Rabies–from organ donations

28 Jun

As if people who need an organ in the first place didn’t already have enough problems, right?

I wouldn’t worry for myself since 1) I do not need an organ (yet) and 2) I’m vaccinated for rabies.  True story.  Thanks, Saint George Veterinary School–this is probably the only good thing to come out of that terrible situation.

Getting vaccinated was a requirment for me to even get on the island, but it wasn’t easy.  Mizzou vet school gives all their vet students the vaccine as part of their tuition.  Since I wasn’t admitted to THEIR program, they didn’t want to share.  I think there was a rabies vaccine shortage in 2008-2009 when I was trying to get it.  So I had to jump through a lot of hoops.  The vaccine itself requires 2 boosters a certain amount of weeks apart (2 weeks each?).  So getting all of it to work out with my woerk schedule also took some doing.  The worst part was EACH shot (x3) was $250.  Out of MY pocket.  The school required it, but did not pay for it, or even offer it.

So long story short, I’m vaccinated against rabies.

Straight from the CDC:

The organ donor was an Arkansas man who visited two Texas hospitals with severe mental status changes and a low-grade fever, according to the MMWR. Neurologic imaging revealed brain hemorrhaging that later caused the man’s death. He was screened according to local organ donation regulations and passed. Rabies testing is not a part of routine organ donation screening.

The donor’s lungs were transplanted into a person at an Alabama hospital who died of complications during the operation. The donor’s liver and kidneys were transplanted into three recipients at Baylor University Medical Center on May 4. Between 21 and 27 days after the transplant, all three recipients developed neurologic symptoms, and later died.

Physicians from Baylor said that it is not uncommon for transplant recipients to experience neurologic symptoms as a result of blood flow problems, medication, or infection. But because the exact causes of death for the three recipients were not identified, specimens were sent to the CDC for diagnostic testing.

Testing by the CDC confirmed the rabies diagnoses, and found a strain of rabies common in bats that live in the area where the donor lived.

After receiving those results, officials at Baylor initiated an investigation to determine whether any other patients had received organs or tissues from the rabies infected donor, said Dr. William Sutker, the chief of infectious disease, during a press conference. Through that investigation, Baylor officials discovered that the fourth patient received a liver from another donor and part of an artery from the rabies-infected donor around the same time as the other three patients. Dr. Sutker said the patient died around the same time as the other patients.

Transmission of the rabies virus during an animal organ transplant is far less likely, Dr. Rupprecht said, because the organs come from a controlled population.

“It’s the one situation where the control measures in veterinary medicine may be tighter than those in human medicine,” he said.

Though it would be impossible to screen human organ donors for all possible diseases, officials from the CDC say the benefits of organ transplantation far outweigh the potential risks. Daniel Hayes, an organ transplant expert at the United Network for Organ Sharing, explained during a CDC teleconference that, though there are an estimated 40,000 cornea transplants in the United States each year, only one case of rabies transmission has been reported. Last year, there were more than 25,000 organ transplants and no reported cases of rabies transmission, he said.

“So, I don’t think that such a rare event should trigger any kind of widespread panic or reaction to do testing for a disease that is so infrequent,” Dr. Hayes said.

On average, there are one to three human cases of rabies in the United States each year, Dr. Rupprecht said. He attributes the low number of cases to the work of veterinarians, public health professionals, and professionals in emergency rooms, and to the biologics available.

And in an effort not to write lazy posts, more links so you don’t have to do any extra typing:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5326a6.htm

http://articles.cnn.com/2004-07-01/health/rabies.organ.transplant_1_organ-donor-rabies-spread-rabies-tests?_s=PM:HEALTH

Whoa.  Thanks to my boss for sharing this news with me.

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