CDC Cuts Unlock a New Fear: Transplant Rabies.

Not content with simply bringing back the milk mustache, RFK Jr. is ushering in the return of the lush, milky goatee of rabies that was far more commonplace in the halcyon days of his youth -when rabies was gloriously unencumbered by the vaccination of humans and pets.

Quick facts about rabies:

1. Rabies is ~100% fatal in both humans and dogs once it becomes symptomatic.

2. Rabies vaccines are ~100% effective when given to pets prophylactically, or to humans in a timely manner after exposure.

3. Rabies is a horrifying death. There are no treatments that do anything other than prolong the agony of fearing water while your brain dumps all meaningful functions. Feel free to watch, if you dare.

Rabies testing is now on hold at the CDC, as of 4/6/26.

Why? For undisclosed reasons… striking given that HHS has a whole page claiming that they are “radically transparent.” Spokesperson Andrew Nixon states that this is “a routine review,” but truthfully, we review things in medical settings all the time without a complete shutdown of services.

This service interruption is primarily due to severe cuts in scientific manpower, but no one in power can live up to their promise for transparency. While there has been a ~25% reduction in total staff across the board, some specialized areas of the CDC have 0-1 scientists left to do the jobs of many. Context is like a lobotomy: way less than 10% of your brain gets cut, but you feel 99% different afterwards!

Can’t we just have Marco Rubio do rabies testing?

No. While he is the de facto guy in the Trump administration to take on the duties of government jobs that have been vacated, he’s kind of busy being Secretary of State, the Acting Administrator of USAID (now shuttered), and interim National Security Advisor but critically -he long ago admitted that he’s “not a scientist.” Picking around through blood and tissue for viruses may have overlap with national security, but it’s definitely a science thing.

Ironically, large labs in New York and California can cover some of the CDC’s routine testing capacity -the very states under attack by the Trump administration for having the audacity to contribute to biology and medicine. It turns out that waging an ideological war of anti-intellectualism upon your own citizens leads to very unexpected outcomes. The secondary bastions of biomedical expertise concentrated in politically “hostile” areas are now the nation’s primary resources for solving diagnostic dilemmas that affect everyone regardless of political affiliation.

The CDC’s role in rabies testing is primarily consultative and specialized rather than routine -it handles difficult and exotic cases (which is important when you are a patient with a difficult and exotic problem). But one service in particular is only provided by the CDC, and thus not duplicatable by blue-state-scientists Stephen Miller thinks are lovingly sucking the toes of Gavin Newsom:

Rabies testing on potential organ transplants.

Wait, what? What does rabies have to do with grandma’s new kidney and little Billy-Ray Cletus’s corneal transplants? They don’t even have their pet raccoon anymore!

Sorry, it doesn’t matter if you -the recipient of organs, were exposed to rabies (at least, not in this context). What matters is if any adorably feral critters sank their chompers into the donor of your organs.

Sit right back and relax as I ease you into this month’s unsettling installment of American Horror Story: the Reality Show.

The CDC is the only laboratory that performs testing for suspected atypical rabies cases in potential, still-living organ donors. There is a unique battery of tests to be done on the saliva, skin biopsies, serum, and spinal fluid of those near death who have generously donated their precious organs to others. But why do they ever need to do this?

Let’s back up a bit. If we exclude kidneys, a rare partial liver, and stool (which isn’t even an organ, but can be transplanted), you have to be brain-dead to relinquish your organs. Motorcyclists who eschew helmets are the apex heroes of the transplant world! Compared to those who die of natural causes, they are young and healthy, and as such: resilient enough that their organs remain intact after their brain acts as a squishy airbag to cushion their high-speed deceleration into a wall or the edge of a tractor trailer bed.

But Hell’s Angels aren’t the only source of organs. A lot of other people find their way to brain death by far less spectacular mechanisms. Sometimes folks undergo a gradual yet steady loss of brain function that culminates in brain death. These are the donors that are directly impacted by the CDC’s testing freeze. Now… I know what you’re thinking:

“that sounds ideal for organ transplants, because there is no component of violent impact that might lacerate livers, puncture lungs, and rupture hearts!”

It certainly seems that way at first, but you have to pause and wonder:

Why is this person’s brain committing suicide without their consent or due to obviously poor choices?

That is the million dollar question, because if you fail to ask it as the transplant doctor, you’ll be out a lot more than a million bucks, because lawsuits and funerals are prohibitively expensive.

The early-brain-retirement scenario I described is not a Snow White story of eternal slumber for the betterment of those who need organs. It’s called acute progressive encephalitis of unknown etiology -which is way less poetic in my opinion, but I only load the trucks around here. This clinical picture rarely inspires anyone to consider rabies (because as you can see in the chart below, its a ridiculously long list of possibilities to explore), and even when rabies is considered, it can’t be specifically investigated without the specialized laboratory support provided by the CDC.

