Cat Bite Without Proper Wound Care: Risks and Vaccination Concerns - Influenza

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A bite from a feral cat without rinsing the wound?


Hello doctor, today I was bitten by a stray cat (it bled) and I have one larger wound on my left hand along with several smaller spots.
I only rinsed the larger wound briefly with saline (just for a moment) and didn't clean the smaller spots, which started bleeding later.
After that, I went to the hospital for a shot.
About an hour later, when the nurse was administering the injection, she wiped the area with alcohol.
I received the tetanus and rabies vaccine (the first dose).
During this time (before reaching the hospital), I felt my heart suddenly race three times, and my hands and feet felt a bit numb.
The wound was painful and tingling.
The hospital measured my temperature at 37 degrees Celsius.
Although I received the rabies and tetanus vaccines, after returning home, I felt like there was something stuck in my throat when I spoke.
I looked online and saw some people mention that after receiving the rabies vaccine, they still felt symptoms of rabies.
I would like to ask if there is a possibility of this happening (since I didn't properly rinse the wound right away)? Before the vaccination, the doctor mentioned that if I had immunity, I shouldn't receive the vaccine.
What does that mean? (My immune system is quite weak.)

Dan, 20~29 year old female. Ask Date: 2018/05/09

Dr. Ke Zhengqin reply Influenza


Hello: Dr.
Ke has retired, and I am Dr.
Lin Wu-Fu from the Infectious Diseases Department responding on his behalf: 1.
Vaccination does not guarantee 100% prevention of rabies, but according to the literature, the probability is quite low, and the prevalence of rabies among feral cats in Taiwan is not high.
Therefore, the likelihood of encountering a rabid feral cat and still contracting rabies after vaccination is extremely minimal.
Additionally, the progression of rabies is very slow, with an incubation period typically lasting 1-3 months, so it is unlikely for symptoms to appear the day after a bite.
2.
Vaccines can generally be classified into live attenuated vaccines and inactivated vaccines.
Live attenuated vaccines contain live viruses (though they are significantly weakened), so they are not recommended for immunocompromised individuals.
Common examples of live attenuated vaccines include the varicella vaccine and the measles-mumps-rubella (MMR) vaccine.
The rabies vaccine is an inactivated vaccine, so there are not many contraindications for its administration.
3.
In addition to tetanus and rabies, there is another condition called "cat scratch fever" that requires special attention after being bitten by a feral cat.
Common symptoms include fever, painful swelling at the wound site, and enlarged lymph nodes in the armpit.
Furthermore, cellulitis is also a common complication following a bite.
Therefore, if you experience fever or persistent swelling at the wound site after being bitten, it is advisable to seek medical attention promptly.
Taipei Hospital, Infectious Diseases Department, Dr.
Lin Wu-Fu.

Reply Date: 2018/05/09

More Info


When it comes to cat bites, especially from stray cats, there are several important considerations regarding the risk of infection and the need for vaccinations. Cat bites can introduce bacteria into the body, leading to potential infections, and they can also pose a risk for diseases such as rabies and cat scratch fever.

Firstly, it is crucial to understand that cat bites can be quite serious. Cats have sharp teeth that can create deep puncture wounds, which may not always bleed significantly but can still harbor bacteria. Common bacteria associated with cat bites include Pasteurella multocida, which is often found in the mouths of cats. If left untreated, these infections can lead to cellulitis, abscess formation, and in severe cases, systemic infections.

In your case, since you mentioned that you were bitten by a stray cat and that there was bleeding, it is essential to have the wound properly assessed and treated. The fact that you only rinsed the wound with saline and did not perform a thorough cleaning is concerning. Ideally, cat bite wounds should be washed immediately with soap and water for at least 5 to 10 minutes to reduce the risk of infection. If you have not done this, there is a higher chance of developing an infection.

Regarding vaccinations, you mentioned receiving a tetanus shot and the first dose of the rabies vaccine. This is a critical step in managing the risk associated with cat bites. Rabies is a viral disease that can be transmitted through the saliva of an infected animal, and while the risk is lower in domestic cats, it is still a concern, especially with stray animals. The rabies vaccine is typically administered in a series of doses, and it is vital to complete the series as recommended by your healthcare provider.

You also expressed concerns about feeling your heart racing and experiencing tingling in your hands and feet after the vaccination. These symptoms could be related to anxiety or a mild reaction to the vaccine, but it is essential to monitor them. If these symptoms persist or worsen, you should seek medical attention.

As for your question about the possibility of contracting rabies despite receiving the vaccine, it is important to note that the rabies vaccine is highly effective when administered correctly and within the appropriate time frame after exposure. However, if you have a weakened immune system, the effectiveness of the vaccine may be compromised. It is crucial to inform your healthcare provider about your immune status, as they may need to adjust the vaccination protocol or provide additional treatments.

In summary, after a cat bite, especially from a stray cat, it is vital to:
1. Thoroughly clean the wound: If you haven't done so already, clean the wound with soap and water as soon as possible.

2. Seek medical attention: Follow up with a healthcare provider for a proper assessment of the wound and to discuss the need for antibiotics, especially if there are signs of infection (redness, swelling, increased pain, or pus).

3. Complete the rabies vaccination series: Ensure you receive all doses of the rabies vaccine as prescribed.

4. Monitor your symptoms: Keep an eye on any unusual symptoms and report them to your healthcare provider.

Taking these steps can help mitigate the risks associated with cat bites and ensure your health and safety.

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