By News Desk  @bactiman63

China reported it’s fourth rabies case caused by organ transplantation on January 2019 since 2015 and details of the case are described in Biosafety and Health in December.

China /CIA

The donor of the organs was a 57-year-old male farmer who was hospitalized in November 2018 of continuous abdominal pain and syncope.

He was later transferred to another hospital with a diagnosis of acute intestinal obstruction. His condition continued to worsen and was declared brain dead and a family member suggested an organ donation program– a total of five organs, including left and right corneas, double kidneys, and liver were transplanted to 5 recipients, respectively.

The donor had no history of exposure or rabies-related symptoms.

The deceased recipient was a 38-year-old female patient of uremia who received the renal transplantation at on November 11, 2018.

She recovered and was discharged two weeks later.

Maryland resident contracted rabies through organ transplant: CDC

The study states: On January 2, 2019, the recipient developed a fever and occasional swallowing discomfort while drinking water. On January 3, she was hospitalized again and developed frequent and urgent urination, aerophobia, tight throat, chills, and hyperhidrosis. In the morning of January 4, symptoms as cyanosis of lips, tight throat, cold limbs, bucking while drinking water, anemophobia, vomiting with white foamy contents, and fever were seen. Together, shock occurred with the loss of consciousness and insensitivity to light (pupils were equal and round bilaterally). Finally, recipient No.1 was declared dead.

The rest of the recipients did not develop rabies-related symptoms but were immediately given the rabies immunoglobulin and vaccinated.

Everything you wanted to know about rabies

Through laboratory, epidemiological and clinical findings, a rabies case caused by organ transplantation was confirmed, despite no further sequencing of the RV from the samples.

The authors conclude collaborations among the departments of public health, clinical sciences, and health administration are essential in avoiding rabies caused by organ transplantation. Active screening programs set for rabies before organ transplantation can also help reduce the risks. Paralytic rabies, often ignored in clinical practice, is a sign of warning. In this report, we strongly call for the inclusion of rabies into the active screening program before the organ transplantation schemes and legislation of regulations to prevent and control such cases, so as to reach the goal of eliminating human rabies by 2030.