteorological variables, lunar phase or tidal coefficient on SAH occurrence.

CONCLUSION

Low temperature and sudden temperature drop were associated with increased occurrence of SAH in Brittany, France.

Are there effects of lunar cycle on pediatric febrile seizure?: A single-center retrospective study (2005-2018)

BACKGROUND

Several studies have reported an association between seizure and the lunar cycle; however, results are conflicting. Thus, we investigated whether emergency department (ED) visits due to febrile seizure (FS) or FS plus were affected by lunar cycle.

METHODS

We reviewed the medical records of patients who were admitted to the ED with a main diagnosis of FS or FS plus from January 1, 2005 to August 31, 2018 (13 years 8 months), a period of 4991 days with 169 lunar cycles. During that period, we collected weather data such as mean temperature, average atmospheric pressure (AP), and humidity according to lunar phase (new moon, first quarter, full moon, and third or last quarter).

RESULTS

A total of 1979 patients were identified. We found male predominant with a mean age of 2.62 ± 2.09 years. Acute pharyngotonsillitis was the most common cause of fever, generalized tonic-clonic seizure was the most common type of seizure, and the mean peak body temperature was 38.77 ± 0.81 °C. The lunar cycle did not affect the onset or frequency of FS after adjustment; however, several factors, including season, O₃ and NO₂ concentrations, and holidays, were associated with FS.

CONCLUSION

We did not find an association between lunar cycle and FS or FS plus. However, several factors, including season, O₃, NO₂, and holidays were associated with FS or FS plus.

The relationship between the moon cycle and the orientation of glass eels (Anguilla anguilla) at sea

Links between the lunar cycle and the life cycle (migration patterns, locomotor activity, pulses in recruitment) of the European eel (Anguilla anguilla) are well documented. In this study, we hypothesized that the orientation of glass eels at sea is related to the lunar cycle. The European eel hatches in the Sargasso Sea and migrates across the Atlantic Ocean towards Europe. Upon reaching the continental shelf, the larvae metamorphose into glass eels and migrate up the estuaries, where some individuals colonize freshwater habitats. How glass eels navigate pelagic waters is still an open question. We tested the orientation of 203 glass eels in a transparent circular arena that was drifting in situ during the daytime, in the coastal Norwegian North Sea, during different lunar phases. The glass eels swimming at sea oriented towards the azimuth of the moon at new moon, when the moon rose above the horizon and was invisible but not during the other moon phases. These results suggest that glass eels could use the moon position for orientation at sea and that the detection mechanism involved is not visual. We hypothesize a possible detection mechanism based on global-scale lunar disturbances in electrical fields and discuss the implications of lunar-related orientation for the recruitment of glass eels to estuaries. This behaviour could help glass eels to reach the European coasts during their marine migration.

Retrospective evaluation of canine and feline maxillomandibular trauma cases. Comparison of lunar cycle and seasonality with non-maxillomandibular traumatic injuries (2003-2012)

OBJECTIVES

To determine relationships between seasonality and lunar cycle and the frequency of maxillomandibular (MM) and non-maxillomandibular (non-MM) injury in canine and feline trauma patients.

METHODS

A medical records database was searched to identify all MM trauma patients (n = 67) and a random sample of non-MM trauma patients (n = 129) according to search criteria. Season of injury, moon phase, and moon luminosity were calculated for the date of injury.

RESULTS

Maxillomandibular injury occurred predominately in the spring and decreased through winter while non-MM injury occurred more frequently in the summer and fall. The difference in the frequency of MM and non-MM injuries during different seasons was not significant (p = 0.071). When comparing the amount of moon illuminated when injuries occurred during the quarters before or after the full moon, a difference (p = 0.007) was noted with a greater number of injuries occurring immediately following the full moon.

CLINICAL SIGNIFICANCE

These results may guide clinicians to closely evaluate trauma patients that are presented on emergency during a particular season or lunar phase. Based on the season at the time of injury, close evaluation for MM versus non-MM trauma may be appropriate.

The lunar cycle, sunspots and the frequency of births in Germany, 1920-1989

Based on multivariate linear regression models, we analyze the effect of the lunar cycle and the number of sunspots occurring on a particular day on the number of births using social security data and controlling for a number of other potential confounders. The daily numbers of births between 1920 and 1989 have been calculated from the full sample of individuals who have been registered at least once in the German social security system. While the lunar cycle does not affect the number of births, the number of sunspots is positively correlated to the number of births. The empirical results may be explained by medical technological progress making natural influences on births less important over time. This interpretation is supported by the results on the intertemporal influence of weekends and holidays on the frequency of daily births.

