The Centers for Disease Control and Prevention, the Food and Drug Administration, the Georgia State Department of Health, and the Florida Department of Health are investigating illnesses among four recipients of organ transplants from a single donor. One of these persons died on August 29. Preliminary evidence suggests that these illnesses may be due to West Nile virus infection.
All four persons received organs from a Georgia resident who died in early August following a motor vehicle accident. Before death, this person had received multiple blood transfusions. Two Georgia residents received organs from this donor. Both became ill with fever and encephalitis. One patient remains hospitalized but is improving. The other patient died; examination of autopsy specimens at the Centers for Disease Control and Prevention were consistent with West Nile or related virus infection. Two Florida residents received organs from this donor. One developed fevers but is now recovering at home. Another developed a neurological illness and remains hospitalized. Specimens from this patient at the Florida State Department of Health tested positive for West Nile virus infection.
Concern about the possibility that blood transfusion or organ donation may have transmitted West Nile infection to recipients of organs from a single donor has prompted the ongoing investigation that is now underway. West Nile virus is spread via the bite of an infected mosquito. Although transmission of West Nile virus via blood transfusion or organ donation has been a theoretical possibility, transmission via these routes have not been previously observed.
Although the exact cause of these four organ recipients’ illnesses and the means that they may have become infected still remains uncertain, as a precautionary measure, remaining blood products from the blood donors of the blood transfusions that were given to the organ transplant donor are being recalled.
Most persons exposed to the West Nile virus do not develop symptoms. Approximately one in five exposed persons will develop a mild flu-like illness and less than one percent will develop severe neurological disease. It is unknown if organ transplant patients are more likely to develop severe disease following exposure to the West Nile virus. Persons who do develop symptoms mostly will have symptom onsets 3 to 14 days after exposure to the virus.
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