Public and military health officials say they’re trying to identify people in at least five states who had close contact with an organ donor who died of rabies or with the organ recipients because they might require treatment.
A 20-year-old Air Force recruit from North Carolina who died of rabies in Florida had symptoms of the disease but wasn’t tested before his organs were transplanted to four patients, one of whom died of rabies nearly 18 months later, federal health officials said Friday.
The three other organ recipients are getting rabies shots and haven’t displayed any symptoms. Doctors at the Centers for Disease Control and Prevention declined to speculate on their chances for survival.
“This case is so unique and atypical that we cannot make predictions,” said Richard Franka, acting leader of the CDC’s rabies team.
Dr. Matthew Kuehnert, director of the agency’s Office of Blood, Organ, and Other Tissue Safety, said investigators don’t know why doctors in Florida didn’t test the donor for rabies before offering his kidneys, heart and liver to people in Florida, Georgia, Illinois and Maryland.
The man in Maryland who received the transplant died in late February. The Defense Department said he was an Army veteran who had transplant surgery at Walter Reed National Military Medical Center in early September 2011.
A rabies test after a death can take four hours once the tissue reaches a lab in Atlanta, New York or California, Franka said. That’s precious time: A donated kidney remains viable for less than 24 hours; other organs last for less than six.
The donor had seizures and encephalitis — a brain inflammation that can be caused by rabies — but those symptoms also can be caused by a variety of bacterial, viral and other more common conditions.
Federal rules require organ banks to disclose “any known or suspected” infectious conditions that might be transmitted by the donor organs.
The donor died in September 2011 at an undisclosed Florida medical facility. Medical workers believed at the time that he died from encephalitis of unknown origin, Florida Department of Health epidemiologist Dr. Carina Blackmore said.
A rabies expert unconnected to the case, Dr. Rodney Willoughby of Milwaukee, said the three other recipients have a strong chance of surviving because they haven’t shown any symptoms.
Their identities haven’t been publicly disclosed.