State reports first known fatal case of Alaskapox

State health officials this week reported the first known fatal case of Alaskapox in an immunocompromised Kenai Peninsula man who was undergoing treatment in Anchorage when he died in late January.

Health officials say the recently discovered species of the double-stranded-DNA virus first identified in Alaska in 2015 comes from the same genus as smallpox, monkeypox and cowpox. It occurs mostly in small mammals like voles and shrews.

The man is one of seven reported Alaskapox infections to date, according to an Alaska Section of Epidemiology bulletin released Friday that provides information about the death.

The fatal case, which took months to diagnose, is significant because Alaskapox had previously only resulted in mild infections, state health officials say. It’s also significant because the case was reported outside of the Fairbanks area for the first time.

It’s likely the man’s immunocompromised status contributed to the severity of his illness, officials say.

Until December, reports of infection involved relatively mild illness consisting of a localized rash and swollen lymph nodes. None of those people needed treatment, but they all had healthy immune systems, according to state epidemiology chief Dr. Joe McLaughlin.

This latest case indicates the virus may be more widespread in Alaska’s rodents and other small animals than previously thought, prompting state recommendations that medical providers make sure they can recognize the symptoms.

“People should not necessarily be concerned but more aware,” said Julia Rogers, a state epidemiologist who co-authored the bulletin. “So we’re hoping to make clinicians more aware of what Alaskapox virus is, so that they can identify signs and symptoms.”

Officials said Friday that additional attention from this latest case could drive up the state’s tally of Alaskapox virus cases as more people recognize the symptoms and get tested.

The cause of the fatal case remains unclear, officials say.

It’s possible the man, who lived in a remote location and had not traveled anywhere, contracted the virus from a stray cat that hunted small mammals and scratched him near the area where his first symptoms started, according to the bulletin. The cat tested negative for the virus but could have carried it on its claws.

The man noticed a tender red bump in his armpit in September and was prescribed antibiotics after seeking medical care several times over six weeks, the bulletin said. By mid-November, his symptoms grew to include fatigue and pain.

He was hospitalized on the Kenai Peninsula and then transferred to Anchorage, where he reported increasingly urgent symptoms and more pox-like lesions, according to the bulletin. A “battery of tests” in December resulted in a positive result for cowpox; testing by the Centers for Disease Control confirmed Alaskapox, it said.

The man began to improve about a week after treatment with intravenous medications but died in late January after experiencing kidney failure and other systemic declines, according to the bulletin.

Health officials recommend anyone with a lesion cover it with a bandage and report any possible symptoms of Alaskapox to a medical provider. Alaskans should also practice good hygiene when hunting and trapping or around pets that may come in contact with animals like voles or shrews.

One Fairbanks-area resident with Alaskapox reported their dog rolled in dead animals but it’s unclear if contact with the dog was the cause of the patient’s infection, McLaughlin said. Several people who later confirmed positive for Alaskapox initially thought they had spider bites, officials said, noting the ability of the virus to fly under the medical radar.

The bulletin includes nine recommendations ranging from urging Alaskans to use safe practices around wildlife to clinics taking steps to protect immunocompromised patients and staff when dealing with the virus.