The Alaska Department of Health confirmed that the first fatal case of Alaska pox, an infectious disease caused by the Alaskapox virus discovered only in 2015, occurred in January 2024. Here's what we know about the symptoms, transmission and treatment of the infection.
First identified in a woman in 2015, Alaska pox is an infectious disease caused by a virus – Alaskapox virus – belonging to the Orthopoxvirus genus of the Poxviridae family. It is the same one that includes the Variola virus responsible for the terrible smallpox – the only human disease to have been eradicated – and the monkeypox virus ( Monkeypox or mpox , as it was renamed by the World Health Organization), recently protagonist of an epidemic that involved multiple countries around the world, including Italy with a thousand cases. All these infections are linked by similar basic symptoms , with the appearance of skin lesions (pustules) and swollen lymph nodes, as well as flu-like manifestations such as chills, fever, fatigue and others.
To date, according to the Alaska Department of Health, Alaska smallpox has been found in only seven people , six of them in the Fairbanks North Star Borough (including the woman above) and one in Kenai Peninsula Borough. The latter is the only one to have died due to complications of the infection. This was an elderly man who lived alone in a wooded area, immunocompromised due to cancer that he had battled for a long time. According to the US health authorities, it was precisely his fragile condition that exposed him to the lethal evolution of Alaskan smallpox. The other six infections in fact gave mild symptoms and resolved quickly. Here's everything we know about this disease.
What is Alaskan smallpox
Alaskan smallpox is an infectious disease caused by the Alaskan smallpox virus that circulates in small mammals . The name is linked to the fact that the disease was discovered in the cold northern United States; to date all seven diagnosed cases are located in Alaska. Experts, however, believe that many more people would have been infected, with cases remaining under trace, subclinical or mildly clinical, and therefore undiagnosed. It is no coincidence that several of those who went to the emergency room with symptoms and signs (skin lesions) believed they had been bitten/stung by a spider or insect. The virus is believed to have been circulating in Alaska for hundreds if not thousands of years.
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What are the symptoms and signs of Alaskan smallpox
The basic symptoms of Alaskan smallpox are similar to those of monkeypox and other similar diseases: presence of one or more skin lesions, swollen lymph nodes, joint pain , muscle pain , and fever , as specified by the Alaska Department of Health . The lesions, pustular and surrounded by more or less red skin, can exceed a centimeter in diameter after five days from the emergence of symptoms, as indicated by the health authorities. In monkeypox, the pustules develop to form a scab and then fall off, leaving a scar. In fragile and immunocompromised subjects, the disease can progress to a severe form and be fatal.
How Alaskan smallpox is transmitted
The Alaskapox virus, according to experts, regularly circulates in small mammals present in Alaska. Monitoring conducted in 2020 and 2021 detected two major reservoirs: the northern red-backed vole ( Clethrionomys rutilus ) and the shrew , of which the most widespread species in the US state is the small Alaskan shrew ( Sorex yukonicus ). Because the deceased man lived on the Kenai Peninsula in southern Alaska, officials believe infected animals may well be present in Canada as well.
The methods of transmission are not yet clear but are believed to be similar to those of other forms of smallpox, such as direct contact with infected animals or their body fluids . Not only small wild mammals such as voles and shrews, but also potentially domestic ones. As Dr. Joe McLaughlin, epidemiologist who heads the Alaska Section of Epidemiology at the state Department of Health, told CNN, the deceased man was caring for a stray cat that hunted small mammals. The cat often entered the house and scratched it; it is believed that the infection was therefore transferred from the feline to humans.
Although human-to-human transmission has not yet been found, it is believed that the Alaskapox virus may also be as contagious as monkeypox. Therefore through close contact with a person, exposure to respiratory droplets (droplets and aerosols) after prolonged face-to-face contact and contact with infected body fluids, especially the material secreted by pustules . For this reason, US doctors recommend that patients cover skin lesions and not share underwear, sheets and clothes with other people.
How to treat Alaskan smallpox
Dr. McLaughlin explained that the infection can be treated with antivirals and immunoglobulin drugs .