When brains die -organs long to follow their departed master, so the decision to harvest or discard them is exquisitely time-sensitive. Just because the patient is on life support, it doesn’t mean that there is an unlimited amount of time to definitively exclude every possible manner of horror. These decisions require rapid, focused, definitive diagnostic confirmation that state laboratories are not be equipped to provide -so while the CDC is closed for “routine maintenance,” the posthumous wishes of potential donors may fail to manifest, as any suspicion of rabies coupled with zero capacity to test for it will lead to dumping their whole body in the trash. This harsh decision is in the interest of preventing a bad rabies outcome for one person, from becoming a bad outcome for over 80 recipients, because that’s where we are with modern organ and tissue donation.

Graphics from Sentinel Diagnostics and Michigan Gift of Life, respectively. Billy Mays needs no introduction.

A single donor can affect many more people than just the comparatively small number of organs that they have locked away in the treasure chest of their thorax and abdomen. But in the absence of specialized investigation, “affecting more people” can be good or bad.

Well… like what?

Late in 2024, a gentleman from Idaho experienced brain death via encephalopathy of unknown origin, and had very generously arranged to donate his organs to those in need. It turned out that 4 people were in need: 1 kidney, and 3 corneas (individual corneas can be divided amongst multiple recipients. As far as I can tell, the donor did not have 3 eyes). Initial screening indicated that he was a suitable donor.

51 days after receiving their kidney transplant, the recipient died in his Ohio community hospital.

About 5 weeks after gaining freedom from dialysis, he experienced tremors, lower extremity weakness, confusion, and urinary incontinence. He was hospitalized a week later with fever, hydrophobia, dysphagia, and autonomic instability -all classic signs of rabies. Two days later, he required a breathing tube and a ventilator. Specimens were collected by the Ohio Department of Health and sent to the CDC for analysis, and he died the day before the diagnosis of rabies was confirmed.

Grim.

Subsequent interviews by the CDC determined that 6 weeks before he died, the donor was scratched by a skunk while holding a kitten. The skunk’s aggression was initially attributed to being directed at the kitten, rather than as a result of the disinhibition of rabies, which was an unfortunate mistake.

Wait… the CDC wasn’t closed for rabies testing when that happened! A fat lot of good they did!

This is a fallacious, yet painfully overused argument to sway a scientifically unsophisticated public to favor abandoning the very services that protect them from harm. Falling short of perfection doesn’t make a process useless:

• Parachutes don’t prevent all skydiving injuries.

• Bullet-proof vests don’t make firefights into harmless recreational games for children.

• Seatbelts and infant car seats don’t prevent all fatalities in car accidents, even when they function perfectly.

Similarly, the CDC’s specialized expertise in interpreting complex and unusual cases of rabies in potential organ donors provides an imperfect layer of additional safety to getting a transplant. Importantly, loss of that service will make transplantation more dangerous for recipients, even though it won’t change anyone else’s day-to-day lives outside of the medical teams who remain forever haunted by the gruesome outcome.

Had the donor’s decline been more obviously related to rabies at the time, the testing done on the recipients could have been done on the donor, and saved several people. It is however impractical to do this on every donor, because most motorcyclists aren’t at risk of infection (the risk is rare overall because of mass pet vaccination), and the time it takes to conduct all of the tests would invariably lead to loss of some organs while waiting for results.

I didn’t get to the worst part of the story yet. Stop interrupting me with bad faith arguments, internal dissenter.

The incident review states:

“In addition to receiving post-exposure prophylactic vaccination, all three cornea graft recipients underwent precautionary graft removal. The relative ease of cornea removal, compared with life-sustaining organs or other tissue types, could also influence clinical decision-making.”

Sounds pretty straightforward. No biggie, just take those glossy instruments of vision right off like a dirty pair of socks. But let’s put ourselves in the patient’s shoes.

You had bad vision leading up to your cornea transplant, and now you have great vision! So cool! Then you get a phone call from the ophthalmologist:

“Hey, Ms. Smith, this is Dr. Glacomafricken from Saint Epstein’s Hospital. Aahh… we need to take the fronts of your eyes off… like… today. You mind coming in? You’ll just leave completely blind until we can find an… um… less infected cornea for you.”

Holy fucking shit! How does one prepare for this? Do you:

• Find a trusted proxy for your vision?

• Speed-learn braille?

• Buy and install a bidet because you won’t be able to visually inspect your toilet paper to know when you’re done wiping?

The list of things to do is long, but your new corneas are now a ticking time bomb for brain death, so indecision and denial will be penalized with profound finality.

The corneas aren’t far from the optic nerves, which connect directly to the brain that rabies so loves to destroy. The poor circulation of this corneal tissue makes it slower to unload its payload of death, and in fact all three recipients survived without being infected. Yay!

But what were they left with in the meantime?

Removal of the corneas reduces the risk of delayed rabies infection, but what do you replace it with? I assure you that they do NOT save your old corneas that didn’t work to begin with, and it’s important to note that there are no artificial substitutions.

In addition to providing sight, the cornea is integral to the structure of the eyeball itself, so you can’t simply leave them off once removed, or the gelatinous fluid will leak out, making your eyes unrecoverable organs even if a suitable transplant substrate is found later. Eyes are like the avocado’s of the face: once you open them, they go bad fast!

If you’re super lucky, there might be a compatible donor who excused themselves from life at the exact moment you needed a surprise second corneal transplant. Cool. Take that option. The other one sucks.

