Rabies Post-Exposure Prophylaxis for Dog Scratch

Assessment of Exposure Risk

A healthy domestic dog that scratches a person should be confined and observed for 10 days, as recommended by the Centers for Disease Control and Prevention, to determine the risk of rabies exposure 1, 2
Dogs that remain alive and healthy 10 days after exposure would not have been shedding rabies virus in their saliva at the time of the incident and would not have been infectious, according to the Centers for Disease Control and Prevention 1
The 10-day observation period is sufficient to reliably determine the risk of rabies exposure for the person who was scratched, as stated by the Centers for Disease Control and Prevention 2

The health status of the animal is crucial, and any illness in the dog during the confinement period should be evaluated by a veterinarian and reported immediately to the local public health department, as recommended by the Centers for Disease Control and Prevention 1
A dog with a history of current rabies vaccination is unlikely to become infected with rabies, according to the Centers for Disease Control and Prevention 3
The circumstances of the incident, such as an unprovoked attack, might be more likely to indicate rabies than a provoked interaction, as suggested by the Centers for Disease Control and Prevention 3
The likelihood of rabies in domestic dogs varies regionally, and local rabies epidemiology should be considered, as stated by the Centers for Disease Control and Prevention 4

Assess need for tetanus prophylaxis and measures to control bacterial infection, as recommended by the Centers for Disease Control and Prevention 5
Confine and observe the domestic dog for 10 days, as recommended by the Centers for Disease Control and Prevention 1, 6
Monitor for any signs of illness or abnormal behavior in the dog during the observation period, as suggested by the Centers for Disease Control and Prevention 2

The essential components of rabies PEP, when indicated, include wound treatment and, for previously unvaccinated persons, administration of both rabies immune globulin and vaccine, as recommended by the Centers for Disease Control and Prevention 5
Administration of rabies PEP is a medical urgency, not a medical emergency, but decisions should not be delayed if exposure is confirmed, according to the Centers for Disease Control and Prevention 5
In areas where canine rabies is not endemic, the risk of rabies from domestic dogs is extremely low, as stated by the Centers for Disease Control and Prevention 6

Delayed reporting of any illness in the dog during the observation period must be promptly reported to the local public health department, as recommended by the Centers for Disease Control and Prevention 1
Inadequate wound care can increase the likelihood of rabies transmission, and thorough wound cleansing alone can markedly reduce the risk, as suggested by the Centers for Disease Control and Prevention 5
The risk assessment should consider the prevalence of rabies in the local dog population, as stated by the Centers for Disease Control and Prevention 4