Cat Scratch Disease

Please click the frequently asked questions below for further information and IPC precautions required:

• What is Cat Scratch Disease (CSD)?

  Cat scratch disease is an infection caused by a bacterium called Bartonella henselae. Some cats, especially kittens, carry Bartonella bacteria in their blood and saliva, and can spread it to humans, by biting, scratching, or licking an open wound. It’s usually fairly mild and eventually goes away without any treatment, although it can take several months.

• How does it spread?

  Most cats in the world are infected by B. henselae at some point in their lives, usually when they are kittens less than a year old. It doesn’t cause them any problems at all, except very rarely. They catch it from fleas that have picked it up from another cat. They can also catch it directly from an infected cat if they have been fighting.

  Most people who get cat scratch disease have caught it from a cat and can remember a scratch, bite or a lick from a cat in the previous week to two months. Very occasionally the affected person doesn’t remember any contact with a cat.

  It is possible they have caught it from an infected cat flea. Some people think it can be caught from other animals such as dogs and rabbits, but this hasn’t been proven.

• What are the symptoms?

  Most people who get cat scratch disease start by getting little spots where their skin has been in contact with a cat’s saliva – so a scratch or a bite nasty enough to have broken the skin is the usual cause. If a cat has licked an open wound, it can cause infection in that way too.

  • The spots start as just small red marks.
  • Then they become fluid-filled, like little blisters.
  • Finally they crust over and scab.
  • Sometimes they can be yellow, pus-filled spots.
  • It is common to think that they are insect bites.
  • They appear sometime between 3 and 12 days after being scratched or bitten (or licked if there is a cut or graze) by a kitten or a cat.

  The next symptom to develop is a swollen gland (lymph node) or glands.

  • Lymph nodes are part of the body’s immune system which defends the body against infection.
  • The lymph node that is nearest the place where the spots developed is the one that swells, although others may swell too.
  • The swelling usually starts about two weeks after the scratch.
  • The most common lymph nodes to swell are the ones in the armpit (axilla) and in the head and neck.
  • The swollen lymph node or nodes can get very large – bigger than a tennis ball.
  • Any affected lymph node is painful, hot, red and tender.
  • Sometimes the lymph node can fester and discharge pus (suppurate) – this affects 2 or 3 people out of every 10 who get cat scratch disease.

  

• Why is this important?

  If NIAS staff are aware that the patient has a suspected or confirmed case this should be communicated to the Control Room (Emergency or Non-emergency as appropriate) and the staff in the receiving unit when transferring the patient to ensure effective patient care and management.

• IPC Precautions
  • Standard Precautions should be used.
  • Hand Hygiene should be completed as per the 5 moments in line with usual practice.
  • Eye protection should be risk assessed for any concern regarding a splash risk.
  • Gloves and Aprons should be risk assessed and worn if contact with the patient’s blood or bodily fluids.
  • Laundry should be treated as per usual local policy.
• What cleaning is required?

  All equipment and the ambulance should have an in-between patient clean, paying particular attention to touch points.

• Do staff need prophylaxis or follow up?

  No staff follow up required.