SECTION I - INFECTIOUS AGENT


NAME: Cat Scratch Disease

SYNONYM: Bartonella henselae

CHARACTERISTICS: Gram-negative bacillus; vegetative and cell-wall defective variant forms.

SECTION II - HEALTH HAZARD

PATHOGENICITY: Mild fever and swelling of the lymph nodes; possible serious abscess formation; 25-60% of patients report a primary cutaneous inoculation lesion at the site of cat scratch or bite; headache, anorexia, weight loss, nausea, vomiting, sore throat, and splenomegaly may develop; nonspecific maculopapular eruptions, erythema nodosum and thrombocytopenic purpura have been observed.

EPIDEMIOLOGY: Worldwide, usually occurs in children during cool months; may become systemic or recurring in immunocompromised individuals.

HOST RANGE: Humans, cats, rodents, dogs.

MODE OF TRANSMISSION: Through cat scratches or bites; contact between a cat's body fluids and abraded skin.

INCUBATION PERIOD: 3 -14 days

COMMUNICABILITY: Cats-only able to transmit disease for a few weeks at a time; young cats are more susceptible to carrying bacteria than older cats. No direct human-to-human transmission.

SECTION III - DISSEMINATION

RESERVOIR: Cats

ZOONOSIS: Yes

VECTORS: Possibly fleas?

SECTION IV

DRUG SUSCEPTIBILITY: Erythromycin, doxycycline

SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to 1% sodium hypochlorite (20% commercial bleach), 2% glutaraldehyde, formaldehyde, 70% ethanol.

PHYSICAL INACTIVATION: Sensitive to heating.


SURVIVAL OUTSIDE HOST: Survives in tap water at room temperature for up to 7 days.

SECTION V - MEDICAL

SURVEILLANCE: Monitor for symptoms; confirmation by testing paired sera by ELISA or indirect fluorescent antibody test; biopsy specimen stained with Warthin-Starry silver stain.

FIRST AID/TREATMENT: Treatment with ciprofloxacin, amoxicillin-clavulanate or sulfatrimethoprim may be useful; efficacy not established. Patients may benefit from analgesics and bed rest. Patients with severe lymph node suppuration may be relieved by needle aspiration of pus.

IMMUNIZATION: None

PROPHYLAXIS: None

SECTION VI: LABORATORY HAZARDS

LABORATORY-ACQUIRED INFECTIONS: Information unavailable.


SOURCES/SPECIMENS: Infected cats.


PRIMARY HAZARDS: Cat bites or scratches.


SPECIAL HAZARDS: None.

SECTION VII - RECOMMENDED PRECAUTIONS

CONTAINMENT REQUIREMENTS: Biosafety level 2 practices and containment facilities for activities involving known or potentially infectious materials.

PROTECTIVE CLOTHING: Laboratory coat and gloves when working with infectious materials.


OTHER PRECAUTIONS: Avoid accidental inoculation and follow general needle safety practices.

SECTION VIII - HANDLING INFORMATION

SPILLS: Allow aerosols to settle; wearing protective clothing, gently cover spill with absorbent paper towel and apply 1% sodium hypochlorite (20% commercial bleach) starting at the perimeter and working towards the center-, allow sufficient contact time (30 min) before clean up.

DISPOSAL: Decontaminate all wastes before disposal; steam sterilization, chemical disinfection, incineration.

STORAGE: In sealed containers that are appropriately labeled.
Information provided by the Colorado State University Office of Biosafety; June 16, 1998.

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