The Centers for Disease Control and Prevention and Maryland Department of Health and Mental Hygiene said the patient was one of four people who had received an organ from the same donor.
In early March, the Maryland Department of Health and Mental Hygiene initiated an investigation that revealed the organ recipient had no reported animal exposures, the usual source of rabies transmission to humans, but identified the possibility of transplant-related transmission of rabies.
The organ transplant occurred more than a year before the recipient developed symptoms and died of rabies -- a time period much longer than the typical rabies incubation period of one to three months, but is consistent with prior case reports of long incubation periods, officials said.
In 2011, the donor became ill and was admitted to a healthcare facility in Florida and then died. At that time, the donor's organs, including the kidneys, heart and liver were recovered and sent to recipients in Florida, Georgia, Illinois and Maryland. At the time, rabies was not suspected as the cause of death and testing for rabies was not performed.
CDC's preliminary laboratory analysis indicated the recipient and the donor both had the same type of rabies virus raccoon-type. This type of rabies virus can infect not only raccoons, but also other wild and domestic animals, officials said.