4 ms·

FTA: “only four donors have transmitted rabies to recipients since 1979” ONLY?! Rabies cases are really uncommon! I’m seeing 17 in the us from 2015-2024. Even

FTA: “only four donors have transmitted rabies to recipients since 1979” ONLY?! Rabies cases are really uncommon! I’m seeing 17 in the us from 2015-2024. Even assume double or triple the rates in earlier decades and, what, maybe 200 since 1978? 2-4% chance a given person who dies of rabies has their organs given to someone else? That’s an order of magnitude higher than I’d have guessed. WTF.

inglor_cz 10mo ago
Theoretically, the donor could die before the rabies infection developed into a disease. For example, in a car crash. IDK if this was ever the case. The incubation period is definitely long enough for this to be a plausible scenario.
- thaumasiotes 10mo ago
  Going by wikipedia, the incubation period can be up to three months. That isn't a particularly significant span of time if we're measuring how likely someone is to suffer an unexpected death. It's long enough that the possibility exists, but that's about all you can say.
  - gus_massa 10mo ago
    Assuming an even distribution of deaths: 3 months / 80 years = 0.3% But there is very little people that is incubating rabies.
    - jjk166 10mo ago
      But the question isn't "what are the odds someone who dies in this period has rabies" it's "what are the odds someone who died after being infected with rabies died before they started showing symptoms" so the rarity of people incubating rabies is irrelevant. Further, rabies incubation is highly variable - symptoms may not appear for years.
    - woleium 10mo ago
      nit: surely the upper bound for an acceptable organ is < 80 years old and > 15? maybe the window is closer to 50 years?
ErrantX 10mo ago
I question whether the original death here would have been tracked as rabies Vs heart attack. Which also suggests perhaps it is slightly more common than data suggests
- toast0 10mo ago
  From the CDC report [1], it's pretty clear that rabies was not considered for the donor until after the donee died and rabies was confirmed. Possibly because the donor had been scratched by a skunk and not biten. The report says the scratch had been noted on the donor risk assessment interview (DRAI), but that skunks are not considered a reservoir for rabies in his area. [1] https://www.cdc.gov/mmwr/volumes/74/wr/mm7439a1.htm https://www.cdc.gov/mmwr/volumes/74/wr/mm7439a1.htm
  - thaumasiotes 10mo ago
    Skunks also aren't aggressive... I thought rabies had to be considered for any interaction with a wild animal. For one showing atypical behavior, the indication is that much stronger.

inglor_cz 10mo ago

Theoretically, the donor could die before the rabies infection developed into a disease. For example, in a car crash. IDK if this was ever the case. The incubation period is definitely long enough for this to be a plausible scenario.

thaumasiotes 10mo ago
Going by wikipedia, the incubation period can be up to three months. That isn't a particularly significant span of time if we're measuring how likely someone is to suffer an unexpected death. It's long enough that the possibility exists, but that's about all you can say.
- gus_massa 10mo ago
  Assuming an even distribution of deaths: 3 months / 80 years = 0.3% But there is very little people that is incubating rabies.
  - jjk166 10mo ago
    But the question isn't "what are the odds someone who dies in this period has rabies" it's "what are the odds someone who died after being infected with rabies died before they started showing symptoms" so the rarity of people incubating rabies is irrelevant. Further, rabies incubation is highly variable - symptoms may not appear for years.
  - woleium 10mo ago
    nit: surely the upper bound for an acceptable organ is < 80 years old and > 15? maybe the window is closer to 50 years?

ErrantX 10mo ago

I question whether the original death here would have been tracked as rabies Vs heart attack. Which also suggests perhaps it is slightly more common than data suggests

toast0 10mo ago
From the CDC report [1], it's pretty clear that rabies was not considered for the donor until after the donee died and rabies was confirmed. Possibly because the donor had been scratched by a skunk and not biten. The report says the scratch had been noted on the donor risk assessment interview (DRAI), but that skunks are not considered a reservoir for rabies in his area. [1] https://www.cdc.gov/mmwr/volumes/74/wr/mm7439a1.htm https://www.cdc.gov/mmwr/volumes/74/wr/mm7439a1.htm
- thaumasiotes 10mo ago
  Skunks also aren't aggressive... I thought rabies had to be considered for any interaction with a wild animal. For one showing atypical behavior, the indication is that much stronger.