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The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

Straight from the Headlines: Cat Lick Causes Blindness in Ohio Woman

In case you have been letting your cat lick your eyeball lately, here’s a warning: don’t.


A woman in Ohio recently lost vision in her left eye after becoming infected with Bartonella henselae, a pathogen that is normally subclinical in cats but can cause a variety of symptoms in humans.


Bartonella is a bacterium that is transmitted through the saliva of cats, and can be found on their fur as well as in their mouths. It may also be transmitted by inoculating a person through a scratch, hence its common name “cat scratch fever.” About 40 percent of cats will have Bartonella in their lifetime, and it’s a disease that’s found worldwide.


The symptoms of Bartonella infection in humans are fairly diffuse: local swelling at the site of the scratch, lymph node swelling, fever, malaise. Once diagnosed, Bartonella can be treated with antibiotics. In the case of the woman in Ohio, she was diagnosed too late to save her vision, but fortunately that is a very rare presentation of the disease.


So how do you protect yourself and your family against this zoonotic disease? Fortunately, simple basic preventive care and hygiene is the most effective way to reduce your risk of exposure.


  1. Use flea prevention: the flea is the vector by which cats transmit Bartonella to each other, so regular use of a safe and effective flea medication will reduce your risk of exposure.
  2. Regular hand washing: since the bacterium is spread through saliva, touching any areas of broken skin after petting your cat could put you at risk.
  3. Don’t let your cat lick open wounds or mucous membranes: I can’t imagine people doing this as a matter of course to begin with, but just in case it was something you were considering, I would counsel you not to.


Generally speaking, Bartonella is not one of the major zoonotic diseases that make us tremble in our boots. If your cat bites you, get your rear into your doctor ASAP — not because of Bartonella, but because of Pasteurella, another commonly found cat mouth bacterium that causes some terrible local infections in cat bite injuries. Now don’t you feel better?


Not to say we all need to isolate ourselves in a bubble and refuse to touch our pets from here on out. I’ve been living and working with cats my whole adult life and the worst I’ve been exposed to from a pet is ringworm when I was pregnant, one of the more common groups to be susceptible to zoonotic disease.


So there’s only two take home lessons here. With some basic precautions, there’s no reason you need to fear your pet. Also, if your eye seems wonky, don’t mess around, see a doctor. Happy petting!



Dr. Jessica Vogelsang



Image:  Inga Ivanova / Shutterstock





Pet 'Kisses': Health Hazard or Health Benefit?


Reduce the Potential for Zoonotic Disease Transmission


Fleas and Your Cat


Cat Scratch Disease — What It Means For You And Your Cat


Comments  7

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  • HHHmmmm.
    06/03/2015 06:05pm

    Do we know how long the woman waited between first onset of symptoms to seeing a doctor?

    I suspect this is another one of those headlines that's trying to grab the reader's attention when there really isn't much else to report.

  • Transmission by saliva???
    06/05/2015 10:08am

    Hi Dr Vogelsang,

    I first saw the article/news report on this via the AVMA Animal Health SmartBrief, which may also be where you heard about it. The original news story was done by a Toledo TV news station.

    Okay ... I'm really confused. Can you cite for me a study that shows that [i]Bartonella henselae[/i] is transmitted to humans via cat SALIVA? Yes, the human physician interviewed by the Toledo news station said that it is transmitted by cat saliva. But human physicians are not always up-to-date on issues involving veterinary medicine and zoonoses.

    I asked my friend and mentor, Dr Richard Ford (DACVIM, emeritus at NC State College of Veterinary Medicine, infectious disease specialist, known for his expertise in vaccines & vaccination protocols) about this. He is not aware of any new information suggesting [i]Bartonella [/i]is transmitted via saliva. He commented that while one may be infected with [i]Bartonella[/i], it may not necessarily be the cause of something (e.g. blindness). It is difficult to prove cause and effect.

