Epidemiologists seek answers to rabies mystery after Md. man’s death

[Reader]

http://www.washingtonpost.com/natio...3e2c84-8da8-11e2-9f54-f3fdd70acad2_story.html

The donor of a kidney that transmitted a fatal case of rabies to a Maryland man was a 20-year-old airman in Pensacola, Fla., training to be an aviation mechanic. When he fell ill two summers ago, physicians thought he had food poisoning from eating fish from the Gulf of Mexico.

His death in a coma three weeks later was attributed to an intestinal infection, dehydration and seizures. He actually died of rabies. The viral infection wasn’t suspected before he died, and his organs were offered for donation. It apparently also wasn’t suspected when his brain was examined in an autopsy.

Tests this week revealed the virus was a type found in raccoons in North Carolina and Virginia. The man was from North Carolina but hadn’t returned home after enlisting in the Air Force 17 weeks before his death. That suggests the virus had been incubating for months before it made him ill...........

In June 2012, the United Network for Organ Sharing (UNOS) warned transplant teams that “extreme caution is urged” before using organs from people with encephalitis — brain inflammation — that might be caused by untreatable viruses such as rabies and West Nile. It did not issue a blanket prohibition............

A microscopic examination of brain tissue might have revealed changes characteristic of rabies. By then, however, one kidney had been transplanted into a 48-year-old Army veteran in an operation at Walter Reed Military Medical Center. Three other organs — another kidney, the liver and the heart — were transplanted into patients in Georgia, North Carolina and Illinois.

Kuehnert said Friday all of them have been found and have started treatment, which consists of an injection of rabies-fighting antibodies and four vaccination shots over a month.

“They’re doing fine,” he said.............

More at link.....

 

[michmi]

Ugh---I'm not even a doctor and it seems to me that inflammation of the brain would signal a not-chronic condition (infection???) and one would need to do extensive testing on the donor.

Since the incubation period for rabies is so long, rabies testing needs to be done on every donor. Period.

I feel so sorry for the person who died of this and that person's family, it is a horrible thing to die from.

 

[Trident]

I've read about people who were somewhat exposed to rabies, without being bitten, who went on to become absolutely crazy. Maybe rabies isn't exactly what we thought it was?

 

[AlwaysShocked]

There is excellent info available about the disease, transmission, etc. here:
http://www.cdc.gov/rabies/exposure/index.html

The basic problem in this case is that the original patient was never properly diagnosed prior to his death. And he had encephalitis. Then his organs were donated.

It boils down to the parameters used for procuring organs. They should not be coming from folks who have an encephalitis from an unknown cause.

Upon reading the CDC article, this has happened before, with both cornea transplants and organ transplants.