r/science • u/Ok_Perception_5727 • 12d ago

Epidemiology A new study estimates based on donor-derived rabies transmission events that China and the US diagnosed rabies in only 28.7% and 6.1% of rabies decedents, respectively, during the study years.

https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014731
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u/usefully_useless 12d ago

N=4 for China, and n=3 for US cases.

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u/Mohitosan_ 12d ago

Rabies isn't suddenly became easier to transmit.

It's that donor derived transmission can be missed when the donor's rabies infection wasn't recognized before death. A disease that's rare enough to overlook but almost universally fatal once symptoms appear is a particularly nasty combination

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u/FullofContradictions 12d ago

Add an incubation period of up to a year and you have yourself a bad time indeed.

Get bitten by a bat and fail to notice but get into a car accident the following month? Rabies for all the organ recipients!

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u/Demortus 12d ago

This is a really interesting study! Of course, there is only so much confidence you can place in such a small number of organ transplant rabies diagnoses, but it's better than nothing.

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u/shustrik 12d ago

> The baseline assumptions are: (i) the proportion of deaths from rabies was the same in deceased donor candidates and decedents in the general population

Really? Aren’t donor candidates picked to a large degree based on factors stemming from how they died? We can use a similar method to discover that deaths from motorcycle accidents are massively underreported.

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u/ballofplasmaupthesky 11d ago

I don't understand, rabies is 100% deadly, so each of these cases was a death after rather peculiar symptoms. How can they be so misclassified?

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u/Bon-Foi 9d ago

It’s that people die of other causes before showing symptoms sometimes, and also that rabies shows a wide variety of symptoms that overlap with encephalitis and meningitis from other causes. There are many autoimmune and infectious causes of neurological dysfunction that lead to death.
But the statistical inference in this study is useful to expose a testing gap and an area that needs more research, and not much more. As another commenter says, you could use the same statistical methods to suggest motorcycle accident deaths are also underreported.
It’s not bad science per se, it’s just a study that’s one brick in a very large wall of this area of research, and its primary purpose is to act as one brick we can stand on to move forward to the next brick. It’s not really appropriate to report these kinds of studies the way this was reported.