— Federal health officials reported that a Michigan man has died of rabies after receiving a kidney from an Idaho donor who later tested positive for the virus. The donor, scratched by a skunk in October 2024, developed neurologic symptoms about five weeks later and died; several organs were transplanted, including the left kidney that went to the Michigan recipient. The recipient developed tremors, weakness and difficulty swallowing about five weeks after the transplant, showed a classic fear-of-water symptom in hospital, and died after roughly one week of inpatient care. The Centers for Disease Control and Prevention identified this as the fourth known instance since 1978 in which an organ donor transmitted rabies to a transplant recipient.
Key takeaways
- The donor was scratched by a skunk on a rural Idaho property in October 2024 and developed symptoms about five weeks later, according to the CDC report.
- Several organs from the donor were transplanted; the left kidney was transplanted into a man in Michigan who later developed rabies symptoms five weeks after surgery.
- The Michigan recipient was hospitalized with fever, difficulty swallowing and hydrophobia and died after approximately one week of hospitalization.
- The CDC says this is the fourth documented donor-to-recipient rabies transmission since 1978, underscoring the rarity but high lethality of such events.
- Rabies post-exposure prophylaxis is highly effective if administered before symptoms, but clinical rabies is almost always fatal once neurologic signs appear.
Background
Rabies is a viral infection most commonly transmitted to humans through bites or scratches from infected mammals; in North America, skunks, bats and raccoons are known reservoirs. The incubation period can vary widely — from weeks to months — which complicates recognition and prevention in transplant medicine. Organ donation relies on rapid assessments of donor risk, but short windows and incomplete exposure histories can leave rare exposures undetected at the time of procurement. Federal public-health authorities periodically review donor-derived infections and have logged a very small number of confirmed rabies transmissions associated with organ donation since systematic tracking began in the late 20th century.
Transplant teams balance the urgent need for organs against the risk of infectious transmission; standard screening includes medical and behavioral histories, laboratory testing for common pathogens and, when indicated, targeted assays. Rabies is not routinely screened by laboratory tests for every donor because of its low prevalence and the difficulty of detecting early infection without specific suspicion. When potential exposures are known — like a recent mammal bite or scratch — public-health guidance calls for expedited testing and consultation with infectious disease specialists and organ procurement organizations.
Main event
According to the CDC report, the Idaho donor was scratched on the shin by a skunk while on his rural property in October 2024. About five weeks after that contact he began to hallucinate and developed trouble walking, swallowing and a stiff neck. Two days into these neurologic symptoms he collapsed and was taken to a hospital in unresponsive condition; he subsequently died. Several of his organs were released for transplantation; one of those was the donor’s left kidney.
The kidney was transplanted into a man in Michigan. Approximately five weeks after the transplant the recipient began to experience tremors, generalized weakness, confusion and newly emergent urinary incontinence. He was admitted to hospital a week later with fever, worsening difficulty swallowing and what clinicians described as a fear of water — a classic sign of rabies-related hydrophobia.
Clinicians pursued diagnostic testing for central nervous system infection as his condition deteriorated. Despite supportive care, the recipient died after about a week in the hospital. Public-health investigators linked his infection to the donor through the clinical timeline and laboratory findings reported to federal authorities; the CDC has classified the event as a donor-derived rabies transmission.
Analysis & implications
This episode highlights a persistent vulnerability in organ transplantation: occult exposures that occur before donation and manifest only after organs have been transplanted. Rabies’ variable incubation period — often several weeks to months — can allow a donor to appear well enough for donation while already incubating the virus. Because rabies is rapidly fatal once neurologic signs start, there is a narrow window to detect and intervene after an exposure but before symptom onset.
Practically, the event is likely to drive renewed attention to donor risk-assessment protocols. That could include standardized questions about recent animal exposures, clearer pathways for rapid testing when an exposure is reported, and expedited notification procedures for recipients if a donor is later found to have a transmissible infection. However, expanding routine laboratory screening for very low-prevalence agents has trade-offs: increased costs, longer procurement delays and potential loss of usable organs.
For transplant recipients and clinicians, this case emphasizes the importance of rapid communication from organ-procurement organizations and public-health agencies when a donor is later discovered to have an infection. In some situations, public-health teams can advise post-exposure prophylaxis for other recipients and potentially limit further transmission; such actions depend on speed and certainty of the diagnosis. At a policy level, regulators and transplant networks may revisit guidance about donor screening questions, exposure-era windows, and laboratory triggers for rabies testing.
Comparison & data
| Metric | Known value |
|---|---|
| Documented donor-to-recipient rabies transmissions (since 1978) | 4 events |
| Time from donor exposure to symptoms (this case) | ~5 weeks |
The table above summarizes the key counts and intervals confirmed by federal authorities. The small number of documented donor-derived rabies events (four since 1978) means statistical analysis of risk is limited; individual cases, however, are highly consequential for affected recipients and public-health systems.
Reactions & quotes
“Only four donors have transmitted rabies to organ transplant recipients since 1978.”
Centers for Disease Control and Prevention (federal report)
“Once clinical signs of rabies appear, the illness is almost always fatal without intensive supportive care and very rare experimental interventions.”
World Health Organization (rabies fact sheet)
Officials from the transplant community and public-health agencies said the case will prompt reviews of current practice. Organ procurement organizations typically coordinate with state health departments and the CDC in such events to identify recipients, recommend testing, and consider post-exposure measures for potentially exposed contacts.
Unconfirmed
- Whether any other organs from the same donor transmitted rabies to other recipients has not been publicly confirmed at this time.
- It is not yet publicly confirmed if the donor reported the skunk scratch to medical providers before organ procurement.
- Details about exact dates of donor death and each recipient’s clinical timeline beyond the broad intervals reported remain under investigation.
Bottom line
This case is a rare but severe reminder that zoonotic exposures can complicate organ donation. Although donor-derived rabies transmission is exceptionally uncommon — four documented events since 1978 — when it does occur the outcomes are catastrophic for recipients because clinical rabies is almost always fatal.
Public-health and transplant systems will likely reassess screening questions, laboratory testing triggers and rapid-notification protocols to reduce the chance of similar events. For clinicians and prospective organ recipients, timely reporting of unusual animal exposures and close coordination with public-health authorities remain the most practical defenses against donor-derived infections.
Sources
- The New York Times (news report)
- Centers for Disease Control and Prevention (official public-health guidance and report)
- World Health Organization (international public-health fact sheet)