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First Death in Alaska Linked to Unknown Orthopoxvirus, Alaskapox

A previously unknown orthopoxvirus, dubbed Alaskapox, has claimed its first life on Alaska’s Kenai Peninsula, according to information released by the state authorities on February 9. An elderly resident reportedly contracted the disease in September 2023, following an encounter with an infected stray feline that delivered a scratch. The individual, undergoing cancer treatments at the time, developed an unusual red lesion under his arm, coupled with extreme fatigue and arm discomfort.

As the weeks rolled on, his condition deteriorated, eventually resulting in a hospital admission due to cellulitis — a bacterial skin infection — on November 17. Following his transfer to an Anchorage hospital, an extensive examination process revealed the true cause of his discomfort and increasingly serious illness. Despite rigorous treatment, his health continued to deteriorate, leading to malnutrition, kidney failure, and ultimately, respiratory failure. His demise came in January 2024, as indicated in the official report.

Described as the first fatal and severe case of Alaskapox, the incident has raised concerns about this relatively unexplored virus. Alaskapox categorizes with orthopox viruses but presents less intense symptoms than relatives such as monkeypox and the infamous smallpox. It is a zoonotic pathogen, meaning it can transfer between animals and people. Small mammals like voles are the primary carriers of Alaskapox.

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Since its first confirmed human host in Fairbanks in 2015, Alaskapox has only manifested in a total of seven individuals, including the man on Kenai Peninsula. Each infection has been traced back to people residing in woodland areas, with pets that had encounters with small mammal species. However, the cases reported have not shown any indication of human-to-human transmission.

Those affected by Alaskapox typically encounter skin sores, joint or muscle discomfort, and swollen lymph nodes. However, according to the Alaska Department of Public Health (ADPH), the infection usually leads to mild conditions and doesn’t pose the same threats as more notorious relatives in the orthopox virus family. The key concern is for immunosuppressed individuals, like the Kenai man, whose bodies may struggle to fight the infection effectively.

Although Alaskapox is related to the orthopox virus family, its threat level to public health significantly diminishes in comparison to deadly viruses such as smallpox, states Dr. Aaron Glatt, an expert in infectious diseases at Mt. Sinai South Nassau Hospital in New York. According to him, the disease is closer in nature and effects to monkeypox rather than smallpox. Public awareness, rather than panic, should be the current approach in dealing with this developing issue.

While there haven’t been significant cases of person-to-person Alaskapox transmission, the ADPH suggests those with symptoms linked to the virus, particularly skin lesions, should maintain proper hygiene. Covering these health parts and avoiding personal item sharing can prevent potential broader contaminations. Guidance from the health department, however, revolves around reported mild cases resolving independently within weeks.

It’s important to note that the infection’s typical course tends to be mild; however, the severity can escalate in individuals with weakened immune systems. As per ADPH, there’s a possibility that Alaskapox infections have been more extensive among Alaska’s small mammals than previously assumed, hinting at unidentified human cases.

Currently, no specific medications target Alaskapox, according to Dr. Glatt’s knowledge. However, he speculates treatments for similar viral infections, such as those for monkeypox, might help, though such treatments haven’t been tested yet. He further alleviates concerns about Alaskapox spreading to other states, stating it remains unlikely as long as the virus’s vectors remain mainly local to Alaska.

With the Kenai Peninsula death marking the first Alaskapox case outside Alaska’s Interior region, it’s suggested that the virus distribution could be wider across the state than initially understood. Plans for testing small mammal populations executed by the University of Alaska Museum and the Centers for Disease Control and Prevention (CDC) are underway for regions beyond the Interior, to help map Alaskapox’s distribution.

Concerned individuals who suspect they have contracted Alaskapox can reach the Alaska Section of Epidemiology at 907-269-8000. This public health service will facilitate appropriate testing and, where necessary, support patients through the right treatment paths, according to announcements from the ADPH.

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