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Intratracheal Inoculation of Fischer 344 Rats with Francisella tularensis
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Francisella tularensis Transmission by Solid Organ Transplantation, 20171

Christina A Nelson, Christian Murua, Jefferson M Jones

    Emerging Infectious Diseases
    |February 8, 2019
    PubMed

    Insights

    A donor transmitted tularemia (Francisella tularensis) through organ donation, leading to sepsis and death in one recipient. This highlights the risk of infectious disease transmission via organ transplantation.

    Area of Science:

    • Infectious Diseases
    • Transplant Surgery
    • Microbiology

    Background:

    • Tularemia is a bacterial disease caused by Francisella tularensis.
    • Organ transplantation carries a risk of transmitting infectious agents.
    • Rare cases of tularemia transmission through organ donation have been reported.

    Observation:

    • Three solid organ recipients (1 heart, 2 kidneys) from a single donor developed fever and sepsis.
    • One kidney recipient died; tularemia was diagnosed retrospectively.
    • Francisella tularensis subsp. tularensis was identified in the donor and recipients.

    Findings:

    • Whole-genome sequencing confirmed identical strains in the donor and recipients.
    • The donor had a history of pneumonia and multiorgan failure.
    • Infected lagomorphs near the donor's residence suggest a potential environmental source.

    Implications:

    • This case documents Francisella tularensis transmission via solid organ transplantation.
    • It underscores the importance of donor screening for infectious diseases.
    • Enhanced vigilance is needed to prevent transfusion-transmitted tularemia.
    Keywords:
    Francisella tularensisTularemiaUnited Statesbacteriabiological warfarebioterrorism and preparednesslaboratory infectionprevention and controltissue donorstransplanttransplantation

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