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Recent evidence suggests that cat scratch disease is transmitted by a cat scratch or bite or by a cat flea bite. Kittens are believed to be more likely to carry the disease than cats. Rare cases have been reported after exposure to a dog and dog fleas.
The estimated annual incidence of cat scratch disease in the United States is 3.7 per 100 000 inhabitants, with the highest attack rate found in the under 10 age group (9.3 per 100 000 inhabitants/year) .
Cat scratch disease is ubiquitously present in the world and is most common in the winter months . It tends to affect younger, healthy individuals and is most often harmless. However, it may also arise in immunocompromised subjects; systemic Bartonella henselae infections have been described in transplant patients or patients treated with ribavirin and pegylated interferon [3, 4]
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