{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T17:02:31Z","timestamp":1785171751801,"version":"3.55.0"},"reference-count":59,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Cat-related injuries are a frequent reason for antirabies consultation, but long-term data on their epidemiology and management remain limited, particularly in European settings that have transitioned from endemic sylvatic rabies to officially rabies-free status. We retrospectively analysed registry data on all patients examined for cat-related injuries at the Zagreb Antirabies Clinic, the Croatian Reference Centre for Rabies, between 1995 and 2025. Among 24,107 animal-related consultations, 3147 (13.1%) involved cats. Most patients were female (64.8%), and children under 18 years of age accounted for 14.7% of the patients. The offending cat had a known owner in 48.5% of cases and was unknown in 45.9%. Records associated with laboratory-confirmed rabid cats accounted for 4.8%, all from 1995 to 2012. Post-exposure prophylaxis (PEP) was administered to 37.6% of patients, and human rabies immunoglobulin (HRIG) to 2.9%. Hospitalisation was rare (1.1%), while injuries most often involved the fist and fingers (59.5%). PEP administration was strongly associated with the rabies risk status of the offending cat, increasing from 8.7% for known-owner cats to 62.0% for unknown cats and approximately 87% for suspected or laboratory-confirmed rabid cats (p &lt; 0.001). In multivariable analysis, animal status remained the principal factor independently associated with PEP (adjusted odds ratio for unknown versus known-owner cats approximately 18), whereas patient characteristics had limited effect. HRIG use declined below 1% in 2015\u20132025, paralleling the elimination of sylvatic rabies in Croatia. Continued structured exposure assessment remains relevant despite rabies-free status, particularly when cats are unknown or unavailable for observation.<\/jats:p>","DOI":"10.3390\/v18080817","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T16:11:56Z","timestamp":1785168716000},"page":"817","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cat-Related Injuries and Rabies Exposure: A Three-Decade Retrospective Analysis from the Zagreb Antirabies Clinic (1995\u20132025)"],"prefix":"10.3390","volume":"18","author":[{"given":"Kre\u0161imir","family":"Tu\u0107in","sequence":"first","affiliation":[{"name":"Institute of Public Health of Zagreb County, Mokri\u010dka ulica 54, 10290 Zapre\u0161i\u0107, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dora","family":"Primorac","sequence":"additional","affiliation":[{"name":"Andrija \u0160tampar Teaching Institute of Public Health, Mirogojska ulica 16, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1559-9020","authenticated-orcid":false,"given":"Ivana","family":"Lojki\u0107","sequence":"additional","affiliation":[{"name":"Croatian Veterinary Institute, Savska cesta 143, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5645-8286","authenticated-orcid":false,"given":"Radovan","family":"Vodopija","sequence":"additional","affiliation":[{"name":"Andrija \u0160tampar Teaching Institute of Public Health, Mirogojska ulica 16, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hampson, K., Coudeville, L., Lembo, T., Sambo, M., Kieffer, A., Attlan, M., Barrat, J., Blanton, J.D., Briggs, D.J., and Cleaveland, S. (2015). Estimating the global burden of endemic canine rabies. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003786"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1080\/01652176.2017.1343516","article-title":"Rabies\u2014Epidemiology, pathogenesis, public health concerns and advances in diagnosis and control: A comprehensive review","volume":"37","author":"Singh","year":"2017","journal-title":"Vet. Q."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/S0140-6736(04)15792-9","article-title":"Rabies and other lyssavirus diseases","volume":"363","author":"Warrell","year":"2004","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/S1474-4422(13)70038-3","article-title":"Human rabies: Neuropathogenesis, diagnosis, and management","volume":"12","author":"Hemachudha","year":"2013","journal-title":"Lancet Neurol."},{"key":"ref_5","unstructured":"World Health Organization (2018). WHO Expert Consultation on Rabies: Third Report, World Health Organization. Available online: https:\/\/iris.who.int\/handle\/10665\/272364."},{"key":"ref_6","unstructured":"World Health Organization, Food and Agriculture Organization of the United Nations, and World Organisation for Animal Health (2018). Zero by 30: The Global Strategic Plan to End Human Deaths from Dog-Mediated Rabies by 2030, World Health Organization. Available online: https:\/\/iris.who.int\/handle\/10665\/272756."