A Michigan man died from rabies after receiving a kidney from a donor later found to be infected, highlighting how rare but devastating rabies transmission through organ transplant can be and why careful screening, timely diagnosis, and post-exposure treatment are critical for both patients and healthcare systems.


A rare and tragic chain of events

When most of us think about rabies, we picture a stray dog or a bat, not a life‑saving organ transplant. Yet, in an extremely rare and tragic case investigated by the U.S. Centers for Disease Control and Prevention (CDC), a Michigan man developed rabies and died 51 days after receiving a kidney from a donor in Idaho. Only later did investigators learn that the donor had been scratched by a skunk six weeks before his own death, and that the rabies infection went undetected during the organ donation process.

This story is frightening, especially if you or someone you love is waiting for, or has received, an organ transplant. It’s important, though, to hold two truths at once: this kind of transmission is extraordinarily rare, and at the same time, it offers powerful lessons about rabies, organ safety, and how we can better protect patients.


Hospital corridor with medical staff walking, representing transplant and infection control
Organ transplantation saves thousands of lives each year, but rare infections like rabies can pose hidden risks.

What exactly happened in this rabies transplant case?

According to the CDC investigation, the organ donor was an Idaho man who died of what initially appeared to be a neurological illness not clearly linked to rabies. Six weeks before his death, he had been scratched by a skunk—an animal known in North America to occasionally carry the rabies virus.

Standard donor screening was performed, but rabies is not routinely tested for in all donors because it is so uncommon, and tests can be challenging to interpret early in the disease. Multiple organs from this donor were transplanted into recipients across different states. One of those recipients, a Michigan man who received a kidney, developed symptoms weeks later and was eventually confirmed to have rabies. He died 51 days after the transplant.

Once rabies was identified in the Michigan recipient, public health authorities rapidly traced other recipients and close contacts and provided post‑exposure prophylaxis (PEP) where appropriate to prevent further illness.

“Rabies transmission through organ transplantation is exceedingly rare, but when it happens, it is almost always fatal if not recognized quickly. This case underscores the importance of considering rabies in donors with unexplained encephalitis or a history of animal exposure.”
— Infectious disease specialist, summarizing CDC guidance

Rabies 101: How the virus spreads and why it’s so deadly

Rabies is a viral infection that attacks the central nervous system. Once symptoms appear, it is almost universally fatal. That’s why prevention and early post‑exposure treatment are absolutely essential.

How rabies is usually transmitted

  • Bites from infected animals — The most common route worldwide.
  • Scratches or saliva contact with broken skin — Particularly from animals like bats, raccoons, skunks, and foxes in North America.
  • Rare, non‑bite exposures — Including organ or tissue transplantation from an infected donor.

Why it’s so hard to catch early

Rabies has an incubation period that can range from days to months. Early symptoms—fever, headache, malaise—look like many other illnesses. By the time classic signs like agitation, confusion, hydrophobia (fear of water), or paralysis appear, the infection is usually beyond the point where treatment can help.

Early recognition of unusual infections is critical, especially when transplant patients develop unexplained neurological symptoms.

How common is rabies from organ transplants?

Organ‑transmitted rabies is one of the rarest forms of rabies transmission documented. Since the first recognized clusters in the early 2000s, only a small number of such incidents have been reported worldwide, usually involving multiple recipients from a single donor with unrecognized rabies.

Why it’s so uncommon

  • Potential donors undergo extensive screening for infections and medical history.
  • Rabies is rare in humans in countries like the United States and Canada.
  • Most rabid animals do not end up in circumstances where their infections lead to human organ donation.

In the Michigan case, the donor’s initial illness did not clearly point to rabies, and his prior skunk scratch was either not recognized as significant or not clearly connected to his neurological decline at the time of death.

“For someone waiting on a transplant list, the risk of dying without an organ is almost always far greater than the risk of acquiring a rare infection from a donor. The system isn’t perfect, but it is designed to make that risk as small as humanly possible.”
— Transplant surgeon, reflecting on donor safety

How organ donation screening works—and what’s changing

The organ donation and transplantation system in the U.S. and many other countries is tightly regulated. Organizations such as organ procurement organizations (OPOs), transplant centers, and public health agencies collaborate to minimize infectious risk.

Typical infection screening in donors

  1. Detailed medical and social history — Including recent illnesses, travel, animal exposures, and high‑risk behaviors.
  2. Physical examination — Looking for signs of infection or unexplained disease.
  3. Laboratory testing — For HIV, hepatitis B and C, syphilis, and many other infections. Emerging pathogens may be added as evidence evolves.
  4. Pathology and imaging review — In selected cases to clarify unexplained neurological or systemic illness.

