- Public health officials are investigating the deaths
of three organ transplant recipients who received donated organs that were
infected with the deadly rabies virus.
-
- The CDC today said the deaths mark the first known cases
of rabies transmission from solid organ transplantation. Although rabies
transmission has occurred previously through cornea transplants, this is
the first report of rabies transmission via solid organ transplantation.
-
- The organ donor, an Arkansas man, died in Texas of a
brain hemorrhage, and his lungs, kidneys, and liver were transplanted on
May 4 into four recipients.
-
- The recipient of both lungs died during the organ transplant
procedure. The other three organ transplant recipients died weeks later
on June 7, 8, and 21 in Texas, but rabies was only recently identified
as the cause of death.
-
- "CDC confirmed yesterday that all three transplant
recipients were infected with a strain of rabies commonly found in bats,"
says Mitchell Cohen, MD, director of the CDC's coordinating center for
infectious diseases.
-
- Although some organ procurement organizations screen
potential donors for possible rabies exposure, officials say there is no
national requirement to screen or test organ donors for rabies. That issue
is expected to be debated by federal health officials as the investigation
into the transplant-related rabies deaths continues.
-
- "This has never happened before, but we need to
do whatever we can to prevent it from happening again," says Virginia
McBride, a public health organ donation specialist at the Health Resources
and Services Administration.
-
- But experts stress the benefits of receiving a donated
organ still far outweigh the potential risks.
-
- "Human rabies is extremely rare, and we see only
a few human cases each year, usually in people who are bitten or scratched
by certain types of bats and often don't know it," says Cohen.
-
- "The benefits of receiving an organ transplant far
outweigh the risk of any infectious disease acquired through transplantation."
-
- Rabies Strain Usually Found in Bats
-
- Rabies is a virus that is most commonly transmitted through
the bite of an infected animal.
-
- The source of the donor's infection has not been identified,
but officials say it is consistent with a strains of the rabies virus commonly
found in bats. Wild animals such as bats, raccoons, skunks, and foxes account
for about 90% of the rabies cases documented each year.
-
- The virus lives within the nervous system and is not
found in the blood or detected by standard screening tests. In addition,
symptoms of rabies may emerge as late as one year after infection, which
would make screening for the disease difficult.
-
- Experts say the virus was most likely passed via the
nerves within the organs that were taken from the donor.
-
- Human-to-human transmission of rabies is also very rare
and has been documented in only two cases in Ethiopia. Officials believe
those cases may have been caused by direct contact with saliva of an infected
individual from a kiss or a bite.
-
- But 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.
-
- The hospitals that cared for the donor and transplant
recipients include:
-
- Baylor University Medical Center, Dallas
- University of Alabama-Birmingham Hospital, Birmingham,
Alabama
- Christus Saint Michael Healthcare Center, Texarkana,
Texas
- Wadley Regional Medical Center, Texarkana, Texas
- Good Shepherd Medical Center, Longview, Texas
- Rabies can be prevented if a series of six shots is given
over a 28-day period to boost the body's defenses against the virus.
-
- However, once symptoms develop, rabies is nearly always
fatal. Early symptoms in humans are non-specific and include fever, headache,
and general malaise. As the condition progresses, other symptoms include:
-
- Insomnia
- Anxiety
- Confusion
- Slight or partial paralysis
- Excitation
- Hallucinations
- Agitation
- Excessive salivation
- Difficulty swallowing
- Fear of water
- http://dailynews.att.net/cgi-bin/news?e=pri&dt=040701&
cat=news&st=news100527&src=webmd
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