What Is Alaskapox? Symptoms and Origins of Virus

With officials announcing the death of the first person due to the recently discovered Alaskapox, experts have raised concerns that the virus may have spread farther across the state amongst its animal population and potentially into broader North America.

In a bulletin on Friday, the Alaska Department of Health said that an older man who had a history of drug-induced immunosuppression because of cancer treatment died in late January after first exhibiting possible symptoms of the disease in mid-September.

Alaskapox is thought to have first emerged in the human population in 2015 in the Fairbanks area and is zoonotic—transferable between animals and humans.

The Alaska Department of Health said that there had been seven recorded instances of infections with the virus to date. Before December, all reported incidents had occurred in the Fairbanks area and involved illness that did not require treatment.

As Alaskapox cases among humans are so rare, understanding of the full extent of the symptoms of the virus and exactly how people are exposed to it remains unclear. However, it comes from the same family of pathogens as smallpox and monkeypox, which can cause a fever, fatigue and rashes on the skin.

Previous cases in 2021 reported lesions on the skin as well as raised lymph nodes, which help fight infections. Unlike chickenpox, the cases so far have been mainly restricted to a single rash or raised spot rather than spreading across the body.

The man who died recently had a tender raised spot on his armpit before beginning to experience pain in the area and a hardening of the spot. He was hospitalized on November 17 as the illness was impeding the movement of his arm, and he developed a burning sensation.

The Alaska Department of Health said the man then developed four smaller pox-like lesions in different places on his body, suggesting an advanced case could see rashes spread.

Despite seeing an improvement in his health after a week of targeted treatment, the man exhibited delayed wound healing, malnutrition, kidney failure and respiratory failure before dying. However, officials cautioned that the man's immunocompromised status likely contributed to the severity of the illness he suffered.

Julia Rogers, an epidemiologist with the Centers for Disease Control and Prevention, who is assigned to the Alaska Department of Health and helped author the bulletin, told Newsweek that people with Alaskapox have suffered symptoms including a fever, swollen lymph nodes and joint or muscle pain, several of whom "initially thought they had a spider or insect bite."

State testing has found Alaskapox prevalent most commonly in four small mammal species—predominantly in red-backed voles—and epidemiologists believe the virus circulates mainly among animals with occasional spillover into the human population.

"The most recent case is the first case of Alaskapox identified outside of the Fairbanks area and the seventh one to date," Rogers said. "Our investigation indicates that Alaskapox virus appears to be more widely prevalent in small mammals in Alaska than previously known, rather than confined to the Fairbanks area."

She said: "Prior trapping studies have indicated red-backed voles appear to be an animal reservoir in the wild for Alaskapox virus." Shrews were also found to be a predominant carrier of the virus in the Fairbanks area.

The Alaska Department of Health has said there is no evidence so far of human-to-human transmission of Alaskapox but noted that other similar viruses can spread through contact with skin lesions.

Rogers cautioned that the "potential for person-to-person transmission cannot be excluded based on other orthopoxviruses (e.g., mpox), and future case investigations will continue to assess whether transmission may have occurred."

The Alaska Department of Health recommended patients avoid touching rashes and sharing clothes, as well as washing clothes and bed linens separately from other household laundry. Rogers advised "people with skin lesions potentially caused by Alaskapox to keep the affected area covered with a bandage."

The man who died lived alone and did not have close contact with small mammals, but cared for a stray cat that scratched him on his armpit in the months before he began developing symptoms in mid-September. However, the stray cat tested negative for the virus, and the man also reported gardening through September.

"We are not sure exactly how the virus spreads from animals to people but contact with small mammals and potentially domestic pets could play a role," Rogers said.

Update 2/13/24, 5:00 a.m. ET: This article was updated to include comment from epidemiologist Julia Rogers of the CDC and Alaska Department of Health.