Child/Adolescent Health

Despite increase in cat ownership, the hospitalization rate for children with cat-scratch disease remains stable

Both children and adults can develop cat-scratch disease (CSD) from exposure to cats infected with Bartonella henselae, but CSD is principally a pediatric disease. Despite the rise in cat ownership in the United States, the rate of children hospitalized for CSD in 2000 was similar to that of the 1980s, according to a new study. Typical CSD is generally benign and self-limited and is characterized by enlarged lymph nodes and fever. However, atypical CSD infections can be accompanied by inflammatory responses involving the neurologic, organ, lymphatic, or skeletal systems, which can lead to hospitalization.

Researchers at the Centers for Disease Control and Prevention, and co-author Claudia A. Steiner, M.D., M.P.H., of the Center for Delivery, Organization, and Markets, of the Agency for Healthcare Research and Quality (AHRQ), used data from the Kids' Inpatient Database of AHRQ's Healthcare Cost and Utilization Project to examine pediatric hospitalizations for CSD. During 2000, an estimated 437 CSD-associated hospitalizations occurred among children younger than 18 years in the United States. The national CSD-associated hospitalization rate was 0.60:100,000 children younger than 18 years and 0.86:100,000 for children younger than 5 years.

Accompanying diagnoses included neurologic complications (12 percent), liver/spleen involvement (7 percent), and other problems (5 percent). Atypical CSD accounted for about 24 percent of the CSD-associated hospitalizations. Hospital stays were as long as 19 days for typical CSD and 22 days for atypical CSD, with average charges almost double for atypical CSD hospitalizations. Procedures usually included operations on lymph nodes or tissues, probably for diagnostic evaluation. The median charge for a CSD-associated hospitalization was $6,140 with total annual hospital charges of about $3.5 million.

See "Epidemiology of cat-scratch disease hospitalizations among children in the United States," by Mary G. Reynolds, M.S., Ph.D., Robert C. Holman, M.S., Aaron T. Curns, M.P.H., and others, in the August 2005 Pediatric Infectious Disease Journal 24(8), pp. 700-704. Reprints (AHRQ Publication No. 06-R011) are available from the AHRQ Publications Clearinghouse.

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