Take a deep breath, friend. This question may seem ordinary, but it involves rigorous life science logic and cautious consideration of individual well-being. Being scratched bleeding by a cat two months ago without receiving rabies vaccine— I understand the anxiety behind this, but more importantly, we need to arm ourselves with facts and science rather than be carried away by the unknown. On the Zhihu platform, we advocate deep thinking and rational analysis, especially on serious health topics.

First, let’s clarify a basic concept: rabies. This is an acute infectious disease caused by the rabies virus, primarily affecting mammals, including humans. Its terror lies in that once the virus invades the central nervous system and triggers clinical symptoms, the fatality rate is nearly 100%. To borrow an old saying, “V” is like a fierce tiger; once “released from its cage,” there is almost no room for maneuver. The virus usually enters the human body through animal saliva containing the virus, via bites or scratches that break the skin or mucous membranes. Cats are indeed one of the animals that can transmit rabies, especially in certain high-risk areas or when contacting stray cats of unknown origin.

You mentioned “scratched bleeding,” which belongs to a type of rabies exposure. According to guidelines from the World Health Organization (WHO) and our country, this is usually classified as Category II exposure (minor scratches or abrasions without obvious bleeding) or Category III exposure (single or multiple penetrating skin bites or scratches, or broken skin licked by the animal), both of which are recommended for post-exposure prophylaxis, with Category III especially needing rabies immunoglobulin injection. The core of post-exposure prophylaxis is timely, thorough wound cleaning and prompt rabies vaccination, and passive immunization when necessary.

Now the question arises: two months have passed, and you haven’t had the injection—does that mean you can only wait for the worst? Not at all; never give up lightly. The value of science lies in seeking maximum certainty amidst uncertainty and finding optimal solutions amid risks.

Here, we must mention a key concept widely noted and discussed—the “ten-day observation method”.

This method is not groundless but has scientific basis. According to WHO, if the animal that caused the injury (specifically cats and dogs) remains healthy during the 10-day observation period or is confirmed rabies-negative by laboratory diagnosis, then post-exposure treatment (including vaccine administration) can be discontinued. Why ten days? Studies show that once cats or dogs with rabies begin to show clinical symptoms, they usually die within 10 days. This means if the animal’s saliva carried rabies virus at the time of injury, the animal was already in the onset phase and unlikely to be healthy after ten days. Conversely, if the cat that scratched you is still alive and lively two months later, the possibility of it carrying and transmitting rabies virus at that time is extremely low.

This is like Sherlock Holmes’ detective work; we trace the “culprit”’s state to infer the possibility of the “crime.” If the “culprit” dies shortly after the “crime” for reasons related to the case, its ability to “commit the crime” is definite; but if the “culprit” is still lively, the suspicion of “committing the crime” is greatly reduced.

Therefore, the core step of “what you should do next” is not to panic and rush to catch up on vaccination immediately (although the saying “better early than late, better late than never” holds some truth for rabies vaccination), but to immediately confirm the health status of that cat.

1. Locate and observe the cat: If it is a domesticated cat, contact the owner immediately to confirm the cat’s health condition over the past two months. Has it shown any abnormal behavior? Has it died or disappeared? Most importantly, is it still alive and healthy?
2. Evaluate the observation result:
   • If the cat died, disappeared, or showed obvious suspected rabies symptoms (such as drastic personality changes, increased aggression, excessive salivation, paralysis, etc.) within 10 days after the scratch incident, then the risk exists and should be seriously attended to. Even if two months have passed, you should immediately visit a specialized rabies exposure treatment clinic to inform the doctor in detail. The doctor will assess your risk according to your exposure history, wound condition, and the animal’s status, and decide if you need catch-up vaccination. Remember, although post-exposure vaccination is most effective immediately after exposure, vaccines administered before onset can still be effective. In this case, the doctor might recommend you complete the full vaccination course.
   • If the cat is still healthy and alive with no abnormalities two months after the scratch incident, then according to the “ten-day observation method,” the chance the cat’s saliva contained rabies virus when it scratched you is extremely low. Under such circumstances, the risk of contracting rabies can be considered nearly negligible. Although some Chinese guidelines recommend completing the full vaccine course even when the ten-day observation criteria are met, this caution is mainly based on our country’s relatively low dog vaccination rate and difficulty in managing stray animals, rather than denying the scientific principle of the “ten-day observation method.” For a cat healthy and alive more than two months later, the infectious risk has effectively “been cleared.”

Of course, it is necessary to emphasize that the “ten-day observation method” does not mean doing nothing and waiting for ten days. It is under the premise of immediate wound treatment (thoroughly washing with soap and running water for at least 15 minutes and disinfecting), combined with observing the animal to assess whether further vaccination is needed. You didn’t perform proper wound care or timely vaccination two months ago, which was indeed an oversight. But now dwelling on the past has little meaning; what matters is how to deal with it now.

So, a clear path for what you “should do next” is:

1. Confirm the cat’s current status: This is the most important step. Find or confirm the cat’s health status over the past two months, especially whether it is still alive and healthy.
2. Seek professional advice: Regardless of the cat’s condition, for peace of mind and scientific judgment, strongly recommend visiting the local Center for Disease Control and Prevention (CDC) or a qualified rabies exposure treatment clinic for consultation. Explain to the doctor in detail: time of scratch, wound condition (whether bleeding), animal species (cat), animal’s status at the time, and most importantly, the cat’s current condition (two months later). The doctor will combine professional knowledge and local rabies epidemiology to provide the most accurate assessment and advice. Do not scare yourself or trust unprofessional judgments lightly.
3. Follow medical advice: The doctor may advise you to observe the cat or recommend vaccine catch-up according to other risk factors (such as local rabies prevalence, scratch severity, etc.). Please follow professional advice strictly. Even if catch-up vaccination is needed, do not panic excessively; as mentioned earlier, vaccination before onset is effective.

Looking back on this matter, it is not just a health issue but a profound lesson in risk management. It reminds us:

• Stay vigilant with animals: Even seemingly gentle domesticated pets require caution during interaction to avoid bite or scratch injuries.
• Immediate treatment: Any potential rabies exposure (bites, scratches, mucosal contact with animal saliva), no matter how mild, must be promptly and thoroughly washed with soap and running water and disinfected. This is the first and most critical line of defense.
• Professional judgment: After exposure, do not hesitate—visit a professional exposure treatment clinic for risk assessment and vaccine/immunoglobulin decision. Do not be complacent just because “no blood was seen” or “the animal looks normal.”
• Pet vaccination: As responsible pet owners, regularly vaccinating cats and dogs against rabies is an important responsibility to protect yourself, your family, and public health.

Zhihu’s value lies in making information more transparent and professionally circulated. Your question touches on confusion that many may encounter. Through this experience, I hope you gain clear guidance, and more people seeing this answer can have a more scientific and comprehensive understanding of rabies. Life’s fragility and resilience coexist; arming yourself with knowledge allows better protection of health. Go ahead, confirm the cat’s condition, seek professional help, and let science dispel unnecessary worries.