An elderly man who lived alone in rural Alaska is the first victim of ‘Alaskapox’, a rare disease identified only nine years ago.
The unidentified, immunocompromised man died in late January, weeks after becoming the seventh person to contract the virus while living on the Kenai Peninsula.
As of Sunday, it is still unclear how he contracted it, although the fact that he did confirms that it has spread beyond local wildlife populations and into local communities.
The man, already a cancer patient, first reported signs of infection in September, citing a tender lesion that appeared near his armpit. The infection worsened and, after six weeks of emergency visits from state officials, he was hospitalized locally.
As the situation continued to evolve, officials said he was transferred to an Anchorage hospital, where staff were able to identify the infection but were unable to save him.
An elderly man who lived alone in rural Alaska is the first victim of ‘Alaskapox’, a rare disease identified only nine years ago. Pictured: An Alaskan smallpox lesion approximately 10 days after symptom onset.
The unidentified, immunocompromised man died in late January, authorities said in a bulletin Friday, weeks after becoming the seventh person to contract the virus. Illustrations from an article titled ‘New orthopoxvirus infection in Alaska resident’
He died at the end of January, stated the bulletin of the epidemiology section of the state Division of Public Health, before recounting the patient’s sad saga.
“In mid-September 2023, an elderly man on the Kenai Peninsula with a history of drug-induced immunosuppression secondary to cancer treatment noticed a tender red papule in his right armpit,” doctors employed by the state sect wrote.
‘Over the next 6 weeks, he presented to his primary care provider and the local emergency department (ED) several times for clinical evaluation of the injury and was prescribed multiple antibiotic regimens.
“A needle biopsy revealed no evidence of malignancy or bacterial infection,” the story continued.
“Despite antibiotic therapy, the patient experienced fatigue and increasing induration and pain in the right axilla and shoulder.”
Then, on Nov. 17, medical professionals wrote, the unnamed man was hospitalized “due to extensive progression of suspected infectious cellulitis” that prevented him from using his right arm.
This led to his transfer to an Anchorage hospital, authorities said, where, even with treatment, the man suffered kidney failure, respiratory failure, malnutrition and a litany of other problems, according to the bulletin.
The victim “resided alone in a wooded area (on the Kenai Peninsula) and reported no recent travel or close contact with recent travel,” the doctor wrote of the patient’s infection and subsequent death.
An extensive battery of tests was performed to discern the cause of the patient’s infection, including “a microbial plasma cell-free DNA sequencing assay” that can identify and quantify molecules from more than 1,500 types of bacteria, viruses, fungi and parasites. .
The test initially came back positive for cowpox virus on Dec. 8, the authors wrote, before a swab from the lesion sent to the Alaska State Public Health Laboratory for further testing ruled out cowpox, monkeypox and smallpox.
However, the test did not exclude Alaskan smallpox (AKPV) as a potential cause, and additional testing from the Centers for Disease Control confirmed that the virus is in the same genus as smallpox and monkeypox.
The man, meanwhile, continued to complain to doctors of a “neuropathic-type burning pain” emanating from his leg and spreading throughout his body, before receiving intravenous treatment aimed at combating the infection.
About 1 week after starting this treatment, doctors wrote how the patient’s condition began to improve. However, ‘Despite intensive medical support in a long-term care setting, the patient subsequently developed delayed wound healing, malnutrition, acute renal failure, and respiratory failure.
A combination of these illnesses contributed to his death in late January 2024, doctors wrote, making him the seventh in Alaska to become ill from the virus and the first to die.
All of the other victims became ill in a borough of Alaska located 370 miles north of the forest where the victim lived alone, called Fairbanks North Star Borough, but all survived.
A northern red-backed vole is seen in this undated photo. Small mammals, especially northern red-backed voles, have been found to be infected with Alaska smallpox, a disease related to monkeypox and smallpox that first emerged in 2015, with six mild cases occurring since so.
This was not the case for the Kenai Peninsula man, who doctors wrote “resided alone in a wooded area and reported no recent travel or close contact with recent travel,” before ultimately dying of malnutrition and kidney failure and respiratory at the end of last month.
Katherine Newell, a CDC Epidemic Intelligence Service officer assigned to the Alaska Department of Health, works with a colleague in the Fairbanks area (the only other region where the virus has been detected) to collect small mammals that could be carrying the virus. virus. The trapping campaign, carried out in September 2021, found around three dozen small animals with signs of past infection or carrying the virus. Most were red-backed voles.
The first was affected in 2015, and two more cases were identified in the summer of 2021. Since then, four other non-fatal cases have emerged, all of which were mild and did not require hospitalization.
This was not the case for the Kenai Peninsula man, to whom doctors wrote ‘he resided alone in a wooded area and did not report recent travel and no close contact with recent travel.
He reported caring for a stray cat at his residence that regularly hunted small mammals and scratched him frequently, doctors wrote, citing a noticeable scratch near his right shoulder in the month before the rash appeared.
This data is particularly important since the virus, apart from humans, has only been found in small mammals, such as voles and shrews.
The patient reported no other recent contact with small mammals, but did report gardening in his backyard until September 2023, the doctors wrote, pointing to the cat as one of the few possible points of infection.
Serum and mucosal swabs collected from the stray cat were sent to the CDC for antibody and orthopoxvirus testing, although all tests were negative.
Doctors, puzzled about the source of infection, wrote: “The route of exposure in this case is still unclear, although scratches from the stray cat represent a possible source of inoculation through fomite transmission.”
They added that the State of Alaska Department of Epidemiology is “working with the University of Alaska Museum and the CDC to conduct AKPV testing in small mammals” in and around the region.
Their efforts, until Sunday, continue.