Rabies testing is not universal because of its rarity and the difficulty of detecting the virus early, but this case and previous clusters have led to stronger recommendations: donors with unexplained encephalitis or a clear history of high‑risk animal exposure are now more likely to trigger consideration of rabies and related testing, or even exclusion from donation.

Transplant team performing surgery in an operating room
Transplant teams balance the urgent need for organs with meticulous screening for infections, including rare threats.

What transplant patients and families can do in practice

You can’t personally control donor screening, but you can play an active role in your own safety before and after a transplant. Here are practical, evidence‑informed steps.

Before transplant: questions to ask

  • Ask about infection protocols: “How are donors screened for infections, and how will you update me if something unusual is discovered later?”
  • Review your vaccination status: Make sure routine vaccines (like influenza, COVID‑19, pneumococcal, hepatitis B) are up to date as recommended by your transplant team. Rabies pre‑exposure vaccination is generally only advised for high‑risk occupations.
  • Understand consent documents: These often explain that while risk is minimized, zero risk of infection can never be guaranteed.

After transplant: monitoring and advocacy

  1. Report symptoms early: Fever, confusion, new neurological symptoms, or unusual behavior should be reported to your transplant team or emergency services immediately.
  2. Keep a clear medication and symptom diary: This helps specialists differentiate side effects from infections.
  3. Stay plugged into your care team: Make sure they have up‑to‑date contact information and that you know how to reach them 24/7.
Open communication with your transplant team is one of the strongest safeguards you have as a patient.

Animal exposures, rabies, and transplant recipients

The original donor in this case had been scratched by a skunk six weeks before death. While most small animal scratches are harmless, any exposure to a potentially rabid animal deserves respect—especially if you are immunosuppressed after a transplant.

If you’re scratched or bitten by an animal

  1. Wash the wound immediately with soap and running water for at least 15 minutes.
  2. Seek medical care urgently—preferably the same day.
  3. Tell providers you are a transplant recipient or otherwise immunocompromised.
  4. Discuss rabies post‑exposure prophylaxis if the animal is wild, unknown, or behaving strangely.
Skunks and other wild animals can carry rabies: any scratch or bite from such animals warrants prompt medical evaluation.

Common fears and obstacles—and how to navigate them

Learning about a case like this can stir up understandable anxiety. Here are some frequent concerns I see reflected in patient stories, and realistic ways to respond.

  • “I’m terrified of getting a transplant now.”
    It’s natural to be scared. Yet without a needed organ, many patients face progressive organ failure and death. Your transplant team can walk you through actual risk numbers and help you weigh them against the benefits.
  • “I don’t want to ‘bother’ my doctors if I feel off.”
    Transplant teams generally prefer “false alarms” to missed infections. You deserve to be taken seriously, especially with new neurological or infectious symptoms.
  • “I feel guilty or anxious because the organ came from someone who died.”
    These emotions are common and valid. Psychological support—counseling, support groups, faith leaders—can help you process complex feelings about donation and risk.
“You’re allowed to ask hard questions about your care. Being an informed, engaged patient is not a burden; it’s part of what keeps you safe.”

What the science and experts say about moving forward

The Michigan rabies transplant case fits into a broader pattern seen in the medical literature: rare, high‑impact events that trigger system‑wide improvements. Each time such a transmission is detected, guidelines are sharpened, education is strengthened, and surveillance is enhanced.

Research and CDC reports emphasize:

  • The extreme rarity of organ‑transmitted rabies.
  • The near‑universality of death once symptomatic rabies develops.
  • The lifesaving value of prompt rabies PEP after high‑risk exposures.
  • The importance of considering rabies in donors with unexplained neurologic illness and animal exposure history.

For transplant candidates and recipients, the overarching message from experts remains consistent: transplantation remains one of the most effective, evidence‑based treatments for end‑stage organ disease. Extremely rare events like this one are taken seriously precisely so they can become even rarer.


Turning fear into informed action

The Michigan man who died from rabies after a kidney transplant did everything he could to fight for his life. The donor, unknowingly infected after a skunk scratch, chose to give others a second chance. Their intertwined stories are heartbreaking—and they’re also catalysts for safer care for future patients.

You cannot erase risk completely, whether from infection, surgery, or simply living daily life. But you can:

  • Stay informed about conditions like rabies and how they spread.
  • Engage actively with your transplant and medical teams.
  • Seek immediate help for unusual symptoms or animal exposures.
  • Support and honor organ donation while advocating for ongoing safety improvements.

If you’re a transplant candidate, recipient, or family member feeling unsettled after reading about this case, consider bringing this story to your next appointment. Ask your team how they would handle a similar situation today. Let the conversation transform fear into partnership, clarity, and a concrete plan to protect your health.

Your call‑to‑action: write down three questions about infection risk and transplant safety and bring them to your next clinic visit. Starting that dialogue is one of the most powerful, practical steps you can take right now.