Alaskapox Death Means Virus ‘More Geographically Widespread’ Than Thought

A man dying from the newly discovered Alaskapox indicates that the viral disease could be “more geographically widespread” than previously thought, according to the Alaska Section of Epidemiology.

His passing marks the first-ever death from the disease, and the first case outside of the region it was first found.

The man, who was from Alaska’s Kenai Peninsula southwest of Anchorage, is the seventh ever discovered case of the disease, according to an Alaska Section of Epidemiology bulletin released on Friday.

Before this death, the six other previous Alaskapox cases resulted in only mild illness and treatable symptoms, all of which occurred in the Fairbanks North Star Borough (FNSB).

“This is the first case of severe Alaskapox [AKPV] infection resulting in hospitalization and death,” the health department said in the statement, and is “the first case of Alaskapox identified outside of the Interior region.”

This “indicates that AKPV appears to be more geographically widespread in Alaska’s small mammals than previously known and warrants increased statewide awareness among clinicians,” the department said.

The disease was first discovered in 2015 in a woman from Fairbanks, Alaska, who was infected with a virus that doctors had never seen before. It was classified as a new form of orthopox virus, and formally named Alaskapox after its genome was fully sequenced in 2019. Other orthopoxes include smallpox, cowpox, and monkeypox (mpox).

The virus is thought to be transmitted from animals to humans, making it zoonotic, as it has been detected in other small mammals nearby, including red-backed voles and shrews, according to the Alaska Department of Health.

However, it also states that it is likely to be more widespread in small mammals across Alaksa and that some cases in humans may have gone undiagnosed.

Exactly how the virus may be passed from animals to humans remains unknown. No human-to-human transmission of the disease has yet been detected, the ADH states, with previous cases likely having been caught from animals.

“We are not sure exactly how the virus spreads from animals to people but contact with small mammals and potentially domestic pets could play a role,” Julia Rogers, an epidemiologist with the Centers for Disease Control and Prevention, who is assigned to the Alaska Department of Health, previously told Newsweek.

Symptoms of infection include skin lesions similar to that of an insect or spider bite, as well as swollen lymph nodes and joint or muscle pain.

The man who died from the virus had a raised spot on his armpit, according to the Alaska Department of Health. He had drug-induced immunosuppression after a course of cancer treatment, and went to the doctor for the raised lump in September 2023. The lesion was found to not be cancerous or due to a bacterial infection, yet the man began to experience pain in the armpit and right shoulder, as well as fatigue.

He was hospitalized in November 2023 with severe pain in the area, and the lesion continued to worsen. More tests were performed, with cowpox initially being suspected, but the CDC later concluded that he was infected with Alaskapox. Despite treatment for the virus, the man died at the end of January after facing delayed wound healing, malnutrition, kidney failure and respiratory failure.

“The patient’s immunocompromised status likely contributed to illness severity. Moreover, being the first case of Alaskapox identified outside of the Interior region, it indicates that AKPV appears to be more geographically widespread in Alaska’s small mammals than previously known and warrants increased statewide awareness among clinicians,” the health department said in the statement.

The man may have been infected by a stray cat that he was looking after, which hunted small mammals and “frequently scratched the patient, including one notable scratch near his right axilla in the month prior to rash onset,” according to the statement.

“The route of exposure in this case remains unclear, although scratches from the stray cat represent a possible source of inoculation through fomite transmission. SOE is working with the University of Alaska Museum and CDC to test small mammals for AKPV outside of the Interior region,” the department said.

While the virus’s transmission method remains unknown, other orthopoxes can be spread via contact with the skin lesions that they cause.

“[The] potential for person-to-person transmission cannot be excluded based on other orthopoxviruses (e.g., mpox), and future case investigations will continue to assess whether transmission may have occurred,” Rodgers said. “People with skin lesions potentially caused by Alaskapox [are advised] to keep the affected area covered with a bandage.”

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