Transplant patients infected with rabies
Three German hospital patients appear to have been infected with rabies through organ transplants and are in critical condition, a medical foundation said today.
Three other patients who received organs from the same donor, a woman who died of a heart attack late last year, are doing fine, the German Foundation for Organ Transplants said.
The donor showed no rabies symptoms at the time of her death, although a recent examination of her brain showed typical signs of the disease, the foundation said.
How the woman may have contracted rabies was unclear, but the group noted that she had been in India in October.
The critically ill patients, in hospitals in Hanover and Marburg, received the donor’s lungs, kidneys and a pancreas. All showed rabies symptoms, the group said.
A patient in Heidelberg who received the liver, as well as two patients in Mainz who received her corneas, were in good health.
“Something like this has never happened in Germany,” foundation head Guenter Kirste said.
”Unfortunately there is no way to medically rule out such rare infections, despite thorough tests of the donor.”
All health professionals who were involved in the transplants and in the care of the patients have been identified and inoculated against the disease, Kirste said.
It all looked like a routine case of organ transplantation. In December, the organs of a deceased donor were delivered from a hospital in the town of Mainz to six patients in hospitals all over Germany.
The donor had died of heart failure without showing any signs of rabies, said Manfred Thelen, the head of the hospital where the organs were extracted.
“It was a young woman of 26 years who was delivered to the hospital in late December,” he explained. “Months before her death she had been on a trekking tour in India. Later she fell ill in a different region in Germany, suffered a heart attack and was admitted here.”
The fact that the young woman had probably caught the virus while travelling in India was only discovered after three recipients of her organs fell ill in January, showing typical signs of the disease.
In some cases, rabies can take several months to appear. But once it breaks out it is usually fatal.
In developing countries, thousands die of rabies every year, while only five cases have been reported in Germany in the past 20 years – one reason why organs are not routinely screened for the rabies virus before being transplanted.
“It’s impossible to test for a possible rabies infection,” said Thelen. “It is a terrible tragedy that the organs were infected, but the situation could not have been avoided.”
Although rare in developed countries, rabies kills thousands of people each year in developing nations. Most human cases arise from dog bites, though many animals can carry the disease.
Symptoms include fever, violent spasms, panic, hallucinations and coma leading eventually to death.
Last May, four people in the southern United States died of rabies after receiving infected lungs, kidneys and liver of a donor in the state of Arkansas who carried the disease.
