The Centers for Disease Control and Prevention and the Maryland Department of Health and Mental Hygiene have just announced that the recipient of an organ donation recently died of a rabies infection in the donor. The deceased was one of four people who received organs from the same donor, and the other three are now receiving rabies treatment. Unfortunately, the rabies victim’s organs were themselves donated to at least five other patients.
Such an event is extremely rare, and it is even more unusual that the patient died more than a year after the organ was transplanted. However, it is unknown whether any hospital negligence was involved in the deadly transplant.
According to the CDC, while potential organ donors are routinely screened for infections that could risk the health of the recipients, rabies is not among the infections screened for. This is the case for two reasons. First, rabies, although deadly, is extremely rare in the U.S., occurring in only one to three people annually. Second and equally important, rabies testing is very slow, and the short period of viability for organs limits the time available for testing. As a result, doctors and hospitals generally think the risk that an organ donor could have rabies is one worth taking.
Even though a biological test for the rabies virus is not performed, potential organ donors are screened through interviews with family and friends, where possible, and a physical examination is performed that might reveal evidence of an animal bite. Rabies is virtually always transmitted through animal bites, most commonly raccoons, skunks and bats, with bats being the most common source.
Basically, if there is no reason to suspect a rabies infection, hospitals don’t test organ donors for it. The irony is, of course, that additional patients were exposed because the rabies test results were not available immediately after the first recipient of the tainted organs died. Maryland’s health agency was only able to detect the disease by testing tissues recovered from the deceased, who died in 2011.
The three other patients who received rabies-tainted organs from the original donor have already been given rabies vaccinations and immunoglobulin treatments. The recipients of the deceased organ beneficiary have not yet been identified, but the CDC is working with public health officials in Illinois, Maryland, North Carolina, Georgia and Florida to find and treat them.
Rabies is rare, but it’s so deadly that it might be worth the effort for researchers to develop a faster test for it. It may be that there was no negligence by the hospitals, surgeons or organ procurement organizations involved, but surely more could be done to prevent such deaths.
Source: Centers for Disease Control and Prevention, “CDC confirms rabies death in organ transplant recipient,” March 15, 2013