Can a cat scratch give you rabies?

The NCDC guidelines say the rabies virus passes to people through an animal's saliva, after bites, scratches, licks on broken skin and contact with the lining of the eyes, nose or mouth. The European Advisory Board on Cat Diseases says the same of cats: the virus is shed in saliva a few days before signs appear and spreads through a bite or a scratch of the skin or mucous membranes.

Dogs cause most cases in India, about 95% according to the NCDC, but cats are next at about 2%, followed by jackals, mongooses and others. The WHO says rabies is virtually 100% fatal once symptoms appear, and that deaths are preventable with prompt treatment. That is why a scratch is not something to wait and see about.

A rabid cat is often not hard to spot, but you cannot rely on that. The ABCD guideline says nearly all rabid cats show the furious form, with aggression, and that the average incubation period in cats is two months but can range from two weeks to many months. A cat can be shedding the virus before it looks ill.

It matters less than you might hope. The NCDC says animals vaccinated against rabies do not get or pass on the disease, but vaccines can fail because of how they were given, the dose, the vaccine's quality or the animal's health. Without a laboratory antibody result, a vaccinated animal cannot be presumed protected, so the guidelines say treatment should be given irrespective of the animal's vaccination status. Take the cat's vaccination card to the doctor anyway: it is part of the history the doctor weighs.

The 10-day watch can change the plan. The NCDC explains that an infected animal usually shows signs, or dies, within 1 to 7 days, which is the basis for observing dogs and cats for 10 days. If the cat stays healthy, the doctor may modify the treatment, depending on the type of course. Treatment still starts on the first day, and only the doctor decides whether to change it. A street cat that cannot be found again cannot be observed, so the doctor will usually plan on that basis.

Yes: cat scratch disease, a bacterial infection that is quite separate from rabies. The CDC says it spreads through scratches from domestic or feral cats, particularly kittens, especially when the scratch is contaminated with flea droppings, and through bites or licks on an open wound. It typically causes a small bump at the scratch, a low fever and tender, swollen lymph nodes one to three weeks after contact with a cat. People with weakened immune systems are at higher risk of severe illness.

If a scratch becomes red, swollen or painful, or glands near it swell in the weeks after, see your doctor and mention the cat. And if your own cat scratches more than usual, or a gentle cat starts lashing out, take it to your vet: pain and illness change how cats behave.