July 1, 2004 -- The Centers for Disease Control and Prevention (CDC) has confirmed the first reported cases of rabies transmission through solid organ transplantation. Confirmation came from laboratory testing of autopsy specimens after the deaths of three persons who had received organ transplants from the same donor.
Rabies is an acute, fatal disease that most often results from a bite of a rabid mammal. Rarely, if ever, do non-bite exposures, including scratches, contamination of an open wound, or direct mucus membrane contact with infectious material (such as saliva or neuronal tissue) cause rabies. Although rabies transmission has occurred previously through cornea transplants, this is the first report of rabies transmission via solid organ transplantation.
The organ donor, an Arkansas resident, had undergone routine donor eligibility screening and testing. Rabies testing is not part of the routine screening process. Lungs, kidneys, and liver were recovered and later transplanted on May 4 into four recipients, one of whom (the lung transplant patient) died during transplant surgery. No other organs or tissues were recovered from the donor.
CDC is working with health officials from Texas, Alabama, Oklahoma, Arkansas, and other public health partners to evaluate potential contacts of the transplant recipients and the donor to determine who needs shots. Those persons include family members as well as healthcare workers who cared for the organ recipients and donor at the following hospitals: Baylor University Medical Center, Dallas, Texas; University of Alabama-Birmingham Hospital, Birmingham, Alabama; Christus Saint Michael Healthcare Center, Texarkana, Texas; Wadley Regional Medical Center, Texarkana, Texas; and Good Shepherd Medical Center Longview, Texas. Individuals whose contact is determined to have placed them at elevated risk of exposure to rabies virus will be advised to receive post-exposure treatment as soon as possible.
For additional information visit the CDC Web site at www.cdc.gov/ncidod/dvrd/rabies.
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