March 15, 2013
Organ Transplant Recipient Dies From Rabies Infection
Brett Smith for redOrbit.com — Your Universe Online
The Centers for Disease Prevention and Control (CDC) announced today a Maryland man who recently died of rabies contracted the disease when he received an infected transplanted kidney a year and a half ago.
As a result of this revelation, three other patients who received organs from the same donor are “doing fine,” but have been given rabies shots as a precaution, according to CDC officials.
The doctors who performed the transplant in 2011 said they knew the donor had encephalitis, but didn´t know rabies was the cause. Because the disease wasn´t suspected as the cause of death, doctors involved with the operation didn´t think to test for it.
Although the number of reported rabies cases is fewer than ten, health officials are thinking about changing their approach to testing donors for the disease.
"What we need, looking forward, is a standardized approach when you have encephalitis of unknown cause so very important things like this aren't missed,” Dr. Matthew Kuehnert, director of the CDC's Office of Blood, Organ, and Other Tissue Safety, told CNN.
Health officials initially doubted the kidney was the cause of the infection because of the 15-month period between the surgery and the patient´s death. The average length for the incubation of rabies is seldom longer than three months. Several unnamed sources told The Washington Post the recipient died at the Veterans Affairs Medical Center in Washington after being hospitalized for about a month.
The Maryland man died on February 27 and health officials made the rabies diagnosis this month while investigating his cause of death. Upon re-examining the donor's case, doctors found that person, who was from Florida, had also died of rabies. The CDC said the two viruses were genetically identical, indicating the organ was the source of the Maryland patient´s rabies.
In addition to vaccinating the other organ recipients, the CDC is looking for anyone who might have come in contact with the donor or the recipients to see if they also have rabies.
The incident marks just the third time rabies has been transmitted by transplanting organs, such as a kidney. In 2004, four people in Texas died from rabies that they contracted from a single donor´s tissue. Health records show there have been at least eight cases of contracting rabies through cornea transplants worldwide.
Rabies isn´t the only disease that has been known to be transmitted through organ transplants. In some cases, the recipient already has the same infection, such as hepatitis C, as the donor organ. In other cases, the patient and physicians decide the risk from the infection is less than the risk of not receiving the organ in time.
Although not as rare as contracting it from a donated organ, about five Americans are infected with rabies each year. The virus is most frequently acquired through contact with a bat. Bites from other infected animals, including raccoons and dogs, account for most of the rest. The CDC did not reveal how the Florida individual had contracted the infection.