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Bedekovi\u0107, T., Lohman Jankovi\u0107, I., \u0160imi\u0107, I., Kre\u0161i\u0107, N., Lojki\u0107, I., Su\u010dec, I., Robardet, E., and Cliquet, F. (2018). Control and elimination of rabies in Croatia. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0204115"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.tvjl.2014.10.026","article-title":"Terrestrial rabies control in the European Union: Historical achievements and challenges ahead","volume":"203","author":"Freuling","year":"2015","journal-title":"Vet. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"20120142","DOI":"10.1098\/rstb.2012.0142","article-title":"The elimination of fox rabies from Europe: Determinants of success and lessons for the future","volume":"368","author":"Freuling","year":"2013","journal-title":"Philos. Trans. R. Soc. Lond. B Biol. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"M\u00fcller, T.F., Schr\u00f6der, R., Wysocki, P., Mettenleiter, T.C., and Freuling, C.M. (2015). Spatio-temporal use of oral rabies vaccines in fox rabies elimination programmes in Europe. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003953"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Robardet, E., Bosnjak, D., Englund, L., Demetriou, P., Rosado Mart\u00edn, P., and Cliquet, F. (2019). Zero endemic cases of wildlife rabies (classical rabies virus, RABV) in the European Union by 2020: An achievable goal. Trop. Med. Infect. Dis., 4.","DOI":"10.3390\/tropicalmed4040124"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lojki\u0107, I., \u0160imi\u0107, I., Bedekovi\u0107, T., and Kre\u0161i\u0107, N. (2021). Current status of rabies and its eradication in Eastern and Southeastern Europe. Pathogens, 10.","DOI":"10.3390\/pathogens10060742"},{"key":"ref_13","unstructured":"(2021). Commission Implementing Regulation (EU) 2021\/620 of 15 April 2021 laying down rules for the application of Regulation (EU) 2016\/429 of the European Parliament and of the Council as regards the approval of the disease-free and non-vaccination status of certain Member States or zones or compartments thereof as regards certain listed diseases and the approval of eradication programmes for those listed diseases. Off. J. Eur. Union, L131, 78. Available online: https:\/\/eur-lex.europa.eu\/eli\/reg_impl\/2021\/620\/oj."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Vodopija, R., Lojki\u0107, I., Hamidovi\u0107, D., Boneta, J., and Primorac, D. (2024). Bat bites and rabies PEP in the Croatian Reference Centre for Rabies 1995\u20132020. Viruses, 16.","DOI":"10.3390\/v16060876"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Fehlner-Gardiner, C., Gongal, G., Tenzin, T., Sabeta, C., De Benedictis, P., Rocha, S.M., Vargas, A., Cediel-Becerra, N., Gomez, L.C., and Maki, J. (2024). Rabies in cats: An emerging public health issue. Viruses, 16.","DOI":"10.3390\/v16101635"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2392","DOI":"10.5455\/OVJ.2024.v14.i9.27","article-title":"Epidemiology of cat bites to people in Uruguay: Effects of the age and sex of the victim, season of the year, and the COVID-19 pandemic","volume":"14","author":"Willat","year":"2024","journal-title":"Open Vet. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1023\/A:1007460213308","article-title":"The epidemiology of bite and scratch injuries by vertebrate animals in Switzerland","volume":"14","author":"Matter","year":"1998","journal-title":"Eur. J. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1056\/NEJM199901143400202","article-title":"Bacteriologic analysis of infected dog and cat bites","volume":"340","author":"Talan","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1128\/CMR.00041-10","article-title":"Microbiology of animal bite wound infections","volume":"24","author":"Abrahamian","year":"2011","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/j.1742-6723.2008.01130.x","article-title":"Animal bites: An update for management with a focus on infections","volume":"20","author":"Dendle","year":"2008","journal-title":"Emerg. Med. Australas."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S1473-3099(09)70110-0","article-title":"Bite-related and septic syndromes caused by cats and dogs","volume":"9","author":"Oehler","year":"2009","journal-title":"Lancet Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Echevarr\u00eda, J.E., Banyard, A.C., McElhinney, L.M., and Fooks, A.R. (2019). Current rabies vaccines do not confer protective immunity against divergent lyssaviruses circulating in Europe. Viruses, 11.","DOI":"10.3390\/v11100892"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"280","DOI":"10.3201\/eid1502.080637","article-title":"European bat lyssavirus transmission among cats, Europe","volume":"15","author":"Dacheux","year":"2009","journal-title":"Emerg. