Update on investigation of rabies infections in an organ donor and transplant recipients
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Update on investigation of rabies infections in an organ donor and transplant recipients

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      Tuesday, July 06, 2004, 11:51 EDT (11:51 AM EDT)


      On July 1, 2004, the Centers for Disease Control and Prevention (CDC) reported that rabies had been diagnosed in three recipients of transplanted organs and in their common donor (see MMWR dispatch). The three transplant recipients developed an unexplained illness after transplantation and later died. Health departments in Alabama, Arkansas, Oklahoma, and Texas are conducting investigations to identify contacts of patients among health-care providers or domestic contacts who might need rabies postexposure prophylaxis. This update provides information on expanded criteria for conducting risk assessments as part of these investigations.

      Pathologic examination of a transplanted kidney removed from one of the recipients demonstrated extensive presence of rabies virus antigen. The amount of antigen present is substantially more than what has been seen in examination of kidneys of some non-immunosuppressed patients who died of rabies. This new finding indicates that there may be a larger-than-usual viral load in these transplanted organs. Although these pathologic tests only indicate the presence of viral proteins - not intact, infectious virions - CDC believes it is prudent in this situation to expand the risk assessments for exposures to include some additional groups. Specifically, expanded criteria are suggested for risk assessments of certain body fluids and the time when these exposures might have occurred.

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