Alaskapox, a novel orthopox virus, has claimed its first fatal victim in Alaska, raising concerns about the potential for widespread infection in small mammals. The Alaska Department of Health reported the case, which involved an elderly man with an underlying health condition living on the Kenai Peninsula. This marks the seventh known case of Alaskapox in the state, but the first outside of the Fairbanks area.
The man, who was undergoing cancer treatment, first noticed a red, tender papule in his right armpit in September 2023. Over the next six weeks, he sought medical care as the lesion worsened. In November, he was hospitalized for cellulitis that affected his arm’s movement. As his symptoms progressed and clinicians discovered four other lesions on his body, lab tests initially indicated cowpox. However, further testing at the state health lab confirmed the presence of a generic orthopox virus.
Samples sent to the US Centers for Disease Control and Prevention (CDC) revealed that the virus was consistent with Alaskapox. However, genetic sequencing suggested that it was distinct from earlier cases reported in Fairbanks. The man received treatment with tecovirimat (Tpoxx), intravenous vaccinia immunoglobulin, and oral brincidofovir, which initially improved his arm symptoms. Unfortunately, his condition deteriorated during his time in a long-term care facility, leading to delayed wound healing, kidney failure, and respiratory failure. He passed away at the end of January.
Investigators discovered that the man had no recent travel history or contact with infected individuals. However, he had been caring for a stray cat at his home that frequently hunted small animals. The cat had scratched him multiple times, including a notable scratch in his right armpit just before his symptoms began. Although blood and mucosal samples from the cat tested negative for orthopox antibodies at the CDC, it is believed that the scratches from the cat may have been the source of the infection.
Health officials noted that the man’s immunocompromised status likely contributed to the severity of his illness. They also emphasized that the detection of Alaskapox outside of the state’s interior suggests a wider prevalence of the virus in small mammals than previously known. This finding highlights the importance of raising awareness among clinicians and conducting further testing on small mammals outside of Alaska’s interior region to better understand the extent of the infection.
The case of Alaskapox in Alaska serves as a reminder of the ongoing threat posed by emerging infectious diseases. As scientists and health officials continue to monitor and study these viruses, it is crucial for individuals to take necessary precautions, especially those with underlying health conditions or weakened immune systems. By staying informed and practicing good hygiene, we can help prevent the spread of such diseases and protect ourselves and our communities.
