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CDC Confirms 'Extremely Rare' Death From Rabies Transmitted By Transplant

A Maryland man who died two weeks ago contracted rabies "through [an] organ transplantation done more than a year ago," the Centers for Disease Control and Prevention confirmed Friday morning.

The CDC adds that:

"In early March, the Maryland Department of Health and Mental Hygiene initiated an investigation after the organ recipient died, which led to the rabies diagnosis. The investigation revealed that the organ recipient had no reported animal exposures, the usual source of rabies transmission to humans, and identified the possibility of transplant-related transmission of rabies, which is extremely rare."

According to The Washington Post, which reported about the donor's death before the CDC's statement was released:

"Transmission of rabies through organ or tissue transplant is extremely rare. Four people in Texas died in 2004 from rabies contracted from a single donor's tissue. There have been at least eight cases around the world contracted through cornea transplants."

The infected donor, CDC says, was a man who died in Florida in 2011. "At that time," CDC reports, "the donor's organs, including the kidneys, heart, and liver, were recovered and sent to recipients in Florida, Georgia, Illinois, and Maryland."

According to the CDC:

"There are typically one to three cases of human rabies diagnosed annually in the United States each year. If rabies is not clinically suspected, laboratory testing for rabies is not routinely performed, as it is difficult for doctors to confirm results in the short window of time they have to keep the organs viable for the recipient."

The Post writes that "the donor, described as a man in his 20s, died of encephalitis, a general term for inflammation of the brain. The condition has many causes. Viruses such as herpes simplex and West Nile virus are among the more common. Rabies is among the rarest."

How the donor got rabies has not been confirmed. The CDC says that "the recipient and the donor both had the same type of rabies virus — a raccoon type." But, it adds, "this type of rabies virus can infect not only raccoons, but also other wild and domestic animals. In the United States, only one other person is reported to have died from a raccoon-type rabies virus."

The Maryland man received a kidney. Now, says the CDC:

"The three other people who received organs from the donor have been identified and are currently being evaluated by their healthcare teams and receiving rabies anti-rabies shots (immune globulin and anti-rabies vaccination). CDC is working with public health officials and healthcare facilities in five states (Fla., Ga., Ill., Md., and N.C.) to identify people who were in close contact with the initial donor or the four organ recipients and might need rabies post-exposure treatment."

Copyright 2020 NPR. To see more, visit https://www.npr.org.

Mark Memmott is NPR's supervising senior editor for Standards & Practices. In that role, he's a resource for NPR's journalists – helping them raise the right questions as they do their work and uphold the organization's standards.