Increased Incidence of Domestic Animal Bites following a Disaster Due to Natural Hazards

Introduction::

During deployment following Hurricane Ike in September 2008, bites from domestic animals were among the top three trauma complaints seen at the National Disaster Medical System (NDMS) Disaster Medical Assistance Team (DMAT) base of operations.

Problem::

Unlike previous reports of frightened, misplaced dogs and cats biting strangers and rescue workers, there was an increase in bites associated with presumed non-rabid pets who were known to the bite victim.

Methods:

This was an observational sampling of all patients presenting for medical care during deployment to the AL-3 DMAT base of operations in Webster, Texas, following Hurricane Ike. Findings were compared with unofficial local norms and observations from the literature.

Results:

Of the people with animal bites presenting to the field hospital, dog bites accounted for 55%, cat bites, 40%, and snake bites, 5%. Most of the wounds required suturing and were not simple punctures. Most bites (70%) involved the hand(s). Some patients presented > 24 hours after the bite, and already had developed cellulitis. One patient required transfer and inpatient admission for intravenous antibiotics and debridement of a hand injury with spread into the metacarpophalangeal space.

Conclusions:

Most of the bites were severe and occurred within the first 72 hours after the hurricane, and waned steadily over the following weeks to baseline levels. No animal bites caused by misplaced dogs and cats biting strangers were seen. There was an increase in bites associated with domesticated pets known to the bite victim. The current NDMS cache is stocked adequately to care for most wounds caused by animal bites. However post-exposure rabies treatment is not part of the routine medications offered. For future disaster preparedness training, pet owners should be aware of the increased potential for dog and cat bites.

Canine and Feline Epileptic Seizures and the Lunar Cycle: 2,507 Seizures (2000–2008)

Epileptic seizures in 211 canine and feline patients diagnosed with idiopathic epilepsy were evaluated for temporal significance in relation to the lunar cycle. Seizure counts were compared among each of the eight individual lunar phases, among each of eight exact lunar phase dates, and by percent of lunar illumination using generalized estimating equations. No statistical significance was found in any of these comparisons excluding a relationship between the onset of epileptic seizures and the phases of the moon. Alteration in anticonvulsant treatment or monitoring of canine and feline patients with idiopathic epilepsy at large was not warranted based on the lunar cycle.

Answering the myth: use of emergency services on Friday the 13th

OBJECTIVE

The aim of the study was to evaluate the risk of Friday the 13th on hospital admission rates and emergency department (ED) visits.

METHODS

This was a retrospective chart review of all ED visits on Friday the 13th from November 13, 2002, to December 13, 2009, from 6 hospital-based EDs. Thirteen unlikely conditions were evaluated as well as total ED volumes. As a control, the Friday before and after and the month before and after were used. χ(2) Analysis and Wilcoxon rank sum tests were used for each variable, as appropriate.

RESULTS

A total of 49 094 patient encounters were evaluated. Average ED visits for Friday the 13th were not increased compared with the Friday before and after and the month before. However, compared with the month after, there were fewer ED visits on Friday the 13th (150.1 vs 134.7, P = .011). Of the 13 categories evaluated, only penetrating trauma was noted to have an increase risk associated with Friday the 13th (odds ratio, 1.65; 95% confidence interval, 1.04-2.61). No other category was noted to have an increase risk on Friday the 13th compared with the control dates.

CONCLUSIONS

Although the fear of Friday the 13th may exist, there is no worry that an increase in volume occurs on Friday the 13th compared with the other days studies. Of 13 different conditions evaluated, only penetrating traumas were seen more often on Friday the 13th. For those providers who work in the ED, working on Friday the 13th should not be any different than any other day.

Impact of the lunar cycle on the incidence of aneurysmal subarachnoid haemorrhage: myth or reality?

OBJECTIVE

To investigate the impact of the lunar cycle on the incidence of aneurysmal subarachnoid haemorrhages.

METHODS

We retrospectively identified all patients admitted to the department of neurosurgery during 1992 and 2004 suffering from aneurysmal subarachnoid haemorrhage. The onset of bleeding was compared with the lunar phase.

