A recent report from the Centers for Disease Control and Prevention (CDC) underscores a critical public health reality for Idaho: rabies, while rarely infecting humans,  remains an ongoing threat, and awareness of the risk is very important after any exposure to wildlife. 

Any potential exposure to rabies requires prompt medical evaluation because the disease is almost universally fatal once symptoms appear. In addition, a rapid public health response can assist the healthcare provider in determining the risk, and evaluating whether other people or pets may have been exposed.

Idaho’s investigation of the recent event started when the CDC reported a fatal case of rabies in a kidney transplant recipient in Ohio whose donated organ originated from an Idaho resident. Rabies was not suspected in the donor at the time the organ was recovered, and the infection was recognized only after the transplant recipient developed symptoms several weeks later. 

Once the diagnosis was confirmed, health agencies across multiple states initiated a comprehensive public health investigation to understand the source of infection and identify anyone who might have been exposed.

In Idaho, the Department of Health and Welfare (DHW), in partnership with the local public health district, other states, and CDC, conducted the public health investigation related to the donor. The investigation added key information needed by healthcare providers, and included clarifying the rabies exposure history, coordinating laboratory testing, assessing potential risks to others, and ensuring that appropriate recommendations for were made for anyone else who may have come into contact with the virus.

Interviews with the donor’s family provided important details not known during the initial clinical assessment. Several weeks before the donor became ill, he sustained a scratch during an encounter with an aggressive  a skunk on his rural property. 

Skunks are not a rabies reservoir in Idaho. However, bat-associated rabies variants circulate widely in the state, and bats can transmit the virus to other mammals. Laboratory testing by CDC later confirmed that the virus involved in this case was consistent with the silver-haired bat variant. It is likely that an infected bat had previously exposed the skunk to rabies. 

The resulting response, which included hundreds of exposure risk assessments, shows the importance of early public health consultation when evaluating potential rabies exposures. 

The case also reinforces well-established guidelines for Idahoans: 

• Avoid direct contact with bats or other wildlife exhibiting unusual behavior.
• Seek medical attention promptly after any potential exposure.
• Notify your local public health district after animal contact in which rabies exposure may have occurred. 

Rabies remains preventable with timely intervention. DHW will continue to collaborate with partners statewide and nationally to identify risks, conduct investigations, and protect Idaho communities from this rare but serious disease.

For more information from the CDC about rabies: https://www.cdc.gov/rabies/index.html

Dr. Christine Hahn is the Division of Public Health Medical Director and Idaho State Epidemiologist.

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov.