Maryland health officials report that the resident who died recently from rabies contracted the disease through an organ transplant.
More people have also been infected.
“There are three other organs involved,” said Karen Black, spokeswoman for the Maryland Department of Health and Mental Hygiene.
According to the Centers for Disease Control and Prevention in Atlanta, those patients are being evaluated and are undergoing post-exposure treatment.
“They have been assessed by their health teams and are receiving treatment,” said Barbara Reynolds, spokeswoman for the CDC.
Health officials will not give any information on the Maryland victim including gender or region where he or she lived.
The donor lived in North Carolina when the rabies exposure occurred, but died in Florida in 2011. The organs donated included kidneys, a heart and a liver that went to patients in Maryland, Florida, Georgia and Illinois.
Persons donating organs in the United States are screened and tested for infectious disease, including HIV and hepatitis. Rabies is not among those tests unless it is suspected.
“A questionnaire asks about animal bites,” Reynolds said.
Reynolds said timing is also an issue.
“Organs are transplanted in hours and days,” she said. Test results for the presence of rabies can take weeks.
Rabies incubation, according to Reynolds, is usually from one to three months from when the bite occurs. However, the CDC said longer incubation periods are not uncommon.
“What’s also rare is human rabies in the U.S.,” she said, adding that transmission from raccoon to human ― which is the case here ― is also rare. “We don’t have a lot of experience with human and raccoon exposure.”
Prior to this new case, the last human rabies death in Maryland was in 1976 in Cecil County. Odette Scrivanich from Red Point died in June after being bitten by a rabid bat.
The CDC is working with the states to determine the series of events that led to the infection. They are also trying to find anyone who may have been exposed to the disease through contact with the unsuspecting patients.
Rabies is transmitted through saliva, usually from a bite, but that saliva can also get into the eyes or mouth or an open wound and spread the infection. Health officials are urging people to get pets vaccinated, stay away from wild animals and report animals with odd behavior.