A Michigan man has died of rabies after receiving a kidney from a donor who was infected with the virus, as per the Centers for Disease Control and Prevention (CDC).
The transplant took place at an Ohio hospital in December 2024. The donor, an Idaho man, was scratched on the shin by a skunk showing “predatory aggression” towards a kitten on his property in October 2024.
Five weeks after the incident, the donor began hallucinating, had trouble walking and swallowing, and developed a stiff neck, according to the CDC report. He collapsed two days later and was taken to a hospital, where doctors briefly revived him before declaring him brain-dead. His family reported the skunk scratch when his organs were donated.
Roughly five weeks after receiving the kidney, the Michigan recipient started getting tremors, weakness, confusion, urinary incontinence, and difficulty swallowing, along with hydrophobia, a primary sign of rabies. His condition quickly worsened. He was hospitalised for a week and then died. Postmortem tests confirmed rabies.
Rabies is a viral disease that affects the brain and nervous system of mammals, including humans.
“This is an exceptionally rare event,” Dr Lara Danziger-Isakov, who leads immunocompromised host infectious diseases at Cincinnati Children's Hospital Medical Center, told The NY Times. “Overall, the risk is exceptionally small.”
Investigators later reviewed the donor's records. Hospital staff did not initially know about the skunk scratch and thought the donor's symptoms came from chronic medical conditions. The CDC said that organ donations are not routinely tested for rabies because human cases are very rare and testing is complex. Donors are screened for HIV and several types of hepatitis, but not for rabies.
Doctors re-examined biopsies taken from both of the donor's kidneys before the transplant. The kidney that was not used tested positive for rabies. Doctors could not test the transplanted kidney. Testing showed that both the donor and the recipient were infected with a rabies strain linked to bats.
The donor's corneas were transplanted into three patients. Doctors removed the corneal grafts after the rabies diagnosis and placed all three recipients on preventive treatment. One graft tested positive for rabies, but none of the patients showed symptoms.
Since 1978, only four organ donors in the US have passed rabies to 13 recipients. Six recipients survived after receiving treatment, while seven died.
