PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Report documents organ transplantation as source of fatal rabies virus case

2013-07-24
(Press-News.org) An investigation into the source of a fatal case of raccoon rabies virus exposure indicates the individual received the virus via a kidney transplant 18 months earlier, findings suggesting that rabies transmitted by this route may have a long incubation period, and that although solid organ transplant transmission of infectious encephalitis is rare, further education to increase awareness is needed, according to a study in the July 24/31 issue of JAMA.

The rabies virus causes a fatal encephalitis (inflammation of the brain) and can be transmitted through tissue or organ transplantation. "Unique rabies virus variants, distinguishable by molecular typing methods, are associated with specific animal reservoirs. Globally, an estimated 55,000 persons die of rabies every year, with most transmission attributable to dog bites. Approximately 2 human rabies deaths are reported in the United States every year and during 2000 through 2010, all but 2 domestically acquired cases were associated with bats. Despite raccoons being the most frequently reported rabid animal in the United States, only l human rabies case associated with the raccoon rabies virus variant has been reported," according to background information in the article. In February 2013, a kidney recipient with no reported exposures to potentially rabid animals died from rabies 18 months after transplantation.

Neil M. Vora, M.D., of the Centers for Disease Control and Prevention, Atlanta, and colleagues conducted a study to determine whether organ transplantation was the source of rabies virus exposure in the kidney recipient, and to evaluate for and prevent rabies in other transplant recipients (n = 3; right kidney, heart, and liver) from the same donor. Organ donor and all transplant recipient medical records were reviewed. Laboratory tests to detect rabies virus-specific binding antibodies, rabies virus neutralizing antibodies, and rabies virus antigens were conducted on available specimens, including serum, cerebrospinal fluid, and tissues from the donor and the recipients.

The researchers found that in retrospect, the kidney donor's symptoms prior to death were consistent with rabies (the presumed diagnosis at the time of death was ciguatera poisoning [a foodborne illness]). Subsequent interviews with family members revealed that the donor had significant wildlife exposure, and had sustained at least 2 raccoon bites, for which he did not seek medical care. Rabies virus antigen was detected in archived autopsy brain tissue collected from the donor. The rabies viruses infecting the donor and the deceased kidney recipient were consistent with the raccoon rabies virus variant and were more than 99.9 percent identical across the entire N gene, thus confirming organ transplantation as the route of transmission.

The 3 other organ recipients did not have signs or symptoms consistent with rabies or encephalitis. They have remained asymptomatic, with rabies virus neutralizing antibodies detected in their serum after completion of postexposure prophylaxis.

"This transmission event provides an opportunity for enhancing rabies awareness and recognition and highlights the need for a modified approach to organ donor screening and recipient monitoring for infectious encephalitis. This investigation also underscores the importance of collaboration between clinicians, epidemiologists, and laboratory scientists," the authors write.

(JAMA. 2013;310(4):398-407; Available pre-embargo to the media at http://media.jamanetwork.com)

Editor's Note: This investigation was supported by the Centers for Disease Control and Prevention, Maryland Department of Health and Mental Hygiene, North Carolina Division of Public Health, and Florida Department of Health and funded as part of routine infectious disease outbreak investigation activities. All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of interest and none were reported.

Editorial: Donor-Derived Infections With Central Nervous System Pathogens After Solid Organ Transplantation

In an accompanying editorial, Daniel R. Kaul, M.D., of the University of Michigan Medical School, Ann Arbor, writes that during the past decade, numerous instances have been reported of donor-derived infection among recipients of solid organ transplants with pathogens associated with central nervous system (CNS) infections, including the West Nile virus and rabies virus.

"Educational efforts to improve recognition of donors with CNS infection and the risks associated with using these donors should be directed not just at the transplant community but at the larger community of physicians involved in the care of potential donors—particularly critical care specialists, neurologists, and infectious disease physicians. These clinicians may not be aware of the potential for donor-derived infection, but accepting transplant centers must rely on the clinical impression of those caring for the potential donor. Although the risk of donor-derived disease is inherent in the process of organ transplantation and cannot be eliminated, raising awareness of the risk of using donors with undiagnosed CNS infection is the best way to reduce the occurrence of these transmissions."

