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Rabies scare for Chicago-area  organ transplant patient

Updated: April 17, 2013 6:06AM



A Chicago-area organ recipient is getting anti-rabies shots after a Maryland person who received tissue from the same donor died from rabies.

The Illinois recipient, from northeast Illinois, received his transplant at Northwestern Memorial Hospital, the hospital confirmed. No further information was available about the recipient.

Two other people also received an organ from the same donor, who died in 2011 after moving there from North Carolina, the Centers for Disease and Prevention said.

The Illinois Department of Public Health said the Illinois organ recipient, has no symptoms of rabies but has started anti-rabies shots as a precaution. IDPH, along with local health departments, is also working to identify any hospital personnel who may need post-exposure prophylaxis, in consultation with CDC, a spokeswoman said.

Public health officials are doing the same in Florida, Georgia and North Carolina, where the other recipients had ties, the CDC said.

“I have no indication that there is any health concerns at this time from them,” said Dr. Barbara Reynolds, crisis communication specialist of the CDC’s office of the director.

In early March, the Maryland Department of Health and Mental Hygiene initiated an investigation after the unidentified organ recipient died of rabies. The investigation had revealed that the recipient had had no reported animal exposures, which is the usual way humans get the disease. They then looked at whether the recipient, who had the organ transplantation more than a year ago, could have gotten the disease from the organ.

This week, CDC laboratories confirmed that a raccoon-type rabies virus was transmitted through organ transplantation, while also pointing out that transplant-transmission of rabies is extremely rare. Four people in Texas died in 2004 from rabies contracted from a single donor’s tissue, the only other case in the United States until now.

Rabies is a rare infection in the United States, accounting for two to three human deaths per year. The rabies virus infects the central nervous system, ultimately causing disease in the brain and death.

All potential organ donors in the United States are screened and tested to identify if the donor might present with HIV, Hepatitis B and C or other common infectious risk. Rabies usually isn’t tested, said Dr. Martin Jendrisak, medical director at Gift of Hope Organ & Tissue Donor Network, the federally designated not-for-profit organ procurement organization that coordinates organ and tissue donation and services to families of donors in the northern three-quarters of Illinois and northwest Indiana.

“In circumstances where we’re considering donation and we have a clear understanding of the cause of death that’s not infectious, the probability that there’s an occult rabies infection is so low as to make testing not worth performing,” Jendrisak said.

He added that, as with rabies, “Every patient is made aware of the full course and risks with the transplant.”

A specialist from the organ-sharing organization’s Ad Hoc Disease Transmission Advisory Committee has said disease transmission from donated organs is extremely rare, occurring in 0.2 percent of cases.

A far greater risk for people on the transplant waiting list is dying because they didn’t get a transplant. There are currently nearly 120,000 people on the waiting list for an organ transplant. About 25,000 people receive transplants each year, while on average 18 people a day die waiting.



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