In an ‘extremely rare’ case, a person has died from rabies after undergoing an organ transplant in an Ohio hospital.
The unnamed Michigan resident received the kidney transplant at the University of Toledo Medical Center (UTMC) in Ohio, in December last year, Michigan Department of Health and Human Services (MDHHS) spokesperson Lynn Sutfin said in a statement, the AP reports. They died in January 2025.
This marks the first human case of rabies in Michigan since 2009. “Person-to-person transmission of rabies is extremely rare, though it has been documented in a very small number of cases involving organ transplantation,” a statement from UTMC reads, as reported by local news WTOL 11.
Rabies is a deadly disease caused by the rabies virus that affects the central nervous system of mammals, including humans. The virus is typically transmitted through the saliva of an infected animal via bites and open wounds, such as scratches.
Related: Can you transplant an organ more than once?
Rabies is almost always fatal once symptoms appear. The time it takes from exposure to symptoms appearing varies from weeks to months, but symptoms usually occur sooner when the wound is closer to the brain. Symptoms initially resemble the flu (fever, headache, weakness) but progress to neurological issues such as confusion, hallucinations, paralysis, hydrophobia (fear of water), and eventually coma and death. Fewer than 20 people have ever survived rabies after symptoms presented, according to the Centers for Disease Control and Prevention (CDC). Around 10 people die from rabies in the U.S. each year, the CDC estimates.
According to the CDC, the vast majority of U.S. rabies cases are a result of exposure to bats, raccoons, skunks and foxes. In the U.S., 7 out of 10 people who die from rabies are infected by bats, while worldwide, domestic dogs cause over 95% of the estimated 70,000 annual human rabies deaths.
The Michigan resident’s rabies was confirmed by the CDC Rabies Laboratory. In a statement, the CDC said that the organ donor was exposed to rabies from a wild animal in Idaho five weeks before they died and their organ was transplanted, ABC News reports. The donor had not died with “traditional rabies symptoms,” and they had not sought out medical help or notified public health officials after their exposure to the animal.
After an animal bite, rabies can be prevented with post-exposure prophylaxis (PEP). This includes immediately washing the wound with soap and water for at least 15 minutes, and receiving four or five doses of the rabies vaccine over the course of 14 days after the bite. The vaccine helps the immune system produce antibodies against the rabies virus. If the person has never been vaccinated against rabies, they will also receive rabies immune globulin (RIG) on the day of the bite, which provides immediate passive immunity while the vaccine triggers the body’s own immune response.
About 800,000 people receive rabies-related medical care from local or state health departments around the U.S. every year.
Several cases of rabies being contracted from a transplanted organ have been reported in the past. A 2005 study in the New England Journal of Medicine reported that four recipients of kidneys, a liver, and piece of an artery died as a result of the donor having contracted rabies from a bat, and a 2020 study in the journal Transplantation revealed that a 5-year-old girl and another recipient died of rabies after a kidney transplant.
Other organ recipients saved
“In addition to the organ donor’s kidney, doctors implanted corneal grafts from the donor’s eyes into three different patients in three states,” the latest CDC statement read. “Based on the concerning symptoms of the kidney recipient who died, CDC worked with Missouri health officials to intercept a fourth corneal graft before it could be implanted into a Missouri resident.”
All of the patients who had received transplants of the donor’s corneal tissue have since been given rabies post-exposure prophylaxis shots and are in good health, the CDC says.
Cases like this are still extremely rare and should not discourage patients from receiving life-saving organ transplants, Dr. Daniel Kaul, a clinical professor at the University of Michigan’s Infectious Disease Clinic who was not involved in the treatment, told local broadcaster WOOD TV8. “The risk of not getting a transplant if you have organ failure is so much higher than this kind of incredibly rare but tragic situation,” he said.
While organs are screened ahead of transplantation, testing for rabies and other rare diseases would take several days, whereas donated organs are only viable for transplantation for a matter of hours, Kaul added. However, donors are excluded if they report having rabies or show any visible symptoms of rabies infection.
The MDHHS noted that all health care providers and anyone else exposed to the Michigan transplant patient have been assessed for rabies exposure and given PEP if necessary.
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