For the rest of us non-leprechauns, we need a temporary measure to seal up our eyeballs until such time that a new donor is found. Those options are silicone (the Eckardt Keratoprosthesis) or a Gore-Tex patch. While each provides exceptional structural support to the compromised eye, the fact that they don’t make eyeglasses or contact lenses out of either material should clue you in that you are now going to have something in common with Daredevil, the blind superhero -and is not super powers. Zoom in on the right image at your own risk.

Imagine hoping someone dies soon so that you can see again.

To whom do we owe these pleasures?

While RFK Jr. has not been identified as the source of this particular reduction in service, it is consistent with his open disbelief in the germ theory of disease, and quite frankly… he is in charge of the CDC, so he either did it, or allowed it to happen. Regardless: he said he was going to do this anyway, long before he even gave up his failed presidential bid.

Less rabies testing capacity will yield more rabies infections. It’s a simple fact, and the man without fear of reality simply does not care about how this may impact Americans who want less rabies in their organs. He doesn’t even believe it’s a risk to those who eat meat and engage in the occasional denim-clad cold-plunge.

But there is a dark, comical, tragic irony at play here.

Kennedy is obsessed with a number of crazy things, chief among them:

• A false belief that root causes of disease are inadequately investigated by scientists and physicians (even though that’s a big part of what physicians do, and it may be all that certain scientists do), and

• A delusion (shared by Casey Means) that he sees mitochondrial dysfunction in any child he thinks “doesn’t look like they’re supposed to.” In case you don’t know this, the diagnosis of mitochondrial disease is a little more involved than gawking at kids in public.

Here’s the funny part:

• Kennedy doesn’t believe in germs, and rabies is most certainly a germ.

• Kennedy does believe in mitochondrial dysfunction, even though he doesn’t know what it is, or how you can acquire it.

Do you know how rabies kills you? It doesn’t melt your brain the way you might think it does if you had the emotional fortitude to watch the videos I linked of people dying of it at the beginning of this essay.

Rabies infects nerve tissue, and makes it stop working without destroying it grossly. People with rabies have barely abnormal scans of their brain and spinal cord, despite having floridly abnormal neurological function.

When rabies viruses infect neurons, they preferentially destroy the mitochondrial within. All of the symptoms that spring forth are related to non-functioning neurons that do not experience gross anatomical changes, but cannot perform in the absence of a single functioning powerhouse of the cell.

Thus, in denial of infectious disease in general, and in pausing rabies diagnostics, Kennedy is nurturing the spread of a known root cause of mitochondrial dysfunction in Americans. And he’s likely quite proud of it.

So where do we go from here?

Republicans should be asking themselves:

“do only liberals get bitten by dogs, skunks and bats? Do only socialists get organ transplants?”

To be fair, organ donation is socialist to its core: giving things of great value freely to those most in need.

As our national institutions are failing under the pressure of ham-handed cuts and populist fuckery, the White House is demanding even deeper cuts to them in fiscal year 2026, assuring that they will fail completely.

Fighting fire with fire in this context is like… fighting a rabies infection by fighting a surfeit of even more rabid skunks: everything is going to become worse in the most predictably ridiculous ways possible. Humorous in the context of Florida-man imagery, but really quite depressing in terms of national health and sanity.

The average right-leaning, religious, non-scientifically-inclined American is quick to dismiss the value of the CDC, since it often works on things that (they think) don’t affect them:

• Syphilis tracking? What care have I for fornicators?

• HIV/AIDS? The gays shouldn’t have gone against God. -Leviticus 18:22

• E-bola? An African problem demands African efforts. Why are my tax dollars used here?

• Hantavirus? A Native American disease. They are a sovereign nation, why can’t they make their own CDC? Assuming we don’t opt to deport them back across the Bering Straight first.

There is no end to the mental gymnastics that people who have been duped into believing that the parts of government that exist to serve and protect them are conspiring to harm them -all because they had to wear a mask at Applebee’s for a year or two. All of these diseases can, and very much have affected white, God-fearing, right-leaning, non-scientifically-inclined Americans. I have personally cared for them suffering from 3 out of 4 of these maladies several times in my very red corner of the country.

Unrealistic skepticism of expertise has long been a quirk of American culture, but it was never intended to be a guiding principle of American policymaking -the way it is now, under Donald Trump. We are witnessing the wholesale destruction of American excellence in science, medicine, agriculture, energy, and even fiscal policy, because a once whimsical belief that any ordinary untrained man can do the extraordinary; and do so better than some over-educated elitist nerd with decades of education and experience in exactly that field. That subtle peculiarity has been co-opted by the MAGA and MAHA movements, to tear down the foundations of everything that has made America either great or healthy over the last century.

While rabies is still rare for now, it may not be in the future.

While it is still relatively safe to get an organ transplant now, it may not be in the future.

Loss of rabies testing -even if it’s only temporary, is just a single small tile in a vast mosaic of impending disaster from calculated, politicized, mass-denial of reality. While it almost certainly doesn’t affect you today, it very well may come knocking at your door in the near future. And if it’s rabies, it’s probably too late.