Michigan resident dies due to rabies post organ donation: From milk to open wound, sources of rabies other than animal bite

In an unfortunate incident, a Michigan resident died of rabies after receiving an organ transplant in Ohio, Toledo-Lucas County (Ohio) Health Department reported Wednesday. A viral disease, despite being preventable, rabies almost always kills once it infects the central nervous system and the symptoms appear.
The Michigan Department of Health and Human Services confirmed the report and said the patient who received the transplant in December, died in January. The health agency said that the investigation revealed the unidentified patient contracted rabies through the transplanted organ.
"A public health investigation determined they contracted rabies through the transplanted organ," the Michigan agency said.
In a case study published in BMC Infectious Diseases Journal, from 2015 to 2017, in a China Medical Centre, four solid organ recipients were successively diagnosed with rabies that were supposedly transmitted from two donors who died due to viral encephalitis of unknown cause and acute disseminated encephalomyelitis.
All the four patients suffered from neurological symptoms associated with rabies and died. The experts involved in the case study conclude that organs should be discarded whenever rabies is confirmed or suspected, especially in cases diagnosed as encephalitis of unknown cause.

Rabies virus belongs to the Lyssavirus genus in the Rhabdoviridae family. A zoonotic viral disease, rabies is preventable by vaccine. It affects the central nervous system and is deadly in almost all cases if not treated on time. Around 99% of the human rabies cases occur due to dog bite or scratch. Children aged between 5-14 years are frequent victims. Rabies infects mammals, including dogs, cats, livestock and wildlife.
Rabies spreads to people and animals through saliva, usually through bites, scratches, or direct contact with mucosa.

In case of humans, symptoms start to develop one to three months after the exposure. In animal cases, signs develop three to eight weeks after the exposure.
Rabies begin with fever, pain and unusual or unexplained tingling, pricking, or burning sensations at the wound site. But as the virus starts affecting central nervous system, progressive and fatal inflammation of the brain and spinal cord develops. Rabies can be rarely cured, and not without severe neurological deficits.
Symptoms can also differ depending on the type of rabies. While one kills after a few days, the other one slowly develops and eventually turns fatal.
Furious rabies signs include hyperactivity, excitable behaviour, hallucinations, lack of coordination, hydrophobia (fear of water) and aerophobia (fear of drafts or of fresh air). After a few days, patients usually die due to cardio-respiratory arrest.
In case of paralytic rabies, muscles gradually become paralysed, starting from the wound site. A coma slowly develops and eventually death occurs.

Rabies isn't a food-borne disease and cow's milk doesn't carry the virus, but in rare cases the pathogen may be present in secretions such as saliva or very rarely in milk when a cow has advanced-stage rabies.
In a rare case, a woman died after contracting rabies post drinking milk from an infected cow. The Uttar Pradesh woman didn't know the cow was infected. She developed symptoms soon after showing symptoms shortly after. She was thereafter turned away by various hospitals, and subsequently died.


Between 1956 and 1977, 4 human cases of rabies virus infection were attributed to aerosolized rabies virus, according to the Journal of Infectious Disease. Aerosolized rabies virus refers to rabies particles suspended in the air, which can potentially infect individuals through inhalation in high-risk environments like caves or laboratories.

Rabies can rarely spread when infected saliva enters an open wound or the mucous membranes, such as the mouth or eyes. This could happen if an infected animal licked an open cut on your skin.
Nonbite exposures such as contaminated wounds, mucous membranes, or inhalation rarely cause rabies in humans. In the US, only 5 of 154 cases (3%) from 1950 to 1980 resulted from nonbite exposure. Four were linked to aerosolized rabies virus in spelunkers and lab workers, while the fifth involved a cornea transplant from an undiagnosed rabies patient.
No, Rabies is not spread by blood. According to the District of Columbia Department of Health, the virus is most commonly spread through saliva when an infected animal bites another animal or person. Rabies is not spread by blood, urine or feces.
Wash the wound well with soap and water if bitten by an animal. Contact your physician immediately to determine if you need to start vaccination known as post-exposure prophylaxis. Treatment is highly effective and life-saving only if received before symptoms develop.