Alaskapox: First known death from the virus

Alaskapox is an orthopoxvirus related to smallpox, cowpox and mpox (initially known as "monkeypox"). Infections have so far only occurred in the US state of Alaska.

There have only been seven recorded cases in humans since the first one was reported in 2015.

Patients infected with Alaskapox report one or more skin lesions similar to spider or insect bites. Other symptoms include swollen lymph nodes and joint or muscle pain that usually clears up in a few weeks.  

Before the patient who died in January, all other cases of Alaskapox were mild and did not require hospitalization. 

How is the virus transmitted?

Researchers believe the virus could be zoonotic, meaning it can transfer from animals to humans.

Alaska health authorities reported that Alaskapox cases were prevalent in 2020 and 2021 in two species of small mammals ― red-backed voles and shrews  ― in the Fairbanks North Star Borough, where most of the human cases were identified.

How exactly the virus made the jump from animal to human is still unclear. Patients could have received the virus from pets that came in contact with infected voles or shrews ― that's what may have happened in the case of the patient who died.

While direct human-to-human has not been observed, experts warn other orthopoxviruses can spread by direct contact with skin lesions and advise people with skin lesions potentially caused by Alaskapox to keep the affected area covered with a bandage.

What do we know about the Alaskapox death?

The only person known to have died from the virus so far was a man from Alaska. Health officials described the man as "elderly" but didn't give an exact age.

He lived on the remote Kenai Peninsula that juts into the Gulf of Alaska off the state's southern coast. The peninsula is more than 483 kilometers (300 miles) from Alaska's Fairbanks area, where the six other cases occurred.

Health officials said this likely indicates the virus has spread to animals outside the Fairbanks area.

The man was taking immunosuppressant drugs as part of his cancer treatment ― "the patient's immunocompromised status likely contributed to illness severity," Alaska's Department of Health stated in a bulletin on the case.

In September 2023, the man discovered a red papule in his right armpit. In November, he was hospitalized with fatigue, pain and reduced mobility in his right arm. Doctors discovered four other lesions across his body.

Tests revealed he had Alaskapox, and "he later exhibited delayed wound healing, malnutrition, acute renal failure, and respiratory failure," according to the Alaska Department of Health.

The patient died in January 2024.

The man had lived alone and hadn't traveled before he became infected. Reports suggest he had been caring for a stray cat that regularly hunted small mammals and would scratch him frequently.

It is possible that the cat had come in contact with an infected vole or other small mammal and then transmitted Alaskapox to the man. 

What should you do if you think you have Alaskapox?

See a doctor if you think you may have contracted the virus.

Avoid touching any lesions on your body and cover them with a bandage to avoid possible transmission. 

The Alaska Department of Health recommends that people who might have Alaskapox "practice good hand hygiene, avoid sharing cloth that might have been in contact with lesions, and launder clothing and linens separately from other household items."

Edited by: Fred Schwaller