• Posted February 14, 2024

Man Dies in First Fatal Case of Alaskapox

Alaska health officials say a man in that state has died after contracting Alaskapox, a rare virus that mostly infects small mammals.

In a statement, the Alaska Section of Epidemiology said the patient was “an elderly man from the Kenai Peninsula with a history of drug-induced immunosuppression" due to cancer treatments.

"This is the first case of severe Alaskapox infection resulting in hospitalization and death," the statement added. "The patient's immunocompromised status likely contributed to illness severity."

Officials aren't sure how the man was infected. "The route of exposure in this case remains unclear, although scratches from [a] stray cat represent a possible source of inoculation," the statement noted.

Just seven human cases of Alaskapox have been reported since 2015, Alaska health officials said.

Until last month, no one had been hospitalized or died of Alaskapox, which typically causes skin lesions, swollen lymph nodes and muscle or joint pain, health officials added.

Of the seven people who have had Alaskapox, six lived in the Fairbanks North Star Borough, where red-backed voles and shrews have been found to have the virus, health officials noted. 

Julia Rogers, an epidemiologist with the U.S. Centers for Disease Control and Prevention, told the New York Times that symptoms of Alaskapox infection tend to be mild.

“There could have been cases in the past that we just did not pick up because of that,” she said, adding that case counts could climb as more doctors learn how to spot it.

When the Alaskan man sought medical help last September after noticing a red bump near his right armpit, he told doctors he had been caring for a stray cat that often scratched him, including once near that spot, health officials said. The stray was tested for other orthopox viruses, and all tests came back negative. Still, health officials said it might have been the source.

Dr. Joe McLaughlin, chief of the Alaska Section of Epidemiology, told The Times that all patients who have had Alaskapox have had a cat or a dog, and that health officials are working to determine whether domestic pets are fueling spread of the virus.

“Because Alaskapox is rare, our No. 1 message is that Alaskans shouldn't be overly concerned about this virus, but more be aware of it,” McLaughlin said.

After the man noticed his lesion, he went to his primary care doctor and the local emergency room several times, according to health officials. He was prescribed several rounds of antibiotics. None helped.

He was hospitalized in November because he could not move his arm. After being transferred to an Anchorage hospital, the man said he was experiencing a “burning pain,” and four smallpox-like lesions were discovered across his body, health officials said.

Following testing, cowpox, mpox and other viruses were ruled out. A swab of the man's lesion was then sent to the U.S. Centers for Disease Control and Prevention, which found it was consistent with other cases of Alaskapox.

While the man was hospitalized, health officials said, he began to experience wounds that took a long time to heal, malnutrition, acute kidney failure and respiratory failure. He died in late January.

More information

The state of Alaska has more on Alaskapox.

SOURCE: State of Alaska Epidemiology Health Bulletin, Feb. 9, 2024; New York Times, Feb. 13, 2024