    Probably the recognized world authority on [i]Bartonella [/i]is Dr Edward Breitschwerdt at NC State. I don't recall him ever suggesting [i]Bartonella [/i]is transmitted via saliva, though I admit I haven't heard him speak in quite a while. Maybe there is new information? And another respected expert on [i]Bartonella [/i]is Dr Mike Lappin at Colorado State who is one of the co-authors (and the corresponding author) for the AAFP's 2006 Panel Report on [i]Bartonella[/i]. A link to that report can be found on the AAFP website at:

    I do remember well a talk on [i]Bordetella [/i]by Dr Lappin (I'm not a vet, but I like to listen to recordings of vet CE conferences ... and I have attended a few with the advocacy of Dr Ford). Dr Lappin emphasized what is also said in the AAFP 2006 Report ... i.e. [i]Bartonella henselae[/i] is transmitted between cats and from cats to people primarily via FLEA FECES (aka flea dirt, flea poop). If you've heard Dr Lappin speak before, I'm sure you can also hear him saying adamantly, "It's the fleas, it's the fleas!, IT'S THE FLEAS!!! ... Don't kill the cat! Kill the FLEAS!!!!"

    My understanding is that fleas feed off of [i]Bartonella[/i] infected cats and get the bacterium in their gut. The fleas then poop out the [i]Bartonella[/i] when they hop on other cats. The cats then ingest the infected flea poop when they groom themselves, infecting the cat.

    Since cats often scratch when they have fleas ... they can then get infected flea poop under their nails/claws and when they scratch a human, they inoculate the scratch with the infected flea poop ... and that is why it is called "cat scratch disease", even though the real culprits are the fleas (their poop) ... not the cat. The cat just inoculates it.

    The AAFP Report mentions one eye disease known to be caused by [i]Bartonella[/i], called Parinaud’s oculoglandular syndrome. The theory is that it gets in the eye by people being around cats with fleas that are infected with [i]Bartonella [/i]... and the people get infected flea poop on their hands and then rub their eye(s) ... thus, "inoculating" their eye with the flea feces. I did some googling on the eye disease and most sites say that it is quite treatable and often clears on its own. Most don't even mention blindness as a consequence of infection ... but it seems to be a rare outcome, more likely in someone who is severely immunocompromised (e.g. AIDS, chemotherapy, etc).

    One other known means of transmission is via infected cat BLOOD ... which cats may get under their claws if they scratch themselves to the point of bleeding ... and then inoculate the infected blood into a wound as they would the flea feces.

    Since there are some people who have gotten [i]Bartonella [/i]without prior contact with cats ... there is speculation (not proven) that it may also be transmitted via flea poop in the environment or possibly via other arthropods. (cf. Q10 in the AAFP Report, p4 of the Report or p216 of the published version in the AAFP's Journal of Feline Medicine and Surgery).

    The 2006 AAFP Panel Report on [i]Bartonella [/i]makes ONE comment about saliva ... in the very last section of the report. Out of an over-abundance of caution, while acknowledging that [i]Bartonella [/i]is not known to be transmitted by saliva, they say:

    "While [i]Bartonella spp.[/i] have not been shown to be transmitted by saliva, cats should not be allowed to lick open human wounds."

    I wasn't surprised by the apparent misinformation on a TV news show or from a human physician who is not current on zoonotic diseases ... but I was surprised to see you, a well respected veterinarian, say it as well. So, I'm losing my confidence and am wondering if there is new evidence that Bartonella henselae is transmitted by cat saliva.

    Like you, I don't want people panicking over this and more cats ending up at a shelter ... or worse. Unless there is new research that you know of, that I don't (always a real possibility) ... people cannot get Bartonella from cat saliva. I hope that accurate information can be given to the public ... and if I'm wrong, please let me know and share the study that shows it can be transmitted by saliva. I don't want to promote false info either.

    Stephanie in Raleigh

  • 06/05/2015 11:03am

    I had cat scratch fever in my eye. I got it from a monkey on an Amazonian island. The monkey did not scratch me, but ate a banana from my hand. So the transmission could have been through saliva. I then scratched my eye - I think - and transmitted the disease to my eye. I did not lose my vision, but my optomologist was very concerned. It took weeks to get an accurate diagnosis, in part because it takes symptoms some time to show after infection. Also the disease is rare and seen most frequently in children who live with cats.

  • 06/05/2015 12:18pm

    Hi KLMD,

    First, I'm glad you recovered without any loss of eye sight. I do have a few questions and would like to know more about what you had.

    "Bartonella" is a species with many different types. The most common type that infects cats ... and is known to cause "cat scratch disease in humans" is Bartonella henselae. Cats are considered the primary reservoir hosts for Bartonella henselae and Bartonella clarridgeiae, and probably for Bartonella koehlerae (I'm getting this info from the AAFP Report on Bartonella).

