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TRANSPLANT PATIENTS HAVE CAUGHT RABIES FROM DONORS
THIS NEWSLETTER IS FOR INFORMATIONAL PURPOSES ONLY. NOTHING IN THIS CONTENT CONSTITUTES MEDICAL, PSYCHOLOGICAL, OR PROFESSIONAL ADVICE. ALWAYS CONSULT A QUALIFIED HEALTHCARE PROFESSIONAL BEFORE MAKING ANY HEALTH RELATED DECISIONS.
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OKAY BACK FROM THE TRANSPLANT WARD 🫀
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ONE DONOR WHOSE ORGANS CARRIED RABIES 🦇
Four Recipients Caught Rabies From One Organ Donor In 2004
The Organs Were Kidneys A Liver And An Arterial Segment
All Four Died Of Encephalitis Whose Cause Was Unknown At First
The Authors Reviewed Medical Records For The Donor And Recipients
Blood Cerebrospinal Fluid And Tissues Were Tested
The Tests Looked For Numerous Causes Of Encephalitis
Samples From The Recipients Were Also Inoculated Into Mice
All Four Developed Encephalitis Within 30 Days After Transplantation
Their Neurologic Condition Deteriorated Rapidly
It Featured Agitated Delirium Seizures Respiratory Failure And Coma
They Died An Average Of 13 Days After Neurologic Symptoms Began
Inoculated Mice Became Ill Seven To Eight Days Later
Electron Microscopy Examined Central Nervous System Tissue
It Demonstrated Rhabdovirus Particles
Rabies Specific Antibody Staining Was Also Used
Staining Demonstrated Rabies Virus In Multiple Tissues
Those Tissues Came From All Recipients
Cytoplasmic Inclusions Consistent With Negri Bodies Were Seen
They Appeared In Central Nervous System Tissue From All Recipients
Three Of The Four Recipients And The Donor Had Rabies Antibodies
The Donor Had Told Others That A Bat Bit Him
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TWO DONORS AND FOUR RECIPIENTS IN CHINA ⏳
A Second Paper Calls Transplant Rabies A Notable Problem In China
From 2015 To 2017 Rabies Was Diagnosed In Four Organ Recipients
All Four Were Recipients At The Authors' Own Centre
The Authors Considered It Transmitted From Two Donors
One Donor Died After An Initial Diagnosis Of Viral Encephalitis
The Other Was Diagnosed With Acute Disseminated Encephalomyelitis
A 6 Year Old Boy Was The First Donor
An 11 Year Old Girl Was The Second Donor
She Lived In Hebei Province In China
Four Of The Five Recipients Of These Two Donors Developed Rabies
Incubation Periods Were 44 Days 48 Days 158 Days And 303 Days
Each Of The Four Had Neurological Symptoms Associated With Rabies
All Four Patients Died
Survival Times Were 44 Days 34 Days 8 Days And 6 Days
Untreated Patients Die 1 To 5 Days After Neurological Symptoms Start
Earlier Studies Covered Rabies Transmitted By Solid Organ Transplants
They Found A Median Incubation Period Of 27 Days
The Range Was 20 To 510 Days
Apart From Two Recipients The Authors Call Their Periods Consistent
They Say Those Two Might Be Associated With Low Toxicity
Another Kidney Recipient Received Timely Postexposure Prophylaxis
That Recipient Has Remained Asymptomatic
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EVALUATING DONORS FOR RABIES 🔍
A Subarachnoid Hemorrhage Killed The 2004 Donor Who Had Been Healthy
The Report On His Case Names Challenges In Transplantation
They Are Preventing And Detecting The Spread Of Unusual Pathogens
The Two Donors In China Had Initial Diagnoses Other Than Rabies
Those Diagnoses Were Reclassified As Rabies Later
Typical Symptoms And Rabies In The Recipients Were The Reasons
Both Donors' Families Denied Exposure To Potentially Rabid Animals
They Also Denied A History Of Rabies Vaccinations
Both Donors Seemed To Be At High Risk For Rabies Exposure
Writing About China The Authors Say Misdiagnosis Of Rabies Is Common
Their Cases Had More Paralytic Rabies Than The General Population
Its Symptoms Are Similar To Those Of Guillain Barre Syndrome
They Say The Similarity Often Results In Misdiagnosis
Laboratory Test Restrictions Make Confirmation Hard Per The Authors
Confirmation Can Come Too Late To Decide Whether To Procure Organs
The Authors Write Donors Often Die Of Encephalitis Of Unknown Cause
They Add That This Is Especially So For Children
Infectious Encephalitis Is Not A Contraindication For Donation
The Authors Say Coordinators And Doctors Need To Recognize Rabies
They Recommend Serological Testing And Aetiological Diagnosis
It Is For Donors At High Risk Or Clinically Suspected Of Rabies
The Authors Say Discard Organs When Rabies Is Confirmed Or Suspected
They Call For A Supervisory System For Donor Derived Diseases
