Md. organ recipient dies, had W. Nile

Authorities tracking donated blood for possible source of virus

October 03, 2002|By Erika Niedowski | Erika Niedowski,SUN STAFF

A St. Mary's County woman who died Tuesday, nearly a month after undergoing a kidney transplant at Johns Hopkins Hospital, had tested positive for West Nile virus, and health officials are trying to find out whether she contracted the virus from donated blood.

State health officials said yesterday that they are confident the woman, who was 55, did not get West Nile from the organ donor, a sibling, who was found not to be carrying the virus.

"As far as I'm concerned, the donor is clear from all the testing we've done," said state Health Secretary Georges C. Benjamin.

But the kidney recipient, whose name was not released, received blood or blood products, including plasma and red blood cells, from as many as 35 donors, health officials said. The U.S. Centers for Disease Control and Prevention is working with the state Department of Health and Mental Hygiene and the American Red Cross to identify the blood donors and determine whether the virus was present in any of the donated blood.

"We're going to be testing the samples from the blood donated that the person received," CDC spokeswoman Bernadette Burden said yesterday.

Though West Nile virus is usually transmitted to humans through infected mosquitoes, federal health officials recently found that it can also be transmitted through organ donation and blood transfusion. One infected person died after contracting the virus from an organ transplant.

Donated blood is routinely screened for HIV, the virus that causes AIDS, as well as for hepatitis B and C. But there is currently no ready test to screen all donated blood for West Nile virus.

Dr. David Blythe, acting state epidemiologist, said the Red Cross began pulling any remaining samples of the donated blood in question even before the woman's case of West Nile virus had been confirmed to make sure that no other patients received it.

Those samples will be tested. In cases where all of a donor's blood has already been distributed, the donor will be contacted by the Red Cross to provide another sample for analysis, Blythe said.

"It's a complex process coordinating all this," he said.

Blythe could not confirm that all of the donated blood in question had been taken out of circulation. A Red Cross spokeswoman could not be reached.

Last month, federal health officials said they were almost certain that West Nile virus could be spread through a blood transfusion after finding that a Mississippi woman had contracted the disease after transfusions from three infected donors.

The CDC previously reported that four people who had received organs from a single donor in Georgia became infected; one died.

Test not available

Officials said all blood donations would probably be screened for the virus as soon as a test could be developed, but that could take several months.

Most people infected with West Nile virus have no symptoms. Those who do become sick usually experience fever, headache, a skin rash and swollen lymph glands. Less than 1 percent of people exposed to the virus develop more severe symptoms, such as coma and paralysis.

Twelve confirmed or likely human cases of West Nile virus have been reported in Maryland this year - twice the number reported last year. Four individuals have died - one more than last year - though the virus has not been confirmed as the cause of death in any of this year's cases.

Nationwide, there have been more than 2,500 human cases and 125 deaths, according to the CDC Web site.

The St. Mary's County woman underwent a kidney transplant at Hopkins on Sept. 6. She was discharged from the hospital Sept. 14 but readmitted two days later. It is unclear why she was readmitted or whether she was showing symptoms of West Nile virus at the time.

Or a mosquito bite

Although health officials will comb the donated blood supply for the virus, they said the woman could have contracted West Nile the more common way: through a mosquito bite. Undergoing a major operation would have left the woman's immune system weakened, Benjamin said, making her more susceptible to infection.

"If she was bitten by a mosquito anywhere along this process, she would have been at a greater risk of having West Nile virus infection," he said.

No human West Nile cases have been reported in St. Mary's County, though three birds recently tested positive for the virus, said Mary H. Novotny, public information officer for the health department there.

Joann Rodgers, a spokeswoman for Hopkins, called the hospital's blood supply "very safe" and said the risk of healthy individuals contracting West Nile virus from donated blood is "very, very tiny."

"That doesn't mean that we don't want to make it even smaller, but we have to wait for the test to become available and for the science to catch up with that," she said. "People should not overstate the risk. ... Generally, the risk is only there in very, very sick patients and immuno-suppressed patients."

Baltimore Health Commissioner Peter L. Beilenson called the woman's death "tragic" but stressed the continued need for organ and blood donations.

"We don't want this to discourage organ donors or blood donors because there's always a huge need for both in the state," he said. "Obviously, there's no risk [of infection] whatsoever in donating an organ."

Sun staff writer Jonathan Bor contributed to this article.

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