Rabies-infected organ donor whose kidney killed recipient had TWO untreated raccoon bites

NORTH CAROLINA --  The rabies-infected man whose organs went to four people, including a kidney recipient who died, is now revealed to have been bitten by raccoons at least twice in the months before he died.

Tests have now also confirmed his rabies-infected kidney caused the recipient's disease and subsequent death and that the rabies originated from raccoons.

Doctors initially attributed the death of U.S. Air Force recruit William Edward Small to other causes, but an investigation prompted by the kidney recipient's death in February found evidence of rabies in the Small’s brain tissue and also brain inflammation, which can be caused by rabies.

The virus was consistent with raccoon rabies and was nearly identical to a virus found in the transplanted kidney and other tissue from the recipient...

Investigators don't know if organs given to three other patients — the North Carolina donor's heart, liver and second kidney_were infected with the rabies virus, but all three were considered at risk. Their recipients received anti-rabies treatment "and to date remain well," said CDC researcher Dr. Neil Vora, the lead author.

The donor was 20-year-old William Edward Small, an avid outdoorsman from North Carolina who got sick after a fishing trip in Florida, where he was undergoing Air Force training.

Small's initial symptoms included nausea, vomiting and fever — which could indicate rabies but also other less serious conditions that are much more common. Doctors thought Small had eaten tainted fish.

Questioned during the organ procurement process, relatives said they didn't know of any recent risk of rabies exposure, and doctors did not test him.

Investigators say they learned during subsequent interviews that Small trapped raccoons for use as bait during hunting-dog training exercises, and had been bitten at least twice by the animals, 18 months and seven months before developing symptoms. He was not treated for those bites.

"If you don't ask specific questions, you don't get specific answers," said Dr. Michael Green, chairman of an advisory committee on disease transmission for the United Network for Organ Sharing.

"At the time these questions are being asked initially, families are often traumatized, in shock," Green said. "They're losing a loved one. They may not be thinking normally or straight or remember all those details."

(Daily Mail, NY Post - July 25, 2013)