Death from Rabies Transmitted via Organ Transplant

A Maryland man died in March 2013 from a case of rabies transmitted inadvertently through the kidney transplant he received back in 2011.

The donor had died in 2011 after checking into a health care facility in Florida, and was not diagnosed with rabies. Rabies cases are extremely rare in the United States. From 1995 through 2011 there were only 49 confirmed case of rabies, or an average of less than 3 cases per year.

Because the disease is so rare and the test for rabies takes a relatively long time, organs for donation are not routinely tested for the disease.

The man’s organs went to several recipients in Florida, Georgia, Illinois and Maryland. A Maryland man who received a kidney transplant died from rabies 16 months after the operation. Since the man had no known contact with animals and died from the extremely rare raccoon variant of rabies, the CDC investigated and confirmed that the donor had also been infected with rabies.

This has happened before. There have been several cases around the world where rabies spread via corneal transplant. In 2004, a man in Texas died from what doctors diagnosed as a subarachnoid hemorrhage, but was in fact rabies. Three organ recipients—one who received a liver and two others who each received one of the man’s kidneys—subsequently died from rabies.

The odd thing here is that in the case of the Texas organ donor, each of the organ recipents was admitted to hospital roughly four weeks after the organ transplant with severe symptoms with death following shortly afterward.

But in the case of the Maryland man, the victim didn’t show any rabies symptoms until 16 months after the transplant. As the CDC put it, “Incubation periods exceeding one year are very rare, making this one of the longer rabies incubation periods recorded.”