(JAMA. 2013;310(4):378-379; Available pre-embargo to the media at http://media.jamanetwork.com)

Editor's Note: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

###

END



ELSE PRESS RELEASES FROM THIS DATE:

Survey assesses views of physicians regarding controlling health care costs

2013-07-24
In a survey of about 2,500 U. S. physicians on their perceived role in addressing health care costs, they reported having some responsibility to address health care costs in their practice and expressed general agreement with quality initiatives that may also reduce cost, but expressed less enthusiasm for cost containment involving changes in payment models, according to a study in the July 24/31 issue of JAMA. "The increasing cost of U.S. health care strains the economy. Because physicians' decisions play a key role in overall health care spending and quality, several ...

Kidney stones associated with modest increased risk of coronary heart disease in women, but not men

2013-07-24
An analysis of data from three studies that involved a total of more than 240,000 participants found that a self-reported history of kidney stones was associated with a statistically significant increased risk of coronary heart disease among women but no significant association was evident for men, according to a study in the July 24/31 issue of JAMA. "Nephrolithiasis [kidney stones] is a common condition, with the prevalence varying by age and sex. A recent estimate from the National Health and Nutrition Examination Survey, a representative sample of the U.S. population, ...

Increasing incidence of Type 1 diabetes among children in Finland appears to have leveled off

2013-07-24
"The incidence of type l diabetes (T1D), one of the most prevalent chronic diseases in children, has increased worldwide," write Valma Harjutsalo, Ph.D., of the Diabetes Prevention Unit, Helsinki, Finland, and colleagues, who conducted a study to examine the incidence rates of T1D between 2006 and 2011 in Finnish children younger than 15 years as well as the 32-year trend (1980-2011). As reported in a Research Letter, all children with newly diagnosed T1D were ascertained using several nationwide registers. Age-standardized and age-specific annual incidence rates for ...

Genetic testing improved student learning in personalized medicine class, Stanford study finds

2013-07-24
STANFORD, Calif. — Students who had their genome tested as part of a groundbreaking medical school course on personalized medicine improved their knowledge of the class materials by an average of 31 percent compared with those who didn't undergo the testing, according to a study by researchers at the Stanford University School of Medicine. While the sample size was small — 23 students sent their saliva to a commercial genetics testing company; eight did not — the results may encourage educators to consider this approach in the future, the authors said. "These results ...

Physical inactivity, poor diet and smoking linked to disability in older population

2013-07-24
Disability is commonly defined as "difficulty or dependency in carrying out activities essential to independent living". With the number of disabled people expected to increase in coming years, researchers feel there is a need to define preventive strategies and slow this progression. Previous research has shown that unhealthy behaviours (such as physical inactivity, poor diet, smoking) have an adverse effect on health. For instance, the risk of obesity, diabetes, cancer, poor cognitive function, stroke, sudden cardiac death and mortality increases with the number of ...

Sharing data with providers associated with plummeting rates of unnecessary medical tests in Sweden

2013-07-24
NEW YORK, July 23, 2013 – The rate of inappropriate cancer scans for low-risk prostate cancer patients in Sweden plummeted in the decade following a joint campaign to curtail such tests by Swedish County Councils and the National Prostate Cancer Register (NPCR) of Sweden, a professional association of Swedish urologists. The results, published today online in the Journal of the National Cancer Institute, suggest that curtailing unneeded medical tests, an urgent healthcare policy goal in the United States highlighted in the Choosing Wisely Campaign, among other initiatives, ...

Wave of blue fluorescence reveals pathway of death in worms

2013-07-24
The final biological events in the life of a worm are described today, revealing how death spreads like a wave from cell to cell until the whole organism is dead. When individual cells die, it triggers a chemical chain reaction that leads to the breakdown of cell components and a build-up of molecular debris. The molecular mechanisms of this are reasonably well understood at a cellular level but we know much less about how death spreads throughout an organism at the end of its life. In worms, the spread of death can be seen easily under a microscope as a wave of blue ...

