The federal Centers for Disease Control and Prevention says a rabies death in Maryland was caused by an organ transplant.
The agency said Friday that three other people -- in Florida, Georgia and Illinois -- who got organs from the same donor are getting anti-rabies shots.
The donor died in Florida in 2011 after moving there from North Carolina.
The CDC says it's working with public health officials and health care facilities in all five states to identify people who were in close contact with the initial donor or the four organ recipients. The agency says those people might need rabies post-exposure treatment.