Four people died of rabies after receiving organs or tissue from a single donor infected with the disease. These are the first documented cases of rabies infection via organ donation, according to the Centers for Disease Control and Prevention (CDC). Rabies has been transmitted via infected corneal transplants, although this is rare.

In May, three recipients received organs and a fourth received an artery segment from the same donor. They all developed mysterious neurologic problems and died in June. In early July, tests confirmed that the donor and recipients had all been infected with a type of rabies found in bats.

The organ donor had arrived in a Texas emergency department with mental status changes, fever, and cerebral bleeding. He died 48 hours later. Routine organ donor testing didn't reveal any reasons to restrict donation. Investigation conducted after the four deaths revealed that the donor had reported being bitten by a bat.

Rabies testing isn't part of routine organ donor screening because rabies is rare in humans. However, federal officials are now considering whether to add rabies to the list of screenable diseases for organ donation.

Rabies, which infects nerve tissue, isn't transmitted in blood, and rabies transmission to health care workers has never been documented in the United States. However, the CDC recommends postexposure prophylaxis (PEP) following needle-stick injury because a needle used for injection may become contaminated with infected nerve tissue. The CDC also recommends PEP for anyone exposed to an infected person's saliva, nerve tissue, or cerebrospinal fluid within 14 days before symptom onset and any time afterward. For more information, visit the CDC Web site at http://www.cdc.gov/ncidod/dvrd/rabies/default.htm.