Person dies of rabies after contracting virus from transplanted organ in Ohio

A Michigan resident has died from rabies after receiving an organ transplant at the University of Toledo Medical Center in Ohio, health officials confirmed this week. The case is considered "extremely rare" and marks the first human rabies death reported in Michigan since 2009.

The patient underwent a kidney transplant in December 2024 and died in January. Following an investigation by the Michigan Department of Health and Human Services, the CDC, and the Ohio Department of Health, officials determined the source of infection was the donated organ.

The donor, who had been exposed to a rabid wild animal in Idaho weeks earlier, had not exhibited typical rabies symptoms or notified public health authorities.

How rabies was transmitted through an organ transplant

The backstory:

According to the CDC, the donor had contact with a wild animal roughly five weeks before death but never sought medical care or displayed traditional rabies symptoms, such as confusion, hydrophobia, or seizures. 

The organ recipient developed symptoms shortly after the transplant and died within weeks. Rabies is nearly always fatal once symptoms appear, and fewer than 20 people have survived it in recorded medical history.

This type of person-to-person rabies transmission is extremely rare but has been documented in prior transplants. A 2005 case in the New England Journal of Medicine involved four transplant patients dying from organs provided by a rabies-infected donor. Another incident in 2020 resulted in two deaths, including a child, from a similar exposure.

What happened to the other transplant recipients

What we know:

In addition to the kidney transplant, corneal tissue from the same donor was used in three recipients across three different states. The CDC said all three patients received post-exposure prophylaxis (PEP) and are doing well. A fourth corneal graft, headed to Missouri, was intercepted before being implanted.

Michigan health officials say all healthcare workers and others who may have had contact with the transplant patient have been assessed and provided rabies PEP if needed.

What we don't know:

Several key questions remain unanswered. It’s still unclear why the donor’s rabies exposure went unreported and whether any warning signs might have been missed during the screening process. Officials have not released the exact timeline of the donor's illness or whether any symptoms were documented before the transplant. 

Additionally, it's unknown how long the kidney recipient showed symptoms before being diagnosed or if earlier intervention could have altered the outcome. The CDC and local health departments have not indicated whether procedural changes will be made to screening protocols going forward.

Why testing for rabies in organ donors is complicated

The other side:

Dr. Daniel Kaul, an infectious disease expert at the University of Michigan not involved in the case, told local media that while the case is tragic, the risk of rabies from transplants remains extremely low. "The risk of not getting a transplant if you have organ failure is so much higher than this kind of incredibly rare but tragic situation," Kaul said, according to reports from Livescience.com.

FILE - A microscopic view of brain tissue infected with the rabies virus, showing inflammation and damage to nerve cells. Rabies is almost always fatal once symptoms appear and typically spreads through the bite or saliva of infected animals. (Photo by Smith Collection/Gado/Getty Images)

Organs are screened for infections, but rabies tests can take several days—longer than the narrow window in which organs remain viable for transplant. Donors are excluded if they report symptoms or suspected rabies exposure, but in this case, none were evident.

What's next:

This case underscores the rare but serious risk posed by undiagnosed infections in organ donors. Health officials stress that organ transplants remain overwhelmingly safe, and such incidents should not deter patients in need of life-saving procedures. Roughly 800,000 people in the U.S. receive rabies-related medical care each year, but fewer than 10 die annually, according to the CDC.

Medical experts say increasing awareness around animal exposures and rapid reporting to public health authorities may help prevent future donor-related cases. The CDC continues to work with state agencies to review protocols and monitor for any further related illnesses.