The CDC is reporting that a Maryland man has died from rabies. The rabies was transmitted by a kidney he received in a transplant operation a year and a half ago. Three others who received other organs from the same man are being given vaccine.
Organs from the donor, who died in 2011 in Florida, were given to recipients in Maryland, Florida, Georgia, and Illinois.
Coincidentally, the donor was training in Pensacola to become an aviation mechanic, and the man who died was a retired veteran of the United States Army.
When the donor passed away, doctors were aware he had encephalitis, but did not perform tests for the rabies virus. His kidneys, heart and liver were delivered for transplant in September, 2011.
Health officials immediately contacted doctors caring for the other three organ recipients. They show no signs of rabies but are being treated with five doses of the rabies vaccine and rabies immune globulin, which gives the body antibodies to protect itself against the rabies virus. Both treatments are shots in the upper arm.
The kidney recipient from Maryland died on February 27 at the VA Medical Center in Washington, and doctors at the CDC diagnosed rabies as the cause of death. Tissue samples taken in an autopsy revealed the rabies as a type generally transmitted by Racoons.
Interviews of the doctors who performed the transplant were shocked that the patient’s death was the result of rabies, said Dr. Matthew Kuehnert, director of the CDC’s Office of Blood, Organ, and Other Tissue Safety.
“Their first reaction was that it seemed unlikely because it’s been almost a year and a half since the transplant,” he said.
In the only other U.S. outbreak of rabies among organ recipients, the four patients died within a month of transplant in 2004.
So why aren’t organ donors tested for rabies? Organ donors are not routinely tested for rabies, even if they show the signs. One reason is rabies is extremely rare, with only one to three cases a year nationwide, according to Dr. Richard Franka, the CDC’s acting rabies team lead.
Also, many lifesaving organs would be lost if donors were tested for rabies. Only three or four facilities in the country are capable of testing for rabies in humans, Franka said, which means most hospitals would have to ship a potential donor’s blood or tissue. It could take two days to get test results, and by then the organs would no longer be usable.
Kuehnert said that what we need is more information when a donor has experienced encephalitis.
“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,” he said.
Columnist-The Guardian Express