by Kimberly Allen, RN
In the US, rabies is a rare occurrence and contracting rabies from another human is even more rare. However, it is possible as one Maryland family discovered. The Centers for Disease Control and Prevention, along with health officials in Maryland, have confirmed that a man has died of rabies. And how did this man contract rabies? Through organ donation. He was the recipient of a new kidney. Unfortunately the organ donor had contracted rabies before dying. Even more alarming is that the man from Maryland was not the only organ recipient, there are 3 others. So why wasn’t the donor tested for rabies? The director of the donor development program at LifeQuest, an organ recovery center, stated the donor was not suspected of having rabies. She further stated that if the donor had been suspected of having rabies they would have absolutely ruled out any donation. The donor patient was believed to be suffering from a food borne illness called ciguatera.
There are currently over 105,000 people waiting for an organ transplant in the US with another 4,000 people being added to the National waiting list every day. Unfortunately, every day approximately 18 people die while waiting for that much needed organ transplant. There are always many more people waiting in desperate need of an organ transplant then there are organs available. Now, with this rabies scare, many patients and health officials are asking why the organs were not tested for rabies. According to the Organ Procurement Organization all organs for donation are tested for HIV I/II, HTLV I/II, hepatitis B core, hepatitis B surface antigen, hepatitis C core, syphilis, cytomegalovirus and Epstein-Barr virus. According to one expert, testing for rabies after death takes approximately 4 hours after the tissue arrives at one of the labs in Atlanta, New York, or California. That is time that many organs do not have. A kidney that has been donated is only viable for less than 24 hours, most organs are viable for less than 6 hours.
Though this particular donor did have encephalitis as well as seizures they were believed to be caused by another infection. Rabies in humans is not only very rare it also resembles numerous other bacterial and viral infections as well as other conditions making it difficult to diagnose. In the current case of rabies infection the recipient received his organ over 1 year before developing symptoms of rabies. This is a significantly longer incubation period than the usual 1 to 3 months. The CDC reports that preliminary tests indicated both the donor and the recipient had the same type of raccoon virus.
The other 3 organ recipients have been identified and are currently receiving anti-rabies injections and are being closely monitored by their health care teams. One rabies expert that is not connected to this case states that the other 3 organ recipients “have a strong chance of surviving because they haven’t shown any symptoms.”
In the US, all potential organ donors are tested and screened thoroughly to determine if the donor poses any risk for infection. This is done by the Organ Procurement Organizations. There are a variety of tools used to determine the viability of each organ. In addition to infectious disease testing and a physical exam the family is asked a series of questions that help evaluate the suitability of an organ donor. this process is designed to ensure that all transplants are safe and successful. As a rule the benefits received from a transplanted organ out weigh the risk of receiving an infectious disease.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.