ATLANTA (Reuters Health) - Although people of any age can contract a bacterial infection from cats called "cat-scratch disease," children may be at particularly high risk, according to researchers at the US Centers for Disease Control and Prevention (CDC).

This infection, which is relatively common and usually not serious, is characterized by chronic fever and swollen lymph nodes. But in up to one in four cases the infection can result in more serious problems that could land a child in the hospital, the researchers report in the March 15th issue of the CDC's Morbidity and Mortality Weekly Report.

What's more, cat-scratch disease might be confused with more severe and alarming diagnoses such as the blood cancer lymphoma and a type of cancer of the nervous system called neuroblastoma.

The CDC estimates that about 22,000 new cases of cat-scratch disease occur in the US each year; and children under 10 years are the most likely to develop the infection.

Cat-scratch disease is transmitted by cat fleas, which pass along the bacterium Bartonella henselae. But exactly how the fleas transmit the disease to humans is unknown. Scratchs, licks or bites from a cat--particularly a kitten--is a risk factor.

The disease is one of the most common causes of chronic swollen lymph glands among children, the CDC report indicates.

"Children may simply be at greater risk of exposure, as they are probably more prone to engage in rough play with cats than are (most) adults," the CDC's Dr. Mary Reynolds explained, "and because they often, unintentionally or otherwise, provoke aggressive behavior from animals," she told Reuters Health.

In the report, the federal agency looked at 32 children treated for cat-scratch disease at a hospital in Texas over a 1-year period. Overall, 14 children had to be hospitalized, and the more severely affected youngsters had a variety of symptoms including high fevers, persistent low-grade fevers, an inability to walk due to back pain and an inflammation of the lining membrane of the heart. Antibiotics can help, although most children recover with no treatment at all.

Cat-scratch disease "can stimulate inflammatory processes in different parts of the body leading to bone lesions, vision loss, encephalitis (a swelling of tissue within the brain and spinal cord), painfully enlarged lymph nodes or other very striking and concerning symptoms," Reynolds said.

"Although these symptoms can be alarming--especially to the parents of a sick child--in most cases...the disease typically resolves within a few weeks to months without long-term side effects," she explained.

According to Reynolds, persons with weak immune systems or those who have heart-valve disease should avoid cats, especially kittens.

"All pet owners should be careful to prevent flea infestations in their pets as cat fleas are involved in maintaining infections in animals," she said, "and naturally, scratches and abrasions from any animal should be thoroughly cleaned as soon as possible."

Cats with the bacteria rarely show signs of infections and there is no vaccine for the disease.

SOURCE: Morbidity and Mortality Weekly Report 2002;51:212-214.

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