Management of Stray Cat Bite Without Visible Injury in Previously Vaccinated Individual
Since you have completed a full rabies vaccination series previously, you need only a simplified 2-dose booster regimen (days 0 and 3) without rabies immune globulin, and the stray cat should be reported to local health authorities for attempted 10-day observation. 1, 2
Immediate Actions Required
Wound Management
- Thoroughly wash the bite area with soap and copious amounts of water for at least 15 minutes, even without visible marks or blood, as this is the single most important intervention to reduce rabies transmission risk 3, 2
- Irrigate with povidone-iodine solution after soap and water cleansing 2
Report to Health Authorities
- Immediately report this incident to your local health department, as all cat bites from stray animals must be reported regardless of severity 1, 4, 2
- The health department will coordinate attempts to locate and confine the cat for 10-day observation 1
Rabies Post-Exposure Prophylaxis Decision
For Previously Vaccinated Persons (Your Situation)
You require a simplified 2-dose booster series only:
- Administer rabies vaccine on day 0 (immediately) and day 3 1
- No rabies immune globulin (RIG) is needed since you have completed prior vaccination 1, 2
- This simplified regimen applies regardless of how long ago your last dose was administered 1
Rationale for Immediate Treatment
- Stray cats pose high rabies risk and should be considered potentially rabid until proven otherwise, especially since the cat cannot be immediately evaluated 1, 2
- More cats than dogs are reported rabid in the United States 2
- Even non-bleeding bites constitute rabies exposure through saliva contact with broken skin 1, 2
- Never delay prophylaxis waiting for animal testing results if the cat is unavailable or high-risk 3, 2
Cat Observation Protocol
If Cat Can Be Located and Confined
- The cat must be confined and observed daily by a veterinarian for 10 days 1, 4
- Do not allow rabies vaccine to be administered to the cat during observation, as this confuses clinical signs 4
- Any illness in the cat during confinement must be reported immediately to the health department 1, 4
- If the cat remains healthy throughout the entire 10-day period, prophylaxis can be discontinued 2
If Cat Cannot Be Located
- Continue the full 2-dose booster series since the cat's rabies status cannot be determined 2
- The cat should be considered potentially rabid 1
Additional Essential Measures
Tetanus Assessment
- Assess your tetanus immunization status and receive a booster if your last dose was >5 years ago for contaminated wounds or >10 years for clean wounds 3, 2
Infection Prevention
- Consider antibiotic prophylaxis, particularly if presentation is delayed >8-12 hours, as cat bites pose the greatest risk for bacterial infection among animal bites 3, 5
- Cat bite infections typically involve both aerobic and anaerobic oral flora 5
Critical Pitfalls to Avoid
- Never delay the 2-dose booster series even if the bite appears minor without visible injury—rabies virus can be transmitted through microscopic breaks in skin 1, 2
- Never administer RIG to previously vaccinated persons, as it is unnecessary and can interfere with vaccine response 1, 2
- Never wait for the cat to be located before initiating your booster doses—begin immediately 3, 2
- Never assume a stray cat is low-risk simply because it has been around your house for months—its vaccination status and exposure history are unknown 2