A US man dies from rabies after receiving an infected kidney
TOI GLOBAL DESK | TOI GLOBAL | Dec 09, 2025, 03:20 IST
A man from Michigan passed away in January 2025, after he was given a kidney infected with rabies from a donor in Idaho, leading the CDC to request that donor screening be made more rigorous if there is a recent animal exposure.
TL;DR
An organ transplant recipient in Michigan was the tragic victim of a rabies infection that was transmitted through a kidney infected with rabies, which came from a donor in Idaho. The CDC is urging the transplant teams to increase their watchfulness if the donor is known to have a history of recent animal exposure.
A detailed investigation by the Centres for Disease Control and Prevention confirmed that a rabies-related death of a Michigan man, only a few weeks after a kidney transplant in January 2025, was the result of an infection via the transplanted organ. The rare transmission of rabies from the donor, an Idaho man with a recent skunk scratch, occurred because the donor was not evaluated for possible rabies infection before organ recovery.
The CDC has identified this case as the fourth documented instance of rabies transmission through a transplanted organ in the United States since 1978. The agency’s report, released recently, details the circumstances leading to the fatal infection and points out the weaknesses in current transplant screening procedures that made it possible.
As stated by the CDC report, the donor from Idaho was discovered unconscious at around dawn on December 2nd, 2024, and it was assumed that he had a cardiac arrest. About a month ago, he had been energetically scratched by a skunk, a universally known animal that is very often the source of rabies. Even though the exposure to an animal was definitely confirmed, the doctors did not think of the patient having rabies when they examined him. After the donor was declared eligible for organ recovery, his heart, lungs, left kidney, and corneas were distributed for transplant and training uses.
The Michigan recipient started exhibiting signs that were typical of rabies about five weeks after the kidney transplant. Doctors separated parts of his saliva, skin, and other body fragments and dispatched them to the CDC for scrutiny.
Tests in the laboratory detected rabies virus RNA, and as the patient did not have a record of contact with an animal, the investigators decided that the source of the infection was the donor.
On the basis of stored samples, the final confirmation was made. An originally stored biopsy of the donor's kidney tested positive for rabies virus RNA. Although a stored serum sample showed no anti-rabies antibodies, the tissue analysis gave unequivocal proof of infection transmitted via the organ. The patient in Michigan passed away seven days after he was admitted to the hospital.
While the donor’s heart and lungs were at a Maryland research facility for training and thus posed no risk to the public, three people had been implanted with corneal grafts. Their transplanted corneas were removed out and each patient started Post-exposure Prophylaxis, a treatment that combines human rabies antibodies with a vaccine given before symptoms appear. The CDC says PEP is extremely effective when started without delay.
Public health officials screened 357 people who might have been in contact with the donor and the transplant recipient. Consequently, 46 people, including healthcare workers and community contacts, were recommended to take PEP.
According to CDC officials, not being able to recognise the donor’s skunk scratch as a potential risk highlights a loophole in the current screening protocols. Even though the exposure was mentioned in the very first evaluation, it was not considered significant clinically because the neurological symptoms of the donor were not thought to be rabies.
Standard donor screening does not include routine rabies testing, and thus, the missed diagnosis was one of the factors. The CDC urged that during the evaluation of donors reporting that they have been in contact with potentially rabid animals in the last year, caution should be heightened.
Based on its findings, the CDC conveyed that health personnel in charge of organ transplant should inquire from public health experts in case the donor with acutely neurologic symptoms is accompanied by a recent history of being bitten or scratched by animals that can transmit rabies. The department explained that prompt discussion may facilitate testing in time, removal of transplanted tissues if the infection has spread, and quick starting of PEP in case it is required.
FAQs
An organ transplant recipient in Michigan was the tragic victim of a rabies infection that was transmitted through a kidney infected with rabies, which came from a donor in Idaho. The CDC is urging the transplant teams to increase their watchfulness if the donor is known to have a history of recent animal exposure.
A detailed investigation by the Centres for Disease Control and Prevention confirmed that a rabies-related death of a Michigan man, only a few weeks after a kidney transplant in January 2025, was the result of an infection via the transplanted organ. The rare transmission of rabies from the donor, an Idaho man with a recent skunk scratch, occurred because the donor was not evaluated for possible rabies infection before organ recovery.
The CDC has identified this case as the fourth documented instance of rabies transmission through a transplanted organ in the United States since 1978. The agency’s report, released recently, details the circumstances leading to the fatal infection and points out the weaknesses in current transplant screening procedures that made it possible.
As stated by the CDC report, the donor from Idaho was discovered unconscious at around dawn on December 2nd, 2024, and it was assumed that he had a cardiac arrest. About a month ago, he had been energetically scratched by a skunk, a universally known animal that is very often the source of rabies. Even though the exposure to an animal was definitely confirmed, the doctors did not think of the patient having rabies when they examined him. After the donor was declared eligible for organ recovery, his heart, lungs, left kidney, and corneas were distributed for transplant and training uses.
The Michigan recipient started exhibiting signs that were typical of rabies about five weeks after the kidney transplant. Doctors separated parts of his saliva, skin, and other body fragments and dispatched them to the CDC for scrutiny.
Tests in the laboratory detected rabies virus RNA, and as the patient did not have a record of contact with an animal, the investigators decided that the source of the infection was the donor.
On the basis of stored samples, the final confirmation was made. An originally stored biopsy of the donor's kidney tested positive for rabies virus RNA. Although a stored serum sample showed no anti-rabies antibodies, the tissue analysis gave unequivocal proof of infection transmitted via the organ. The patient in Michigan passed away seven days after he was admitted to the hospital.
While the donor’s heart and lungs were at a Maryland research facility for training and thus posed no risk to the public, three people had been implanted with corneal grafts. Their transplanted corneas were removed out and each patient started Post-exposure Prophylaxis, a treatment that combines human rabies antibodies with a vaccine given before symptoms appear. The CDC says PEP is extremely effective when started without delay.
Public health officials screened 357 people who might have been in contact with the donor and the transplant recipient. Consequently, 46 people, including healthcare workers and community contacts, were recommended to take PEP.
According to CDC officials, not being able to recognise the donor’s skunk scratch as a potential risk highlights a loophole in the current screening protocols. Even though the exposure was mentioned in the very first evaluation, it was not considered significant clinically because the neurological symptoms of the donor were not thought to be rabies.
Standard donor screening does not include routine rabies testing, and thus, the missed diagnosis was one of the factors. The CDC urged that during the evaluation of donors reporting that they have been in contact with potentially rabid animals in the last year, caution should be heightened.
Based on its findings, the CDC conveyed that health personnel in charge of organ transplant should inquire from public health experts in case the donor with acutely neurologic symptoms is accompanied by a recent history of being bitten or scratched by animals that can transmit rabies. The department explained that prompt discussion may facilitate testing in time, removal of transplanted tissues if the infection has spread, and quick starting of PEP in case it is required.
FAQs
- What happened to the other organ recipients?
Three cornea recipients had their grafts removed and were given Post-exposure Prophylaxis. The donor's heart and lungs were used for research training and did not present a risk. - What does the CDC recommend moving forward?
The CDC asks transplant teams to collaborate with public health experts if donors with acute neurological symptoms have also had recent animal exposure.