Children should not be left unsupervised to play with a dog, say experts in this week’s BMJ. Their advice is part of a review aimed at doctors who deal with dog bites.

Dog bites and maulings are a worldwide problem, particularly in children, write Marina Morgan and John Palmer. Every year 250,000 people who have been bitten by dogs attend minor injuries and emergency units in the United Kingdom, and half of all children are reportedly bitten by dogs at some time, boys more than girls.

Accurate death figures are difficult to obtain, but in the past five years, two to three cases a year have made news headlines.

Based on the latest medical evidence, they advise doctors how to examine and treat a patient presenting with a dog bite. They discuss the risk of infection and when to refer to specialist care. For travellers bitten abroad, they suggest assessing the risk of rabies.

In terms of prevention, they suggest that children should be taught to treat dogs with respect, avoid direct eye contact, and not tease them. They should be taught not to approach an unfamiliar dog; play with any dog unless under close supervision; run or scream in the presence of a dog; pet a dog without first letting it sniff you; or disturb a dog that is eating, sleeping, or caring for puppies.

Dog owners also need to change their behaviour, writes Rachel Besser, a children’s doctor and lifetime dog owner, in an accompanying article.

It is clear that not all dog owners appreciate that children should not be left unsupervised with a dog, she says. Just as some parents are obliged to take parenting classes, she would like to see equivalent mandatory classes for expectant dog owners to teach them about the responsibilities of dog ownership. Educational programmes for children are also needed to instil precautionary behaviour around dogs.

Finally, she would like to see vets advising dog owners about bite prevention, and doctors promoting bite prevention when treating patients who have been bitten by dogs.

BMJ-British Medical Journal