Risk of Rabies Transmission from Cat Scratches

Transmission Risk Assessment

Nonbite exposures such as cat scratches very rarely cause rabies, but transmission is possible if saliva or other potentially infectious material from a rabid cat contaminates open wounds or abrasions, as reported by the Centers for Disease Control and Prevention 1, 2
Cat scratches alone do not constitute a rabies exposure unless they are contaminated with saliva or other potentially infectious material from a rabid animal, according to the Centers for Disease Control and Prevention 3, 4
For rabies transmission to occur, the virus must be introduced into fresh, open cuts in skin or onto mucous membranes, as stated by the Centers for Disease Control and Prevention 2, 3
The contamination of scratches with saliva from a rabid animal constitutes a nonbite exposure that requires assessment for potential post-exposure prophylaxis, as recommended by the Centers for Disease Control and Prevention 1, 5
Rabies virus is inactivated by desiccation, ultraviolet irradiation, and other factors and does not persist in the environment - if the suspect material is dry, the virus can be considered noninfectious, according to the Centers for Disease Control and Prevention 2, 6

The decision to initiate rabies post-exposure prophylaxis depends on the nature of the exposure, the epidemiology of rabies in the area, the species and vaccination status of the animal involved, and the availability of the animal for observation or testing, as stated by the Centers for Disease Control and Prevention 2, 3, 5, 7
If the cat appears healthy and is available for observation, it should be confined and observed for 10 days, as recommended by the Centers for Disease Control and Prevention 7
If the cat remains alive and healthy 10 days after the incident, it would not have been shedding rabies virus in its saliva at the time of the scratch, according to the Centers for Disease Control and Prevention 7

Consult with local or state public health officials to determine the need for rabies post-exposure prophylaxis following a cat scratch, as recommended by the Centers for Disease Control and Prevention 1, 3
Post-exposure prophylaxis should be considered if the scratch was contaminated with saliva from a rabid or potentially rabid cat, or if the cat is unavailable for observation or testing and rabies is endemic in the area, as stated by the Centers for Disease Control and Prevention 2, 3, 5