BALTIMORE (WJZ) — Maryland health officials release new information about a rare case. A man dies of rabies he received through an organ transplant.

Mike Hellgren tells us about more people who could be at risk.

Health officials identified hospital workers, friends and family members who were in contact with his saliva–which is how you can contract rabies–and they are being treated. But the case raises questions about screening for these transplants.

Federal and state health officials confirm the man from Maryland who died became infected with rabies through a kidney transplant. The CDC calls it “extremely rare.”

Charlie Alexander’s organization, Living Legacy, facilitates transplants.

“That would trigger a response to all potential recipients of organs related to the very same donor so we can immediately track the well being of those other recipients and treat them,” he said.

Organs of the donor–a 20-year-old Air Force recruit–went not only to Maryland, but also to patients in Florida, Georgia and Illinois.

“All three have started preventive treatment to prevent rabies,” said Katherine Feldman, Md. Dept of Health veterinarian.

The case has raised questions about screening. Donors typically undergo a physical examination, questioning of close contacts and infectious disease testing–but no tests for rabies.

“It is not cost effective to screen for it, and the testing takes so much time that the organ would not be still ready to be used if you had to wait for those results,” said Feldman.

And while this case is rare and disturbing, it’s not the first time it’s happened.

In 2004, four people in Texas died from a single donor’s tissue. Now this latest case could prompt changes.

“I would be very comfortable in saying there will be another look at how we screen, specifically for rabies transmission,” Alexander said. “You’re dealing in the world of rare events. We can be wrong.”

The transplant happened at Walter Reed in Bethesda.

What’s also unusual is the time from the transplant to the death was more than a year. Rabies usually works much faster.

Maryland’s last death from rabies was 36 years ago.