A Michigan resident died last year after unknowingly receiving a kidney infected with rabies, marking one of the rarest medical events recorded in U.S. transplant history. The case, recently detailed in a report from the U.S. Centers for Disease Control and Prevention (CDC), is only the fourth documented instance of rabies transmission through organ donation since 1978.
A Tragic Chain of Events
The kidney recipient, who underwent transplant surgery in Ohio in late 2024, appeared to be recovering normally before developing neurological symptoms about five weeks later. He experienced tremors, confusion, limb weakness, and eventually hallmark signs of rabies such as hydrophobia and difficulty swallowing. Despite rapid medical intervention, he died within a week of being hospitalized. Laboratory analysis confirmed the presence of rabies virus in multiple tissue samples.
How the Donor Became Infected
According to the CDC’s investigation, the organ donor was an Idaho man who encountered a skunk on his rural property just weeks before his death. While holding a kitten at the time, he attempted to remove the skunk, sustaining a deep scratch on his shin. He did not believe he had been bitten and did not seek medical evaluation.
About a month later, he developed severe neurological symptoms, was hospitalized, and eventually declared brain dead. His symptoms were mistakenly linked to preexisting health issues, and the potential animal exposure was not initially known to hospital staff.
Organs Recovered Before Rabies Was Suspected
Following the donor’s death, several organs-including his heart, lungs, kidney, and corneas-were recovered for potential transplantation. Initial blood tests did not indicate rabies infection, and the donor’s left kidney was transplanted into the Michigan patient. Other major organs were used only in medical training, and therefore no samples remained to confirm infection.
Later, the CDC examined stored biopsy material from the donor’s right kidney and detected rabies virus genetic material matching the silver-haired bat variant, a strain commonly found in North America. This finding confirmed the donor’s infection and strongly linked the Michigan patient’s illness to the transplanted organ.
Precautionary Measures for Other Recipients
The donor’s corneas had been processed into four grafts for eye surgeries. Three were implanted in patients in California, Idaho, and New Mexico before the rabies link was discovered. All three individuals underwent precautionary corneal removal and received full rabies post-exposure treatment. None developed symptoms. A fourth graft scheduled for a patient in Missouri was withheld once the investigation began.
Medical Experts Highlight Rare but Serious Risk
While rabies remains one of the deadliest infectious diseases, transmission through organ donation is exceedingly uncommon. Between 1978 and 2013, only three similar events were reported in the U.S., involving nine recipients in total. Because rabies infection in human donors is extremely rare, routine screening is not currently part of standard organ-donor testing protocols.
Public health officials say the case underscores the importance of rapid consultation when a donor exhibits unexplained neurological symptoms-especially if any possibility of animal exposure exists.
The CDC emphasized that the overall risk of rabies transmission through transplants remains extremely low, but increased awareness can help prevent similar tragedies. The Michigan case also represents the first confirmed human rabies infection in the state in roughly 15 years.
