Man dies in first known fatal case of Alaska smallpox virus

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

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

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

Dr. Julia Rogers, an epidemiologist at the Centers for Disease Control and Prevention, said in an interview Tuesday that symptoms of Alaskan smallpox infection were generally mild.

“There could have been cases in the past that we just didn’t catch because of that,” Dr. Rogers said, adding that recorded cases may increase as more doctors learn to identify them.

The Alaska Epidemiology Section, which did not release the name of the man who died from 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 it was still unclear how the man had contracted the virus. The man lived alone in a wooded area, had not traveled recently or had close contact with anyone who had recently traveled, according to the state Department of Health.

The man told doctors that he had been caring for a stray cat in his home and that the cat frequently 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 reported. officials said. The cat was subsequently tested for other orthopox viruses and all tests were negative, according to the Department of Health. Still, health officials said it was possible that the stray cat had been the source of the virus.

Dr Rogers said it was possible the stray cat’s claws carried the virus by scratching other rodents.

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

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

“Because Alaska smallpox is rare, our number one message is that Alaskans should not worry too much about this virus,” Dr. McLaughlin said, “but that more people need to be aware of it.”

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

The man was hospitalized on Nov. 17 because the injury 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 smallpox-like lesions were found all over his body, health officials said.

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

While the man was hospitalized, health officials said, he began experiencing injuries that were slow to heal, malnutrition, acute kidney failure and respiratory failure. He died in late January, the Health Department said.

Dr. McLaughlin said that because immunocompromised people have experienced worse symptoms with other orthopox viruses, it is important for Alaska doctors to make an early diagnosis of Alaska smallpox.

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