What are the rabies guidelines for a dog bite from an owned but not present canine (dog) in Massachusetts?

From the Guidelines

In Massachusetts, if you're bitten by an owned dog whose rabies vaccination status is unknown because the dog isn't present, you should immediately wash the wound thoroughly with soap and water for at least 15 minutes, then seek medical attention. The healthcare provider will assess the need for rabies post-exposure prophylaxis (PEP) based on the circumstances, as recommended by the Advisory Committee on Immunization Practices (ACIP) 1. Massachusetts law requires that the dog be quarantined and observed for 10 days by animal control or a veterinarian, as stated in the compendium of animal rabies prevention and control 1. If the dog remains healthy during this period, rabies PEP is typically not necessary. However, if the dog cannot be located for observation, PEP may be recommended, which consists of rabies immune globulin (RIG) and a series of four rabies vaccine doses given on days 0,3,7, and 14, as outlined in the human rabies prevention guidelines 1. The decision to start PEP should not be delayed while waiting to find the dog. Massachusetts has a mandatory rabies vaccination law for dogs, so there's a good chance the dog is vaccinated, but this must be verified. You should also report the bite to local animal control or the board of health, as they can help locate the dog and verify its vaccination status. Some key points to consider include:

• The importance of prompt medical attention and wound cleaning
• The role of animal control and veterinary observation in determining the need for PEP
• The potential risks and benefits of PEP, including the use of RIG and rabies vaccine
• The need for verification of the dog's vaccination status and the importance of reporting the bite to local authorities. It is essential to follow the most recent guidelines and recommendations from reputable sources, such as the ACIP and the National Association of State Public Health Veterinarians (NASPHV), to ensure the best possible outcome in terms of morbidity, mortality, and quality of life 1.

From the FDA Drug Label

The following recommendations are only a guide Apply these in conjunction with knowledge of the animal species involved, circumstances of the bite or other exposure, vaccination status of the animal, and presence of rabies in the region. Dogs, cats, and ferrets Healthy and available for 10 days observation Persons should not begin prophylaxis unless animal develops clinical signs of rabies.* Rabid or suspected rabid Immediately begin prophylaxis. Unknown (e.g., escaped) Consult public health officials.

The guidelines for a dog bite from an owned but not present dog in Massachusetts are:

• If the dog is healthy and available for 10 days observation, persons should not begin prophylaxis unless the animal develops clinical signs of rabies.
• If the dog is rabid or suspected rabid, immediately begin prophylaxis.
• If the dog is unknown (e.g., escaped), consult public health officials. It is essential to consult local and state public health officials if questions arise about the need for rabies prophylaxis 2.

From the Research

Rabies Guidelines for Dog Bite from Owned but Not Present Dog in Massachusetts

• The provided studies do not specifically address the rabies guidelines for dog bites from owned but not present dogs in Massachusetts 3, 4, 5, 6, 7.
• However, the studies discuss the general guidelines for rabies post-exposure prophylaxis (PEP) which may be applicable to dog bites in general.
• According to the studies, PEP consists of:
  • Washing the wound with water and soap for 15 minutes 3
  • Assessing the need for rabies biologicals based on specific criteria 3
  • Administering rabies immunoglobulin or monoclonal antibodies deep in and around all wounds if required 3, 5
  • Starting the WHO-recommended intradermal 1-week vaccination regimen if necessary 3, 4
• The studies also discuss the importance of adherence to guideline recommendations for rabies IG patient selection, dosing, timing, and anatomical site of administration 5.
• Additionally, the studies highlight the need for clear doctor-patient communication and sharing of up-to-date knowledge among healthcare professionals to ensure effective PEP 3, 6.

Specific Considerations

• The 1-week, 2-site ID PEP schedule is considered safe, immunogenic, and cost-effective 4.
• Changes in the rabies vaccine product and/or the route of administration during PEP are possible, but more research is needed to understand the safety and immunogenicity of novel PEP schedules in special populations such as infants and immunocompromised individuals 4.
• Administering rabies vaccines during pregnancy is considered safe and effective 4.

Massachusetts Specific Guidelines

• Unfortunately, there are no specific studies provided that address the rabies guidelines for dog bites from owned but not present dogs in Massachusetts.
• It is recommended to consult the Massachusetts Department of Public Health or the Centers for Disease Control and Prevention (CDC) for specific guidelines on rabies PEP in Massachusetts 6.