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Leopardi, S., Barneschi, E., Manna, G., Zecchin, B., Priori, P., Drzewniokov\u00e1, P., Festa, F., Lombardo, A., Parca, F., and Scaravelli, D. (2021). Spillover of West Caucasian bat lyssavirus (WCBV) in a domestic cat and westward expansion in the Palearctic region. Viruses, 13.","DOI":"10.3390\/v13102064"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/B978-0-12-387040-7.00012-3","article-title":"Bats and lyssaviruses","volume":"79","author":"Banyard","year":"2011","journal-title":"Adv. Virus Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/zph.12002","article-title":"Bat rabies surveillance in Europe","volume":"60","author":"Schatz","year":"2013","journal-title":"Zoonoses Public Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1111\/zph.13141","article-title":"Human cat borne rabies as the new epidemiology of the disease in the Andes mountains","volume":"71","author":"Escobar","year":"2024","journal-title":"Zoonoses Public Health"},{"key":"ref_28","unstructured":"Ministry of Health of the Republic of Croatia (2026, June 02). Ordinance on the Implementation of Immunization, Seroprophylaxis and Chemoprophylaxis against Communicable Diseases and on Persons Subject to This Obligation; Official Gazette (Narodne Novine) No. 103\/2013, amended by No. 144\/2020 and No. 133\/2022. Available online: https:\/\/www.zakon.hr\/c\/podzakonski-propis\/46759\/."},{"key":"ref_29","first-page":"784","article-title":"From the archives of the Zagreb Antirabies Clinic: Hospitalized persons due to animal bites from 2007 to 2021 (Part Two)","volume":"63","author":"Vodopija","year":"2024","journal-title":"Acta Clin. Croat."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Jur\u010dev Savi\u010devi\u0107, A., Buzov, J., Vu\u010dica, I., Marasovi\u0107 \u0160u\u0161njara, I., and Savi\u010devi\u0107, N.J. (2025). Surveillance of humans exposed to the potentially rabid animals and rabies post-exposure prophylaxis in Split-Dalmatia County, Croatia, 2015\u20132024. Medicina, 61.","DOI":"10.3390\/medicina61122119"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"World Health Organization (2018). Rabies vaccines: WHO position paper, April 2018\u2013Recommendations. Vaccine, 36, 5500\u20135503.","DOI":"10.1016\/j.vaccine.2018.06.061"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"A166","DOI":"10.1016\/j.vaccine.2018.11.010","article-title":"Modelling to inform prophylaxis regimens to prevent human rabies","volume":"37","author":"Hampson","year":"2019","journal-title":"Vaccine"},{"key":"ref_33","unstructured":"Rupprecht, C.E., Fooks, A.R., and Abela-Ridder, B. (2018). Laboratory Techniques in Rabies, World Health Organization. [5th ed.]."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.jfms.2006.11.001","article-title":"Incidence of and risk factors for cat bites: A first step in prevention and treatment of feline aggression","volume":"9","author":"Palacio","year":"2007","journal-title":"J. Feline Med. Surg."},{"key":"ref_35","first-page":"420","article-title":"Reported cat bites in Dallas: Characteristics of the cats, the victims, and the attack events","volume":"105","author":"Wright","year":"1990","journal-title":"Public Health Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"723","DOI":"10.2460\/javma.22.11.0494","article-title":"Clinical and epidemiologic features of persons accessing emergency departments for dog and cat bite injuries in California (2005\u20132019)","volume":"261","author":"Campagna","year":"2023","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"100743","DOI":"10.1016\/j.onehlt.2024.100743","article-title":"The epidemiology and clinical features of post-exposure prophylaxis for rabies: A retrospective study of 9772 cases","volume":"18","author":"Jiang","year":"2024","journal-title":"One Health"},{"key":"ref_38","first-page":"501","article-title":"Dog and cat bites: Rapid evidence review","volume":"108","author":"Ortiz","year":"2023","journal-title":"Am. Fam. Physician"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.jhsa.2013.11.003","article-title":"Cat bite infections of the hand: Assessment of morbidity and predictors of severe infection","volume":"39","author":"Babovic","year":"2014","journal-title":"J. Hand Surg. Am."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jinf.2006.01.001","article-title":"Cat bite wound infections: A prospective clinical and microbiological study at three emergency wards in Stockholm, Sweden","volume":"53","author":"Westling","year":"2006","journal-title":"J. Infect."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"204","DOI":"10.2174\/1874325001408010204","article-title":"Bite injuries to the hand\u2014Review of the literature","volume":"8","author":"Raval","year":"2014","journal-title":"Open Orthop. J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"47","DOI":"10.5435\/JAAOS-23-01-47","article-title":"Human and other mammalian bite injuries of the hand: Evaluation and management","volume":"23","author":"Kennedy","year":"2015","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1111\/j.1445-1433.2004.03189.x","article-title":"Cat bites of the hand","volume":"74","author":"Mitnovetski","year":"2004","journal-title":"ANZ J. