An important new study on Cat Scratch Disease (CSD) was recently published by researchers at the U.S. Centers for Disease Control (CDC) in the journal Emerging Infectious Disease. CSD is an acute infection with the bacteria Bartonella henselae and characterized by acute fever and persistent swollen lymph nodes. Based on an analysis of 9 years of private health insurance claims data for people under the age of 65, key findings include:
- CSD appears to be a bigger concern for immunocompetent adults and for females compared to men than previously recognized.
- Average annual incidence of CSD is 4.7 per 100,000 persons <65 years of age in the US, with an estimated total of 12,500 patients receiving a CSD diagnosis each year in the United States.
- Given the limitations of the MarketScan insurance claims database (a convenience sample excluding claims from persons >65 years of age, military personnel, uninsured persons, or Medicaid/Medicare enrollees), the actual incidence of CSD may be much higher.
Evidence Beyond CSD
CSD and other types of Bartonellosis are not notifiable conditions. As a result, information on the epidemiology of Bartonella-related disease is extremely limited. Importantly, current research from teams around the globe have published important evidence further challenging traditional understandings of CSD and other Bartonella spp infections. Notable emerging evidence includes:
- Up to 15 species of Bartonella are now implicated in human illness and infection has been documented in countries all around the globe.
- Veterinarians and other animal workers are the highest risk group for Bartonella spp infection identified to date. Along with other zoonotic and vector-borne infections, Bartonellosis constitutes an occupational hazard for veterinary workers.
- Tick transmission is possible. We know that several species of ticks may carry Bartonella henselae in the US and Europe; however, the likelihood of tick transmission has not been established.
- Emerging research increasingly links Bartonella spp infection (bartonelloses) to chronic illnesses, affecting the cardiovascular system, neurological system, and rheumatologic systemin immunocompetent patients and not just in patients with weakened immune systems.
Fortunately, innovations in diagnostic approaches for confirmation of Bartonella spp infection in patient samples are driving research and discovery into the medical importance of these elusive bacteria and supporting efforts to raise awareness about the occupational risks and potential prevalence of Bartonella spp infection.
As always, PREVENTION IS KEY. For the prevention of CSD, CDC researchers recommend “comprehensive flea control for cats can help reduce the risk for human infection. Risk may also be reduced by washing hands after contact with cats, to remove potentially infectious flea feces that could enter breaks in the skin. Furthermore, because cats that hunt outdoors are at substantially greater risk for B. henselae bacteremia, limiting hunting activity of cats may reduce risk for human infection.”
To limit occupational exposure, we recommend that veterinarians and other animal workers use personal protective devices. We also urge pet owners and animals workers to use appropriate flea and tick control practices to ensure the health and safety of the animals and the people who care for them.
To learn more about the latest research and emerging clinical picture related to Bartonella sppinfection, please see our FREE medical education webinar, Understanding Bartonella.