Reuters Health Information (2004-07-01): First rabies cases from organ transplant reported by CDC
First rabies cases from organ transplant reported by CDC
Last Updated: 2004-07-01 15:22:04 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Three patients acquired
rabies and died after receiving organs from the same infected donor,
marking the first time rabies has been spread through solid organ
donation, an infectious disease expert from the Centers for Disease
Control and Prevention announced at a media briefing Thursday.
"This has never happened before," Dr. Mitchell Cohen, director of
the coordinating center for infectious diseases at the CDC, told
reporters. "Human rabies is very rare -- we see only a few human cases
each year and it is usually in people who have been bitten or scratched
by bats. The risk of healthcare-associated transmission is considered
to be extremely low."
Although there have been reports of rabies transmission through
cornea transplants, this is the first report of transmission from solid
organ transplantation, CDC officials noted.
The rabies infections originated from a previously healthy male
Arkansas resident who presented to an emergency room in Texas with
mental status changes and fever. Neuroimaging revealed a brain
hemorrhage and the patient died 48 hours later.
Routine donor eligibility testing revealed no contraindications to
transplantation and the family gave consent for donation, Dr. Cohen
said. Rabies testing is not currently part of the screening procedure.
The donor's lungs, kidney, and liver were transplanted into patients
in Texas and Alabama on May 4,, 2004. Three recipients were later
hospitalized with symptoms including hypotension, seizures, and
lethargy. All three patients died.
In the last few weeks, a series of tests were performed on the
recipients and, on Wednesday, the CDC confirmed that all three were
infected with a strain of rabies commonly found in bats.
"The CDC is working with all the states and hospitals involved to
determine who came in contact with the donor and the recipients and who
might need shots to prevent rabies," Dr. Cohen said.
These include patient family members and healthcare workers at the
following hospitals: Baylor University Medical Center, Dallas;
University of Alabama-Birmingham Hospital; the Christus Saint Michael
Healthcare Center and the Wadley Regional Medical Center, Texarkana,
Texas; and the Good Shepherd Medical Center, Longview, Texas.
"The Health Resources and Services Administration will be carefully
reviewing what happened and working with the CDC to see if there are
steps that can be taken to further reduce this very small risk" of
rabies transmission from organ transplantation, Dr. Cohen added.