Atmospheric rivers set to increase UK winter flooding

2013-07-24
The prolonged heat wave that has bathed the UK in sunshine over the past month has given the country an unexpected taste of summer that has seemed to be missing in recent years. However, a new study published today, 24 July, in IOP Publishing's Environmental Research Letters, has provided warnings that will chime with those accustomed to more typical British weather. According to the study, winter flooding in the UK is set to get more severe and more frequent under the influence of climate change as a result of a change in the characteristics of atmospheric rivers ...

Mayo Clinic-led study: US physicians, patients' best interests, health care costs

2013-07-24
ROCHESTER, Minn. — A new study of attitudes about health care costs reveals that an overwhelming majority of U.S. physicians feel a responsibility to address costs, but prioritize their obligations to patients' best interests over cost concerns. Results of the random survey of 2,500 U.S. physicians are published in this week's Journal of the American Medical Association (JAMA). "Physicians feel stuck in a difficult position," says lead author Jon Tilburt, M.D., Mayo Clinic's Biomedical Ethics Program and Center for the Science of Health Care Delivery. "Despite their sense ...

Direct nitrogen fixation for low cost energy conversion

2013-07-24
A simple, low-cost and eco-friendly method of creating nitrogen-doped graphene nanoplatelets (NGnPs), which could be used in dye-sensitized solar cells and fuel cells, is published in Scientific Reports today. The work, carried out at Ulsan National Institute of Science and Technology (UNIST) in South Korea, could be a step towards replacing conventional platinum (Pt)-based catalysts for energy conversion. The search for economically viable alternatives to fossil fuels has attracted attention among energy communities because of increasing energy prices and climate change. ...

LAST 30 PRESS RELEASES:

Pink skies

Monkeys are world’s best yodellers - new research

Key differences between visual- and memory-led Alzheimer’s discovered

% weight loss targets in obesity management – is this the wrong objective?

An app can change how you see yourself at work

NYC speed cameras take six months to change driver behavior, effects vary by neighborhood, new study reveals

New research shows that propaganda is on the rise in China

Even the richest Americans face shorter lifespans than their European counterparts, study finds

Novel genes linked to rare childhood diarrhea

New computer model reveals how Bronze Age Scandinavians could have crossed the sea

Novel point-of-care technology delivers accurate HIV results in minutes

Researchers reveal key brain differences to explain why Ritalin helps improve focus in some more than others

Study finds nearly five-fold increase in hospitalizations for common cause of stroke

Study reveals how alcohol abuse damages cognition

Medicinal cannabis is linked to long-term benefits in health-related quality of life

Microplastics detected in cat placentas and fetuses during early pregnancy

Ancient amphibians as big as alligators died in mass mortality event in Triassic Wyoming

Scientists uncover the first clear evidence of air sacs in the fossilized bones of alvarezsaurian dinosaurs: the "hollow bones" which help modern day birds to fly

Alcohol makes male flies sexy

TB patients globally often incur "catastrophic costs" of up to $11,329 USD, despite many countries offering free treatment, with predominant drivers of cost being hospitalization and loss of income

Study links teen girls’ screen time to sleep disruptions and depression

Scientists unveil starfish-inspired wearable tech for heart monitoring

Footprints reveal prehistoric Scottish lagoons were stomping grounds for giant Jurassic dinosaurs

AI effectively predicts dementia risk in American Indian/Alaska Native elders

First guideline on newborn screening for cystic fibrosis calls for changes in practice to improve outcomes

Existing international law can help secure peace and security in outer space, study shows

Pinning down the process of West Nile virus transmission

UTA-backed research tackles health challenges across ages

In pancreatic cancer, a race against time

Targeting FGFR2 may prevent or delay some KRAS-mutated pancreatic cancers

[Press-News.org] Report documents organ transplantation as source of fatal rabies virus case