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1Repair Windows errors before they cause bigger problems2Fix the driver behind crashes, sound loss and screen glitches3Clear out junk files and repair common Windows errorsCat-scratch disease (CSD) is an uncommon human infection, even though the bacterium that causes it circulates widely among cats. The best U.S. estimate found 4.7 diagnosed cases per 100,000 people younger than 65 each year, based on insurance claims from 2005–2013—not a current count of every infection or a lifetime risk for individual cat owners.
Children, especially those ages 5–9, were diagnosed most often. A scratch contaminated with flea feces is the usual route, but prompt wound cleaning, handwashing, veterinary-guided flea control and sensible cat handling substantially reduce exposure.
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How common is cat-scratch disease?
The most detailed U.S. estimate comes from a CDC-published analysis of commercial health-insurance claims covering 2005 through 2013. Investigators identified 13,273 people with a CSD diagnosis: 12,735 treated as outpatients and 538 admitted to hospital. The authors estimated an average of 4.7 diagnosed cases per 100,000 people under age 65 each year, or about 12,500 diagnoses annually in that age range.
That figure describes diagnosed illness in a privately insured, under-65 population during an earlier period. CSD was not nationally notifiable, the analysis did not include people 65 and older, and some infections may never have been diagnosed. It therefore should not be presented as a current all-age national case count or as the probability that a particular cat owner will become sick.
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| Measure | What the CDC analysis reported | How to interpret it |
|---|---|---|
| Overall diagnosed incidence | 4.7 per 100,000 people under 65 per year | Average annual diagnosed rate from 2005–2013 claims |
| Outpatient diagnoses | 4.5 per 100,000 people under 65 per year | Estimated roughly 12,000 outpatient diagnoses annually |
| Inpatient admissions | 0.19 per 100,000 people under 65 per year | Estimated roughly 500 hospitalizations annually |
| Highest-age group | Children ages 5–9: 9.0 outpatient diagnoses and 0.4 inpatient admissions per 100,000 per year | Historical claims rate, not a child’s individual risk |
| Geographic variation | 6.1–6.4 per 100,000 in the West South Central, East South Central and South Atlantic divisions; 2.2 per 100,000 in the Mountain division | Differences in diagnosed rates across U.S. census divisions |
CDC’s current public guidance says CSD occurs throughout the United States, is more common in the Southeast and is diagnosed more often in children under 15. The historical claims pattern is consistent with that age and regional distribution, but it cannot establish today’s exact rate.
Why cat infection is not the same as human disease
CSD is caused primarily by Bartonella henselae. Cats can carry the bacterium in their bloodstream without appearing ill. CDC veterinary guidance reports documented bacteremia in about 30–40% of domestic and adopted shelter cats; CDC public information also notes that some studies found the organism in up to one in three healthy cats, particularly kittens.
Those percentages measure bacterial carriage in cats, not the frequency of CSD in people. A cat carrying B. henselae does not mean every person who touches it will be infected, and most cat scratches do not result in CSD. Because carriage can be temporary and testing does not predict which human exposures will cause illness, CDC does not recommend testing or treating a healthy cat for B. henselae.
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Fleas maintain the infection cycle
Cats can acquire B. henselae through flea bites. Flea feces may contain the bacteria; when contaminated material gets into a scratch, it can inoculate a person. This is why controlling fleas matters even when a cat looks healthy.
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Scratches are the usual route
A scratch from a kitten is a familiar exposure, but an adult cat can also transmit the organism. Bites and a cat licking an open wound are additional possible routes. Direct transmission to people through cat flea bites has been suggested, but CDC says it has not been proven. The practical focus is preventing contaminated claws, teeth or saliva from contacting broken skin.
Who is more likely to have complications?
Children account for the highest diagnosed rates in the historical U.S. data, partly because they have frequent close contact with kittens and may play in ways that provoke scratches. People with weakened immune systems have a greater risk of severe or disseminated disease. Their clinician may need to evaluate symptoms more urgently than would be necessary for a healthy adult with a minor, healing scratch.
CDC advises people with weakened immune systems that they can still own cats, but should avoid cats younger than one year old. They do not need to have a healthy cat tested or treated solely because of their immune status.
