By John Q. Hosedrinker 
In a rare instance, a Michigan man died of rabies after receiving a kidney transplant from an Idaho man who succumbed to the disease. The donor was scratched by a skunk while protecting a kitten. Following the recipient’s death and a review of the donor’s medical history, authorities discovered the skunk encounter and later confirmed the donor’s rabies infection through kidney biopsies. This led to a “likely three-step transmission chain” from a bat to a skunk to the donor and finally, to the recipient. The CDC has reported that this is only the fourth recorded transplant-transmitted rabies event in the U.S. since 1978.
Read the original article here
Man dies of rabies after kidney transplant from donor who saved kitten from skunk: This is a story that truly makes you shudder. It’s a medical nightmare, a tragic sequence of events stemming from a seemingly heroic act that ultimately led to devastating consequences. The case, as you might have gathered, involves a man who received a kidney transplant from a donor whose history included a close encounter with a skunk and a kitten.
The investigation uncovered a horrifying chain of events. The donor, unknowingly infected with rabies, transmitted the disease through his kidney. The recipient of that kidney unfortunately succumbed to the deadly virus. The ripple effect was even more tragic, with three other individuals who received cornea grafts from the same donor needing to undergo preventative treatment.
The initial tests for rabies on the donor, performed after his death, came back negative. This seemingly contradictory result raises an immediate question: how could a man be diagnosed with rabies and transmit it, if the tests didn’t reveal its presence? The answer lies in the complexities of the disease. It turns out that a different analysis from the kidney itself offered the truth, detecting a specific strain consistent with rabies found in silver-haired bats. This indicates that the donor was indeed infected.
The timeline is crucial in understanding the situation. The donor, a man in Idaho, had a history of being scratched by a skunk. The donor risk assessment interview, or DRAI, revealed this detail, which should have been a major red flag. According to the donor’s family, the incident involved the skunk showing “predatory aggression” towards a kitten the donor was holding. The man apparently fought off the skunk, but not before sustaining a scratch that bled.
The symptoms that the donor displayed leading up to his death were also a concern. Five weeks before his collapse, the donor became confused, had difficulty swallowing and walking, experienced hallucinations, and had a stiff neck. These are all classic signs of rabies. Despite these troubling symptoms, the true nature of his illness was initially missed. The failure to connect these concerning symptoms and his interaction with a skunk is a critical failure.
The fact that the initial tests for rabies were negative underscores a crucial point. Rabies can sometimes be challenging to detect in the early stages, as the virus can exist in a dormant phase. It is often most easily detected in the central nervous system, which is why animals suspected of carrying the virus are usually tested by examining brain tissue. The tests not catching the infection right away creates a significant problem here.
The Centers for Disease Control and Prevention (CDC) stated that this was only the fourth reported case of transplant-transmitted rabies in the United States since 1978. While the overall risk of transplant-transmitted infection is extremely low, this case highlights the devastating consequences when things go wrong.
The story echoes a plot from a “Scrubs” episode, which, given the real-world events, seems to mirror a tragic incident. There are striking similarities, including the frantic rush to harvest organs after an unexpected death, the failure to initially screen for the disease, and the devastating outcome for the recipients. This raises questions regarding the screening process and its execution, and how to improve it so that it is able to detect and prevent such an outbreak.
The entire situation is a perfect storm of failures. The donor’s exposure to the skunk, the lack of thorough investigation into his symptoms, and the negative initial rabies tests all contributed to this heartbreaking outcome. Every step along the way, there were opportunities to prevent this tragedy. The fact that the man, and the recipients died from the consequences of a skunk bite is a shocking and devastating testament to the importance of thoroughness in medicine.