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Adverse Occurrence type:
Rabies transmission through organ transplant is rare, but has been reported multiple times throughout the world, including North America, Europe, and Asia, and appears to be increasing in recognition.
Time to detection:
Two patients infected, 10 and 14 days respectively from onset of symptoms. Donor was not detected at time of death.
Alerting signals, symptoms, evidence of occurrence:
Fever, muscle spasms, laryngeal spasms, followed by death of both organ recipients. Incubation period was 42 and 48 days after transplant. Cornea recipients received vaccination and survived.
Demonstration of imputability or root cause:
Rabies in donor, as shown by RT-PCR in both organ recipients; sequences were identical. The organ donor was not tested (body cremated, no archived samples).
1) Probable Rabies Virus Transmission through Organ Transplantation, China, 2015. Hang Zhou et al. Emerging infectious Disease Volume 22, Number 8—August 2016 2) Rabies transmission following organ transplantation in China. Gong C et al. J Infect. 2017 Apr;74(4):427-431
Would be helpful to be able to list how many recipients of organ/tissue and which were ill and which asymptomatic. Otherwise further description is confusing. There should be branch points for listing of each recipient status (and donor).
Expert comments for publication:
Transmission of rabies transmission through organ transplantation has been reported across 3 continents as is likely underreported as a cause of death in transplant recipients. The cornea recipients were asymptomatic and vaccinated, and survived without explantation of grafts.