The Centers for Disease Control report that “three people have died from rabies”:http://www.cdc.gov/od/oc/media/pressrel/r040701.htm contracted after receiving transplants that originated with the same donor. The donors lungs, liver and kidneys were recovered. The lung recipient died during the transplant of unrelated causes. The recipients of both kidneys and the liver died of rabies. In their “more detailed investigation”:http://www.cdc.gov/mmwr/preview/mmwrhtml/mm53d701a1.htm of the events, the CDC report that the donor
bq. as an Arkansas man who visited two hospitals in Texas with severe mental status changes and a low-grade fever. Neurologic imaging indicated findings consistent with a subarachnoid hemorrhage, which expanded rapidly in the 48 hours after admission, leading to cerebral herniation and death.
Rabies has about a three-week incubation period, and the three surviving recipients were re-admitted to hospital between 21 and 27 days after their transplants, where they died. Regular readers of CT know that one of my main “research interests”:http://www.u.arizona.edu/~kjhealy/vita.php3 has been the social organization of exchange in human blood and organs. In particular, I’ve looked at how the logistical underpinnings of the procurement system “drive variation”:http://www.kieranhealy.org/files/drafts/alt-org.pdf in rates of donation, and argued that it’s a mistake to frame the debate about organ donation in terms of stylized images of givers versus sellers. In other words, whether the process is industrialized matters more than whether it is commodified. Often, it’s only in tragic cases like this that this logistical aspect is brought to light. Of course, that doesn’t mean I think highly rationalized organizational systems are a necessarily a bad thing. Just take the CDC itself, and its remarkable “Morbidity and Mortality Weekly Report”:http://www.cdc.gov/mmwr/, which tracks what people are dying from this week in the United States. The MMWR was where the earliest signs of the size of the “HIV disaster”:http://www.kieranhealy.org/files/papers/ts.pdf became apparent to the epidemiologists, though alas not to the blood banks or the Reagan administration.
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Randy Paul 07.02.04 at 2:28 am
leading to cerebral herniation and death.
One wonders how thorough their autopsy was. Granted, rabies is rare in humans, but couldn’t have at least put a section of the brain under the microscope and looked for the presence of Negri bodies?
While realizing that time is of the essence in transplants, one wonders just how careful the authorities are . . .
Mac Thomason 07.02.04 at 7:08 pm
There’s a story in my local paper today; a fourth patient (in Birmingham) was also given transplanted organs from the donor but died on the operating table. As usual, I was unforgiveably jocular about it.
According to the CDC this is the first recorded instance of rabies being transmitted through organs, but eight people (at least) have contracted the virus through cornea transplants.
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