Transmission of Rabies Virus from an Organ Donor to Four Transplant Recipients

Neurologic deterioration followed by fatal encephalitis occurred in four patients who had received kidneys, liver, and an artery segment from the same donor. Multiple studies showed evidence of rabies virus in both central nervous system tissues from the four recipients and nerve tissue in the transplanted organs. The donor was thought to have been well before a subarachnoid hemorrhage. It was later learned that he had told friends of being bitten by a bat. Neurologic deterioration followed by fatal encephalitis occurred in four patients who had received kidneys, liver, and an artery segment from the same donor. Multiple studies showed evidence of rabies virus. Rabies is an acute encephalitis caused by viruses in the genus Lyssavirus, family Rhabdoviridae, that is nearly uniformly fatal in unvaccinated hosts. Although the virus is present in animal reservoirs, infection in humans is rare in the United States, with only two cases reported in 2003 1 , 2 and no more than six cases reported in any year in the past decade. 3 The primary mode of transmission is through the bite of an infected animal, most commonly a bat in the United States. 4 Although transmission of rabies virus from corneal transplants has previously been described, 5 to our knowledge, no cases ascribed . . .