A fatal scratch: Michigan man dies of rabies from transplanted kidney after donor saved kitten from skunk
By isabelle // 2025-12-10
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  • A Michigan man died from rabies received through a kidney transplant.
  • The organ donor had been scratched by a rabid skunk weeks before his death.
  • Donor screening missed the rabies risk due to the symptom's rarity and unclear history.
  • Three other patients received corneal tissue from the same donor and received preventative treatment.
  • This tragic case highlights critical gaps in donor screening for rare pathogens.
A Michigan man’s death from rabies, contracted through a lifesaving kidney transplant, exposes a tragic gap in medical screening and a chilling reminder of the virus’s stealth. The case, confirmed by the Centers for Disease Control and Prevention, began not with the recipient, but with an act of compassion in Idaho. In late October 2024, a skunk approached an Idaho man as he held a kitten in an outbuilding on his rural property. During an encounter that rendered the skunk unconscious, the donor sustained a shin scratch that bled, but he did not think he had been bitten. According to the family, the donor attributed the skunk’s behavior to predatory aggression toward the kitten. Five weeks later, the donor’s world collapsed. He began experiencing confusion, difficulty swallowing, hallucinations and a stiff neck. He then fell unconscious at home and didn't wake up. Though resuscitated and hospitalized, he was declared brain dead and removed from life support five days later. His organs, including a left kidney, were donated in December 2024. The Michigan recipient received that kidney in an Ohio hospital.

A rapid and fatal decline

About five weeks post-transplant, the recipient began experiencing tremors, weakness in his lower extremities and urinary incontinence, as well as confusion. His condition rapidly deteriorated, and he was hospitalized. Within a week of being hospitalized, the patient died of his infection. Postmortem testing confirmed the presence of rabies RNA and antibodies. Investigators, having ruled out other exposures, turned their attention to the donor. Retroactive testing by the CDC found the rabies virus in a biopsy from the donor’s right kidney. While a sample from the transplanted left kidney was too small to test, the evidence strongly pointed to the organ as the source. This was the fourth reported transplant-transmitted rabies event in the United States since 1978. However, the risk for any transplant-transmitted infection, including rabies, is low.

Why wasn't this caught?

The breakdown occurred at multiple points. Hospital staff members who treated the donor were initially unaware of the skunk scratch and attributed his pre-admission signs and symptoms to chronic co-morbidities. Furthermore, rabies is excluded from routine donor pathogen testing because of its rarity in humans in the United States and the complexity of diagnostic testing. The donor risk assessment form completed by the family did document the animal encounter, but as the CDC notes, no standard guidance currently exists for addressing reported donor animal exposures by transplant teams. The consequences extended beyond the kidney recipient. Three other patients received corneal tissue from the same donor. Those grafts were swiftly removed, and the patients were placed on preventative medication, remaining asymptomatic. Health officials also contacted hundreds of people who may have had contact with the donor, recommending preventative treatment for dozens. This tragedy forces a difficult conversation about risk management in the high-stakes field of organ transplantation. On one hand, the system is designed to save lives quickly with scarce resources, and rigorous testing for every extremely rare pathogen could delay or prevent vital transplants. This is a rare event, and overall, the risk is exceptionally small. Fewer than 10 humans die from rabies annually in the U.S. thanks to effective post-exposure prevention. However, for the families involved, the statistical rarity is no comfort. A simple scratch, misinterpreted and then medically overlooked, cascaded into two needless deaths. It highlights the critical importance of exhaustive patient history-taking and the potential peril of dismissing unusual animal exposures in rural areas. While transplant protocols save countless lives, this case is a sobering reminder that nature’s deadliest viruses can exploit the narrowest of gaps. It asks a piercing question of our medical institutions: in the race to save lives, are we asking enough of the right questions? Sources for this article include: LiveScience.com NYPost.com FoxNews.com
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