The first person to die from rabies in 40 years in Maryland was infected by a transplanted organ, the Centers for Disease Control and Prevention said on Friday.
The donor died in Florida, and the heart, kidneys and liver from the patient were transplanted into other people, the CDC said.
At the time of the donor's death, rabies was not suspected as the cause and testing for rabies was not performed. Rabies was only recently confirmed as the cause of death after the current investigation began in Maryland.
"Shortly before becoming ill, the donor had moved to Florida, but was a previous resident of North Carolina where it is believed the exposure may have occurred. How the donor may have gotten rabies is currently under investigation," the CDC said in a statement.
"In 2011, the donor became ill and was admitted to a healthcare facility in Florida and then died. At that time, the donor's organs, including the kidneys, heart, and liver, were recovered and sent to recipients in Florida, Georgia, Illinois, and Maryland," the CDc said.
"At the time of the donor's death, rabies was not suspected as the cause and testing for rabies was not performed. Rabies was only recently confirmed as the cause of death after the current investigation began in Maryland."
Potential organ donors in the United States are screened and tested to identify if the donor might present an infectious risk. Lab testing for rabies is not routinely performed, because results could not be determined in the short time period organs are viable for the recipient. Transmission of rabies through organ transplant is extremely rare, according to the CDC.
People can become infected with rabies without knowing it. it is transmitted in saliva -- which is why animal bites are dangerous -- and blood. But vaccination after a bite can prevent symptoms. Once a patient develops symptoms from rabies, it is almost always fatal. Bats are most frequently linked with transmitting the virus to humans, while raccoons, skunks, and foxes are the most commonly reported rabid animals.
"The three other people who received organs from the donor have been identified and are currently being evaluated by their healthcare teams and receiving rabies anti-rabies shots (immune globulin and anti-rabies vaccination)," the CDC said.
"CDC is working with public health officials and healthcare facilities in five states (Fla., Ga., Ill., Md., and N.C.) to identify people who were in close contact with the initial donor or the four organ recipients and might need rabies post-exposure treatment," the agency says.
Most transplants in the US are safe. More than 28,000 are performed in the U.S. each year, while more than 114,000 people are waiting for organ transplants, according to the United Organ Sharing Network. In 2011 a total of 6,669 died waiting for organ transplants.
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