RESULTS

We did not observe any significant impact of the lunar cycle on the incidence of aneurysmal subarachnoid haemorrhage in 717 consecutive patients (p=0.84).

CONCLUSION

The impact of the lunar cycle on aneurysmal subarachnoid haemorrhage is a myth rather than reality.

The influence of the full moon on the number of accessions to an animal emergency centre

OBJECTIVE

To test the hypothesis that the number of animal emergency centre accessions is associated with the time of the full moon.

DESIGN AND PROCEDURE

Retrospective study. A comparison was made of the number of accessions to the University of Melbourne Animal Emergency Centre in the period February 2003 to January 2006 on full moon and non-full moon days, adjusted for day of the week and public holiday. A three day period with the day of the full moon as the middle day was taken to be a full moon period.

RESULTS

A total of 12,102 animals were presented to the Centre in this time. An adjusted count ratio of 1.048 (95% CI 0.97 to 1.14; P = 0.26) for accessions on full moon days compared with those on non-full moon days indicated that there was no significant association between the full moon and the number of accessions per day.

CONCLUSION

There was no significant difference between the number of animals presented to the University of Melbourne Animal Emergency Centre on full moon days and non-full moon days.

Canine and feline emergency room visits and the lunar cycle: 11,940 cases (1992–2002)

OBJECTIVE

To determine the frequency of canine and feline emergency visits with respect to the lunar cycle.

DESIGN

Retrospective case series.

ANIMALS

11,940 dogs and cats evaluated on an emergency basis during an 11-year period.

PROCEDURES

Date of emergency visit, signalment, and chief complaint were retrieved from a medical records database. Emergency type was categorized as animal bite, cardiac arrest, epilepsy, ophthalmic, gastric dilatation-volvulus, trauma, multiple diseases, neoplasia, or toxicosis. The corresponding lunar phase was calculated and recorded as new moon, waxing crescent, first quarter, waxing gibbous, full moon, waning gibbous, last quarter, or waning crescent. The effect of lunar phase on the frequency of emergency visits was evaluated by calculating relative risk.

RESULTS

Of 11,940 cases, 9,407 were canine and 2,533 were feline. Relative risk calculations identified a significant increase in emergencies for dogs and cats on fuller moon days (waxing gibbous to waning gibbous), compared with all other days.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that more emergency room visits occurred on fuller moon days for dogs and cats. It is unlikely that an attending clinician would notice the fractional increase in visits (0.59 and 0.13 more canine and feline visits, respectively) observed in this study at a facility with a low caseload. If the study is repeated at a facility with a robust emergency caseload, these results may lead to reorganization of staffing on fuller moon dates. A prospective study evaluating these findings under conditions of high caseload is necessary to determine the clinical relevance.

The influence of the weather and the phase of the moon on post-operative nausea and vomiting

BACKGROUND

Post-operative nausea and vomiting (PONV) is believed and previously reported to be influenced by the weather and the phase of the moon. We therefore determined the effects of specific and general weather patterns as well as the lunar phase on PONV in adults undergoing balanced inhalation anaesthesia.

METHODS

The incidence of PONV was prospectively evaluated in 1801 patients undergoing elective surgical, urologic and head and neck procedures. Air temperature, barometric pressure, air water vapour pressure and the general weather situation were obtained from the National Weather Institute in Germany on the days of surgery. Corresponding categories of temperature, pressure, vapour pressure and their day-to-day changes, the general weather situation and the phase of the moon were used to group the patient data. The differences between the proportion of patients having PONV and the proportion predicted to have PONV according to their calculated risk were determined for each category. Further, bivariate and multivariate testing was applied.

RESULTS

Within 24 h after anaesthesia, PONV occurred in 555 of the patients (31%). There was no correlation between weather conditions and PONV occurrence or between the phase of the moon and PONV occurrence. Even when corrected for the patients' risk and other potentially confounding factors in multivariate logistic regression analysis, no statistically significant impact of the hypothesized factors could be detected.

CONCLUSION

These data suggest that neither the weather nor the phases of the moon have any clinically relevant effect on the incidence of PONV after general anaesthesia.

