Fatal dog attacks in the United States cause the deaths of about 30 to 50 people in the US each year,[1] and the number of deaths from dog attacks appears to be increasing.[2] Around 4.5 million Americans are bitten by dogs every year, resulting in the hospitalization of 6,000 to 13,000 people each year in the United States (2005).[2] A 2018 literature review with meta-analysis by breed, focusing on dog bite injuries to the face, head and neck, concluded that "of the cases in which the breed was known, the Pit-bull was responsible for the highest percentage of reported bites across all the studies followed by mixed breed and then German Shepherds," and that "injuries from Pitbull's and mixed breed dogs were both more frequent and more severe."[3][4]