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1097\/TA.0000000000000531","article-title":"The current concepts in management of animal (dog, cat, snake, scorpion) and human bite wounds","volume":"78","author":"Aziz","year":"2015","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_45","first-page":"217","article-title":"From the archives of the Zagreb Antirabies Clinic: Hospitalized persons due to animal bites from 1995 to 2006","volume":"75","author":"Vodopija","year":"2021","journal-title":"Acta Med. Croat."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1007\/s10096-013-1840-x","article-title":"Dog and cat bite-associated infections in children","volume":"32","author":"Esposito","year":"2013","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Brunt, S., Solomon, H., Brown, K., and Davis, A. (2021). Feline and canine rabies in New York State, USA. Viruses, 13.","DOI":"10.3390\/v13030450"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.2460\/javma.258.11.1205","article-title":"Rabies surveillance in the United States during 2019","volume":"258","author":"Ma","year":"2021","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"524","DOI":"10.15585\/mmwr.mm6823e1","article-title":"Vital signs: Trends in human rabies deaths and exposures\u2014United States, 1938\u20132018","volume":"68","author":"Pieracci","year":"2019","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_50","unstructured":"Ministarstvo Poljoprivrede, Uprava za Veterinarstvo i Sigurnost Hrane (Ministry of Agriculture, Directorate for Veterinary Medicine and Food Safety) (2026, June 02). Rezultati Provedbe Oralne Vakcinacije Lisica (Results of Oral Vaccination of Foxes). (In Croatian)."},{"key":"ref_51","unstructured":"Ministarstvo Zdravstva Republike Hrvatske (Ministry of Health of the Republic of Croatia) (2026, June 02). Provedbeni Program Imunizacije, Seroprofilakse i Kemoprofilakse za Posebne Skupine Stanovni\u0161tva i Pojedince Pod Pove\u0107anim Rizikom u 2026. Godini (Program of Immunization, Seroprophylaxis and Chemoprophylaxis for Special Population Groups and Individuals at Increased Risk in 2026), (In Croatian)."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"283","DOI":"10.3161\/1733-5329(2007)9[283:EBLAEE]2.0.CO;2","article-title":"European bat lyssaviruses: An ecological enigma","volume":"9","author":"Vos","year":"2007","journal-title":"Acta Chiropterol."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"McElhinney, L.M., Marston, D.A., Wise, E.L., Freuling, C.M., Bourhy, H., Zanoni, R., Moldal, T., Kooi, E.A., Neubauer-Juric, A., and Nokireki, T. (2018). Molecular epidemiology and evolution of European bat lyssavirus 2. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19010156"},{"key":"ref_54","unstructured":"Hrvatski Sabor (Croatian Parliament) (2026, June 02). Zakon o Zdravlju \u017divotinja (Animal Health Act). Narodne Novine, (In Croatian)."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1016\/S0140-6736(13)62707-5","article-title":"Current status of rabies and prospects for elimination","volume":"384","author":"Fooks","year":"2014","journal-title":"Lancet"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Fooks, A.R., Shipley, R., Markotter, W., Tordo, N., Freuling, C.M., M\u00fcller, T., McElhinney, L.M., Banyard, A.C., and Rupprecht, C.E. (2021). Renewed public health threat from emerging lyssaviruses. Viruses, 13.","DOI":"10.3390\/v13091769"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"8","DOI":"10.37797\/ig.41.1.2","article-title":"Clinical manifestations of Bartonella henselae infection among children: A single centre study","volume":"41","year":"2021","journal-title":"Infektol. Glas."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"489","DOI":"10.20473\/jmv.vol8.iss2.2025.489-503","article-title":"Quantifying zoonotic risk from cats (Felis catus): A systematic meta-analysis of pathogen prevalence","volume":"8","author":"Handoko","year":"2025","journal-title":"J. Med. Vet."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"IOL5-0013-2015","DOI":"10.1128\/microbiolspec.IOL5-0013-2015","article-title":"Diseases transmitted by cats","volume":"3","author":"Goldstein","year":"2015","journal-title":"Microbiol. Spectr."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/8\/817\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T16:12:46Z","timestamp":1785168766000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/8\/817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,25]]},"references-count":59,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["v18080817"],"URL":"https:\/\/doi.org\/10.3390\/v18080817","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,25]]}}}