The influence of the full moon on the number of admissions related to gastrointestinal bleeding

The objective of this study was to analyse whether the number of admissions for gastrointestinal bleeding to our bleeding unit increases during the full moon. In a prospective study, we included 447 consecutive patients with gastrointestinal haemorrhage admitted to our bleeding unit during a period of two years. The number of admissions was allocated to the corresponding day of the lunar cycle, and full moon and non-full moon days were compared. A wide variation in the number of admissions throughout the lunar cycle was observed. There were 26 admissions on the 25 days of full moon and 421 admissions in the remaining 713 days of non-full moon. This difference was mainly related to a higher incidence of haemorrhage in men and variceal haemorrhage at full moon. The results of this study suggest an increase in the number of admissions related to gastrointestinal haemorrhage in our bleeding unit during the full moon, especially in men and in patients experiencing variceal haemorrhage. However, the wide variation in the number of admissions throughout the lunar cycle could limit interpretation of the results. Therefore, further studies are needed to clarify the possible influence of the moon on gastrointestinal haemorrhage.

The influence of the full moon on seizure frequency: myth or reality?

To investigate a possible relationship between seizure frequency and the lunar cycle, we reviewed the occurrence of seizures recorded in our epilepsy monitoring unit over a 3-year period. Analysis of the total number of seizures (epileptic plus nonepileptic) showed no significant association. A separate analysis revealed that for nonepileptic seizures, there was an increase at the full moon, and for epileptic seizures, an increase in the last quarter. We conclude that there is no "full moon" effect on seizures as a whole, although there is a possible effect on nonepileptic seizures.

Sex difference in response to stress by lunar month: a pilot study of four years' crisis-call frequency

BACKGROUND

This study is in response to the question of whether the moon can influence daily levels of stress.

METHOD

Four years of telephone-call frequency data were obtained from a single crisis-call centre. We used the method of lunar-day numbers 1 to 29 for analysis. We also tested the concept of 'strong moons' as occurring when the Sun was near to the lunar-node axis.

RESULTS

An increase in calls was recorded from females and a decrease in calls by males during the new moon period, suggesting a sex difference in response, and there were proportionally more calls by males a fortnight later. A comparable swing in the male/female call-ratio on a weekly basis over Fridays and Saturdays was noted. Limitations of staffing at the call-centre prohibited comment on seasonal correlations.

CONCLUSION

Lunar-related studies of stress should endeavour to separate the data by sex or the effect can be lost. Distress-calls by women were more strongly linked to the lunar month than were those by men.

Modelling risk factors for injuries from dog bites in Greece: a case-only design and analysis

We conducted a study using a newly developed dataset based on Emergency Departments records of a network of hospitals from Greece on injuries from dog bites. Our goal is three-fold: (a) to investigate if surrogate factors of leisure time are associated with increased risk of injury from bites; (b) to address recently reported contradictory results on putative association of lunar periods and injuries from dog bites; and (c) to offer a general methodology for addressing similar case-only designs with combined factors of which some can exhibit cyclical patterns. To address these goals, we used a case-only design of our dataset, and conducted an analysis where we controlled simultaneously for weekday/weekend effects, season of year (winter, spring/fall, summer), and lunar periods, because any one of these factors can contribute to the degree of exposure to injuries from dog bites. We found that increased risk of injury from bites was associated with weekends versus weekdays (RR=1.19, 95% CI: 1.10-1.29), summer versus winter (RR=1.24, 95% CI: 1.11-1.39), and fall or spring versus winter (RR=1.31, 95% CI: 1.19-1.45). The results support the hypothesis that longer leisure time at these levels of factors does increase the risk of having a bite injury. Moreover, after controlling for these factors, risk of bite injury was not associated with moon periods, thereby also helping settle a longstanding argument.

Moon cycles and violent behaviours: myth or fact?

We formulated the hypothesis that lunar phases, identified by the fraction of the illuminated visible surface of the moon, have a relationship with the frequency of victims of aggression seen in an emergency department. If such a relationship exists, an increase in the frequency of incidents with the phases of full moon or new moon would be expected. In order to test this hypothesis, the daily frequency of victims of violent behaviour seen in the emergency department was used to create a temporal series of data. This was then correlated with a temporal series of lunar luminosity data from the same time period. Crossed correlations in the delay range -7 to +7 days showed coefficient values ranging between -0.102 and +0.034, demonstrating weak correlations without statistical significance. Despite the attractiveness of the popular belief that the moon influences human behaviour, the analysis of our data does not support an association between lunar phases and frequency of violent behaviour. That is, we cannot predict the frequency of cases from a knowledge of lunar luminosity, at least in the period over which our study was performed.