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Typical illness
The first visible sign may be a small bump or pustule where the scratch occurred. A low-grade fever and tender, enlarged lymph nodes commonly follow. Lymph nodes often become noticeable one to three weeks after the exposure, so the scratch and the illness may not occur on the same day.
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Uncommon but serious disease
Rare complications can affect the eye, liver, spleen, brain, bones or heart valves. They are more concerning in people with weakened immune systems, but anyone with severe, persistent or unusual symptoms needs medical assessment rather than watchful self-treatment.
When to contact a healthcare professional
Contact a healthcare provider if you or a child develops any of the following after a cat scratch or bite:
- A fever one to three weeks after the exposure
- Tender or visibly enlarged lymph nodes
- A pustule or bump at the scratch site that is not settling
- Eye, neurologic, abdominal, bone or heart-related symptoms
- Worsening illness or unusual symptoms in someone with a weakened immune system
Clinicians often make the diagnosis from the symptom pattern and a compatible cat exposure. Laboratory testing can help when illness is severe, atypical or difficult to distinguish from another condition. Do not use a positive cat test—or the fact that a cat looks healthy—as a substitute for medical evaluation of a person.
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Treatment: what to expect
Most CSD cases are self-limited and improve without extensive intervention. CDC says antibiotics are required for immunocompromised patients. For otherwise healthy patients, a clinician may recommend treatment based on the severity of illness and the patient’s preferences. Severe or disseminated disease can require a longer course and specialist care.
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There is no appropriate over-the-counter antibiotic regimen for CSD. Do not start leftover medicine, stop a prescribed course early or treat the cat in an attempt to treat a person. A healthcare professional should select any drug, dose and duration after considering the symptoms and the patient’s health.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Practical prevention steps
1. Reduce scratches, bites and wound contact
- Handle kittens and unfamiliar, stray or frightened cats calmly; avoid games that encourage pouncing or clawing.
- Do not allow a cat to lick an open cut, healing wound or the eyes.
- Supervise young children around cats and teach them not to pull tails, ears or legs.
- Move away and seek adult help when a cat is showing fear or aggression instead of trying to restrain it.
2. Clean every scratch promptly
- Rinse the area and wash it thoroughly with soap and running water as soon as possible.
- Remove visible dirt without aggressively scrubbing or damaging the skin.
- Seek medical advice for a deep wound, a bite, uncontrolled bleeding or signs of infection, and for any concerning symptoms that develop later.
Cleaning does not guarantee that CSD will be prevented, but it removes contaminated material before it can remain in the wound.
3. Wash hands after cat contact
Wash with soap and water after handling cats, litter, food bowls or items that may have flea dirt on them. Hand hygiene is particularly important before eating and after caring for a kitten or a cat with fleas.
4. Use veterinarian-guided flea control
Ask a veterinarian to select a flea-control product labeled for your cat’s species, age and weight, and follow the label and veterinary directions. Flea control lowers the opportunity for cats to acquire and spread B. henselae, but no product should be described as preventing every case of CSD.
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Never use a product containing permethrin on a cat. Permethrin products intended for dogs or other species can be toxic to cats. If accidental exposure occurs, contact a veterinarian or an animal poison service immediately and follow their instructions.
5. Limit flea and stray-cat exposure
Keeping cats indoors and away from stray cats can reduce contact with fleas and with cats whose infection status is unknown. Indoor living does not eliminate all flea risk, so continue the preventive plan recommended by the veterinarian.
6. Make a plan for household members with weakened immunity
People with weakened immune systems should avoid owning cats under one year old and should discuss safe handling, scratch avoidance and flea control with their healthcare professional and veterinarian. They do not need to surrender a healthy cat or arrange routine B. henselae testing solely because of immune status.
7. Do not declaw to prevent CSD
CDC does not recommend declawing cats as a CSD-prevention strategy. Preventive handling practices, wound care and flea control address the relevant exposure without that surgery.
Questions the numbers cannot answer
The 4.7-per-100,000 estimate cannot tell you the chance of illness after one scratch, the current rate in a particular state, or the risk for adults 65 and older. It is also not a measure of all infections because it came from diagnosis codes in commercial insurance claims and CSD was not nationally reportable. A veterinarian can help with cat-specific concerns, while a healthcare professional should assess a person’s symptoms and medical risk.
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