A rare case of rabies transmission through a kidney transplant has been reported in the United States. A Michigan man died from rabies after receiving a kidney from a donor who had also died from the disease. The donor, a man from Idaho, was infected after being scratched by a raccoon while defending a kitten. The infection is believed to have spread from a bat to the raccoon, then to the donor, and finally to the recipient via the donated kidney. This is the fourth known case of rabies transmission through organ transplantation in the U.S. since 1978.
Hospital staff were initially unaware of the donor's raccoon scratch and attributed his pre-hospital symptoms to underlying chronic conditions. "This is an extremely rare event," said Dr. Lara Danziger-Isakov, director of infectious diseases for immunocompromised patients at Cincinnati Children's Hospital Medical Center. "The risk is very, very low in general." According to a report from the Centers for Disease Control and Prevention (CDC), the recipient began showing symptoms about five weeks after his transplant, including tremors, lower limb weakness, confusion, and hallucinations. Although initial post-mortem tests for rabies were negative, a biopsy of the transplanted kidney revealed a strain consistent with bat rabies. The investigation pointed to a possible three-stage transmission chain: a bat infected the raccoon, which then scratched the donor, leading to the transmission of the virus to the recipient.