    According to the AAFP Report, the majority of people with "cat scratch disease" have been infected with Bartonella henselae or Bartonella quintana. However, while Bartonella henselae is transmitted by cat fleas ... Bartonella quintana is transmitted by lice and cats are not considered an important factor in its transmission to people.

    So, my first question to you is what strain of Bartonella did you have? Was it indeed Bartonella henselae ... the type that is most commonly found in cats? Or was it another strain/type of Bartonella ... which may infect monkeys?

    I don't know if Bartonella henselae is known to infect monkeys in the Amazon. There is no mention of that in the AAFP Report on Bartonella. In my limited knowledge, I think that with some infections that can infect more than one species ... even when it is the same "bug" ... it may affect each species differently. That may mean different signs/symptoms of infection in the different species ... and, perhaps, may result in a different means of transmission.

    My point/question is that even if you were infected with Bartonella henselae from monkey saliva ... it may be that in that SPECIES of monkey, it makes its way to the salivary glands and is present in the saliva. It wouldn't necessarily mean that is true of Bartonella henselae in cats ... which is the subject of the article and this blog.

    I have a lot of respect for the veterinary researchers. I haven't looked for supportive studies, but I feel confident that they have looked for Bartonella in the saliva of infected cats. It would make sense to test saliva to find out if it can be transmitted that way. The physician in the news story says that it can be transmitted in the saliva of cats ... but the veterinary researchers and experts who wrote or were sources for the AAFP Bartonella Report have concluded that it is not known to be transmitted in cat saliva.

    So, my question is, first ... was it actually Bartonella henselae (the type found in cats, known to cause cat scratch disease) that you had? And, if so, even if it is transmitted in monkey saliva ... is there any scientific evidence that it is transmitted through the saliva of CATS? They are different species and the Bartonella may react and be transmitted differently between the two.

    Stephanie in Raleigh

  • 06/05/2015 06:15pm

    Don't know. It was a deductive diagnosis. A definitive diagnosis would have required a lymph node biopsy, which they felt was too invasive with unnecessary risks.

  • 06/05/2015 08:21pm

    Hi KLMD,

    I can understand not wanting to do the needed diagnostics to confirm that you had Bartonella. But, unfortunately for researchers, there is no way to know if you actually had Bartonella ... nor if it was Bartonella henselae, i.e. the same type that is found in cats. And without testing the saliva of the monkey, there is no way to know if it was transmitted via the saliva. It's also possible that, unknowingly, you may have gotten an infected flea feces on your hand (from the monkey or elsewhere) and accidentally inoculated yourself when rubbing your eye.

    It's an interesting case, but I don't think scientists would be able to draw any conclusions from it without proper diagnostics and testing. Ultimately, it is good that you recovered and are okay.

    Stephanie in Raleigh

  • Let's talk RINGWORM!!!
    06/12/2015 12:42am

    Dr. V. Thank you for clarifying this horrid headline. You mentioned ringworm. Im facing that now or think I still am and it's getting worse not better. Desperately need advice!!!

    Last year foster kitten tested positive for ringworm. Gave her medication and foster sister. But she had already been exposed to other cats and nested in closet where all of my cats had circulated. All my cats had lesions including myself. Kitten was since adopted and fine. I was instructed to wash all bedding and bathe or lime dip cats once a week. I have 7 pets. there is no way I can physically bathe them once a week with my back. I bathe 2-3 a week. But I have been doing laundry everyday to minimize. But now the itching has escalated to sharp itchiness like needles!! for me and I notice cats itching/scratching even more yet I'm cleaning more. And one of my cats has URI with green eye discharge. I took her in to vet and said it was URI but her bloodwork was normal. Vet said antibiotics wont' help. Yet when I gave her little of Clavamox it was helping. And I've run out. Now the puffy runny eyes has returned and green eye discharge. Poor Geisha is miserable. Its going on 2 months now. Sounds like the herpes virus. Lycene has not helped. Other cats start to sneeze and get congested and then it goes away, then it comes back. No more lesions. but itchiness still there. What is the sharp needle feeling?? PLEASE what should I do??? The vicious cycle is getting worse not better. DESPERATE!!!

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