Organ Transplant Rabies Scare
Written by Faith Anderson on March 17, 2013
Transmission of Rabies Virus
In Maryland alone, about 200 medical workers, relatives and others have been evaluated for potential exposure to rabies, which can be transmitted through infected saliva. In Florida, 90 people have been identified as potentially exposed to the virus, and the Illinois Department of Public Health indicated that the only potential exposures there were people who worked with the patient or the transplanted organ. Health officials in North Carolina and Georgia are also involved in the rabies investigation prompted by the Maryland man’s transplant death, although the official number of potentially exposed individuals has not been reported for those states.
According to health officials, the rabies virus can be spread through the infected individual’s saliva and mucus membranes, but human-to-human transmission is rare. As the CDC reports, there has only been one documented case of transmission by a bite in the United States. A veterinarian in Maryland, Katherine Feldman, reported on March 15 that medical professionals usually take precautions to avoid transmission of such viruses, and “we don’t share saliva with that many people in our day-to-day goings about.” Unfortunately for the transplant recipients, the rabies virus can also be transmitted through infected organs after they are transplanted.
Organ Donor Never Tested for Rabies
CDC spokesperson Melissa Dankel has reported that investigators are still trying to determine how the transplant donor was infected with the raccoon rabies virus that was found in his brain tissue and in the brain tissue of the deceased Maryland man. She says that the donor was an outdoorsman who may have been bitten by a wild animal in North Carolina, where he lived prior to moving to Florida and beginning training as an Air Force aviation mechanic 17 weeks prior to his death. The donor reportedly visit a clinic at the Pensacola Naval Air Station in August 2011 complaining of vomiting and abdominal pain, and was transferred to a civilian hospital four days later. He later developed encephalitis, a brain inflammation that can be caused by a number of diseases, including rabies, but he was never tested for the virus.
Defense Department spokesperson Cynthia Smith reported that the donor died of severe gastroenteritis- inflammation of the small intestine and stomach – complicated by dehydration, seizure and electrolyte abnormalities. The Florida Department of Health listed the cause of death as encephalitis of unknown origin. According to federal guidelines, organ banks are required to disclose any known or suspected infectious conditions that could be transmitted by donor organs. In addition, federal regulations published in 2012 for assessing organ donors with encephalitis urge “extreme caution” if the suspected cause is a viral pathogen, like rabies. Unfortunately, these guidelines hadn’t yet been published when the Florida patient died.
Rabies Transmission Possibly Caused by Negligence
Amazingly enough, this isn’t the first time organ recipients have died from rabies transmitted by an infected donor. In addition to one case reported in Germany, there was another case in the United States in 2004, in which all four organ recipients died from the rabies virus. One of the recipients who died in the 2004 case was an 18-year-old boy from Texas who received a kidney transplant after suffering kidney problems since he was a child. “The word has got to get out there and something’s got to change,” said the victim’s mother. “These people, like my son, he thought the transplant was going to give him a new life and a new opportunity to move forward, and it killed him – over somebody’s negligence and their plain old stupidity, and that’s what it is.”