Probable Rabies Virus Transmission through Organ Transplantation, China, 2015

Abstract

During July 2015, physicians at a hospital in Beijing, China, diagnosed rabies in 2 patients who had each received a kidney from a common organ donor who had died from acute progressive encephalitis of unknown cause. The patients had rabies incubation periods of 42 and 48 days. Altered mental status developed in both patients and progressively worsened to deep coma within 80 days after transplantation; both patients died. Two other transplant recipients received corneas but remained well after receiving timely rabies prophylaxis. An effective regulatory system for testing donors should be implemented to decrease the occurrence of donor-derived infectious diseases. In addition, health education should be improved to enhance public awareness of transplant-associated infectious diseases. Transplant recipients and other persons with exposure to organs or tissues from donors with rabies must be provided consistent health monitoring and follow-up, including rabies postexposure prophylaxis; any remaining organs and tissues must be quarantined and not transplanted.

Keywords: China; cornea transplant; infectious encephalitis; kidney transplant; organ donor; organ transplantation; rabies; tissue transplantation; transmission; transplant recipient; transplant-associated transmission; virus.

Figure

Clinical course of a transplant donor, 2 recipients of kidneys, and 2 recipients of corneas in investigation of probable transplant-associated transmission of rabies virus, China, 2015. RT-PCR, reverse transcription PCR.