Man Dies in First Known Fatal Case of Alaskapox

The Alaskapox virus is normally found in small mammals, including red-backed voles like the one above.Credit…Michael Penn/The Juneau Empire, via Associated Press

An Alaska man died last month of Alaskapox, a rare virus that occurs mostly in small mammals and can cause skin lesions, according to state health officials.

Alaskapox was first identified in 2015 in a woman who lived near Fairbanks, Alaska, and there have been a total of seven cases of the virus reported to the Alaska Section of Epidemiology. Until last month, no one had been hospitalized or died of Alaskapox, which can also cause swollen lymph nodes and muscle or joint pain, Alaska epidemiology officials said on Friday.

Of the seven people who have had Alaskapox, six lived in the Fairbanks North Star Borough, where red-backed voles and shrews have been found to have the virus, according to the Alaska Department of Health. Alaskapox has not been found to spread between humans.

Dr. Julia Rogers, an epidemiologist with the Centers for Disease Control and Prevention, said in an interview on Tuesday that the symptoms from Alaskapox infection were generally mild.

“There could have been cases in the past that we just did not pick up because of that,” Dr. Rogers said, adding that it is possible that recorded cases could increase as more doctors learn how to identify it.

The Alaska Section of Epidemiology, which did not release the name of the man who died of the virus, said in a statement that he was “an elderly man from the Kenai Peninsula with a history of drug-induced immunosuppression.”

Alaska health officials said that it was still unclear how the man had contracted the virus. The man lived alone in a forested area, had not traveled recently or had close contact with someone who had traveled recently, according to the state Health Department.

The man told doctors that he had been caring for a stray cat at his home, and that the cat often scratched him, including once near his right armpit, about a month before he noticed a red papule had formed there in September 2023, Alaska health officials said. The cat was later tested for other orthopox viruses, and all tests were negative, according to the Health Department. Still, health officials said it was possible that the stray cat could have been the source of the virus.

Dr. Rogers said that it was possible that the stray cat’s claws were carrying the virus from scratching around other rodents.

“But we can’t say for certain how the specific mode of transmission occurred with this patient or for the previous patients,” Dr. Rogers said.

Dr. Joe McLaughlin, an Alaska state epidemiologist and chief of the Alaska Section of Epidemiology, said in an interview that all patients who have had Alaskapox have had a cat or a dog, and that health officials are working to determine what role domestic pets may play in the spread of the virus.

“Because Alaskapox is rare, our No. 1 message is that Alaskans shouldn’t be overly concerned about this virus,” Dr. McLaughlin said, “but more be aware of it.”

In the six weeks after the man noticed the lesion, he went to his primary care doctor and the local emergency room several times because of the lesion, according to the Health Department. He was prescribed several rounds of antibiotics, which did not help, health officials said.

The man was hospitalized on Nov. 17 because the lesion had affected his ability to move his arm, and he was later transferred to a hospital in nearby Anchorage, health officials said. While hospitalized there, the man said he was experiencing a “burning pain,” and four small pox-like lesions were found across his body, health officials said.

After a number of tests, health officials said, doctors were able to rule out cowpox, mpox and other viruses. A swab of the man’s lesion was later sent to the Centers for Disease Control and Prevention, which found that it was consistent with other cases of Alaskapox, according to health officials.

While the man was hospitalized, health officials said, he began to experience wounds that took long to heal, malnutrition, acute kidney failure and respiratory failure. He died in late January, the Health Department said.

Dr. McLaughlin said that because people who are immunocompromised have experienced worse symptoms with other orthopox viruses, it’s important for doctors in Alaska to make an Alaskapox diagnosis early.