A man passed away from rabies following a kidney transplant from a donor who likely contracted the virus after being scratched by a skunk. This unusual chain of infection was documented in a report by the Centers for Disease Control and Prevention (CDC), marking only the fourth case of transplant-transmitted rabies in the United States in the past fifty years. The transplant took place in an Ohio hospital in December 2024.
The recipient showed symptoms like tremors, weakness, confusion, and urinary incontinence five weeks after the transplant, leading to urgent medical attention. He was hospitalized the following week due to fever and a rapid decline in health, eventually necessitating ventilation before his passing.
Rabies was found in the recipient’s saliva and brain tissue, despite his lack of animal contact, prompting an investigation into the organ donor. The donor, from Idaho, had succumbed to rabies after a skunk scratch on his property. It was revealed that the donor had disclosed the skunk incident during the risk assessment interview.
The donor’s family recounted an encounter where the donor fought off a skunk that had shown aggression towards a kitten, resulting in a scratch on the shin. The donor later experienced confusion, hallucinations, swallowing difficulties, and a stiff neck before being found unresponsive and declared brain dead.
Although initial screenings on the donor did not detect rabies, further testing on preserved samples revealed the presence of the virus in the kidneys. Investigators determined that the donor had died from rabies and transmitted it through the kidney transplant, creating a unique transmission chain involving a bat, skunk, donor, and recipient.
Such incidents are extremely rare due to the low occurrence of rabies in the U.S. and the complex diagnostic procedures needed for detection. The CDC highlighted the minimal risk of transplant-transmitted infections like rabies. Other tissues from the donor were traced, leading to precautionary measures for cornea graft recipients who remained asymptomatic.
Rabies is not routinely screened for in organ donors in the U.S. as it is uncommon in humans and challenging to detect. Medical experts emphasized the rarity of such events and the overall low risk involved.