Contaminated Kidney Donation Results in Michigan Resident's Death from Rabies
Rare Case of Rabies Transmitted Via Organ Transplant Reported in Michigan
A tragic and extremely rare case of rabies transmitted through an organ transplant has been reported in Michigan, marking the first human case of rabies in the state since 2009. The incident was first reported by WTOL, a media outlet based in Toledo, Ohio.
The recipient, whose identity remains undisclosed, underwent the transplant in December 2024 and died from the infection in January 2025. The infection was contracted from the kidney of a deceased donor.
Rabies is a virus that can infect the brain and spinal cord of most mammals. It's typically spread through the saliva of infected animals, often from scratches or bites. However, in this case, the donor was infected but undiagnosed, leading to the rare transmission via organ transplant.
The typical timeline following such transmission is rapid. The rabies virus enters peripheral tissues and migrates retrograde along nerve pathways to the central nervous system (CNS). Neurologic symptoms such as encephalitis develop within days to weeks, and progression is swift to coma and death without timely prophylaxis. In this case, the recipient developed encephalitis within weeks of the transplant and died within two weeks of symptom onset.
The causes underlying this rare transmission mode include the virus residing in the donor's nervous tissue undetected at the time of organ procurement, immunosuppression in organ recipients allowing rapid viral progression, lack of typical exposure history delaying diagnosis, and the rabies virus targeting the brainstem and limbic system, leading to fatal encephalitis.
Organ transplantation policies now carefully screen for infectious diseases including rabies to reduce this risk. However, because acquisition via transplantation bypasses usual peripheral exposure routes, symptoms may appear atypical, complicating early detection.
The University of Toledo Medical Center, where the procedure was performed, found that all best practices and standard safety protocols were appropriately followed. The health officials in Michigan and Ohio, as well as the Centers for Disease Control and Prevention, have confirmed the incident.
It's worth noting that fatal cases of rabies transmitted via transplantation are rare. Transplantation-related rabies is a bigger problem in China, where rabies is more commonly reported. The latest human case of rabies documented in the U.S. occurred in 2025.
Americans can still catch rabies, usually from bats or other infected wildlife. Therefore, it's crucial to avoid contact with wild animals and seek medical attention if such contact occurs.
The CDC noted in its investigation of a similar case in 2013 that donors aren't routinely tested for rabies unless they're suspected to have it. This underscores the importance of thorough screening and vigilance in preventing such rare but tragic occurrences.
[1] Centers for Disease Control and Prevention. (2013). Update: Rabies Transmission through Organ Transplantation — United States, 2012. MMWR Morb Mortal Wkly Rep, 62(45), 903-906. [2] Organ Procurement and Transplantation Network. (2019). Donor Selection and Screening. Retrieved from https://optn.transplant.hrsa.gov/resources/donor-selection-and-screening/ [4] Centers for Disease Control and Prevention. (2015). Rabies Transmission through Organ Transplantation — United States, 2013. MMWR Morb Mortal Wkly Rep, 64(4), 88-90.
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