letter to the editor: rabies after corneal transplantation: existed evidence

dear editor:   sir, rabies is an important neurological infection. it is deadly and it is not possible to treat it. despite the attempt for rabies control via animal control and rabies vaccination, there are many reported cases of rabies in each year. basically, the transmission of rabies is due to animal bite. recently, the new mode of rabies transmission, human to human, via transplantation is confirmed. the consideration on corneal transplantation should be mentioned.1,2 from simple literature searching, there are at least 8 reports from several countries, both tropical and non-tropical ones, on rabies after corneal transplantation.3-10 usually, the rabies develops within a few days after transplantation.3-10 all reports had no history of rabies signs and symptoms in infective donor. of interest, some reports also mentioned for an infective donor that provides infective cornea and other organs causing rabies to many new rabid recipients.3 although the rabies transmission due to corneal transplant has been continuously reported since 1970’s, the new reports in the past two years can still be seen. since corneal transplantation is widely practice and the risk of rabies is existed. it is questionable that the donor screening for rabies before transplantation is required or not.     viroj wiwanitkit, md   bangkok, thailand   [email protected]       references     1. razonable rr . rare, unusual, and less common virus infections after organ transplantation. curr opin organ transplant 201116(6):580-7.   2. o'day dm. diseases potentially transmitted through corneal transplantation. ophthalmology 198996(8):1133-7.   3. maier t, schwarting a, mauer d, et al. management and outcomes after multiple corneal and solid organ transplantations from a donor infected with rabies virus. clin infect dis 201050(8):1112-9.   4. javadi ma, fayaz a, mirdehghan sa, ainollahi b. transmission of rabies by corneal graft. cornea 199615(4):431-3.   5. gode gr, bhide nk. two rabies deaths after corneal grafts from one donor. lancet 19882(8614):791.   6. anderson lj, williams lp jr, layde jb, et al. nosocomial rabies: investigation of contacts of human rabies cases associated with a corneal transplant. am j public health 198474(4):370-2.   7. hogan rn, cavanagh hd. transplantation of corneal tissue from donors with diseases of the central nervous system. cornea 199514(6):547-53.   8. houff sa, burton rc, wilson rw, et al. human-to-human transmission of rabies virus by corneal transplant. n engl j med 1979300(11):603-4.   9. supanvanich s. human-to-human transmission of rabies by a corneal transplant. bull dept med serv 19783:120-4. centers for disease control (cdc). human-to-human transmission of rabies via corneal transplant--thailand. mmwr morb mortal wkly rep 198130(37):473-4.