Alaskapox: first human death from recently discovered virus

Health officials downplay risk of human-to-human transmission of disease found in small mammals

Kenai Peninsula
Kenai Peninsula in south central Alaska, where the unnamed man is believed to have contracted the fatal disease
(Image credit: Joe Sohm/Visions of America/Universal Images Group via Getty Images)

An elderly man living in a remote region in southern Alaska has become the first person to die from a recently discovered viral disease known as Alaskapox.

The illness is believed to have been contracted from contact with small mammals, but US health officials have been quick to downplay fears of widespread person-to-person transmission.

What is Alaskapox?

Alaskapox, or AKPV, is a double-stranded DNA virus first discovered in 2015. According to the Alaska Division of Public Health, it belongs to group of viruses called orthopoxviruses, is related to smallpox, cowpox, and monkeypox, and "primarily occurs in small mammals".

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Symptoms include swollen lymph nodes and joint or muscle pain, with patients displaying one or more skin lesions that at first look like a spider or insect bite.

"We are not sure exactly how the virus spreads from animals to people but contact with small mammals and potentially domestic pets who come into contact with small wild mammals could play a role," said the Alaska Health Department.

Although "human-to-human transmission of AKPV has not yet been observed", the department added, "some orthopoxviruses can spread by direct contact with lesions (particularly broken skin contact with lesion secretions)".

What has happened?

Seven diagnoses of Alaskapox have been reported since 2015. Six were in the Fairbanks region, the second-largest population centre in Alaska, and "did not require treatment", with patients suffering only "mild infections", reported Sky News.

The seventh was an elderly man with a weakened immune system who lived alone in a forested area of the Kenai Peninsula, in the south of the state. He was given antibiotics after he spotted a lesion in his armpit in September, but his symptoms worsened. After experiencing fatigue and increased pain in the area and shoulder, the unnamed man was transferred to hospital in Anchorage, where an "extensive battery" of tests were performed, leading to the AKPV diagnosis. Despite initially responding to treatment, he died in late January, following respiratory and kidney failure.

Health officials said where and how he had contracted the virus was "unclear", but Alaska Public Media reported that he had been "feeding and interacting with a stray cat who he said scratched him regularly and hunted small mammals". The cat tested negative for the virus, "but could have carried it on its claws", said the Anchorage Daily News.

The AKPV strain found in the deceased man was "distinct" from that found in the Fairbanks region, which "might indicate the virus is more widespread in Alaska than previously thought" said Alaska Public Media. Health officials are reportedly working with the University of Alaska Museum and the Centers for Disease Control and Prevention (CDC) to test small mammals for AKPV outside the region.

Dr Julia Rogers, a CDC epidemiologist assigned to the Alaska Division of Public Health, said that she expected any AKPV infections to remain rare. And if someone who is not immunocompromised did contract the disease, it was unlikely that they would die, she said.

A bulletin from Alaska's Health Department said AKPV merited "increased statewide awareness" among medics, due to its seemingly widespread transmission in small mammals. The authorities made nine recommendations to those with suspected Alaskapox, including avoiding touching lesions, keeping them dry and covered, and maintaining good hand hygiene.

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