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Alaska reports fatal case of Alaskapox

Alaska Department of Health epidemiologists have reported the first known fatal case of Alaskapox, a new orthopox virus first identified in 2015. The fatal infection involved a man with an underlying health condition. jacent living on the Kenai Peninsula.

The man’s infection is the seventh case of Alaskapox in the state and the first to be located outside of the Fairbanks area, officials said in a Feb. 9 epidemiology bulletin.

Alaska reported its most recent cases of Alaskapox virus in 2021, involving a young girl and a middle-aged woman from the Fairbanks area. There was no relationship between the patients, but both had pets, including cats, and had spent time outdoors during the summer.

The patient was undergoing treatment for cancer

The old man’s symptoms began in mid-September 2023 with a red, tender papule in his right armpit. At the time, he was undergoing immunosuppressive therapy as part of cancer treatment. Over the next 6 weeks, he sought treatment for the injury, which worsened. In November, he was hospitalized with cellulitis that limited the movement of his arm.

He was transferred to an Anchorage hospital as pain and other symptoms worsened and clinicians noted four more lesions on different parts of his body. Laboratory tests were initially positive for cowpox, and follow-up tests at the state health laboratory were positive for generic orthopox virus.

A sample sent to the U.S. Centers for Disease Control and Prevention (CDC) was consistent with Alaskapox virus, but genetic sequencing suggested it was distinct from samples from previous cases reported in Fairbanks.

After treatment with tecovirimat (Tpoxx), intravenous immunoglobulin vaccine, and oral brincidofovir, his arm symptoms initially improved, but during his stay in a long-term care facility, his condition worsened. deteriorated and he presented with delayed wound healing, kidney failure and respiratory problems. failure. He died at the end of January.

Man had scratches from a stray cat

Investigators found he had no recent travel history or contact with people who had. The man was caring for a stray cat in his home that regularly hunted small animals. The cat scratched the man frequently, including a notable scratch on his right armpit in the month before his symptoms appeared.

The man reported no other contact with small animals, but had been gardening in his backyard until September 2023. Blood and mucous samples taken from the cat were negative in orthopox antibody tests performed at the CDC.

Authorities said the man’s immunocompromised status likely contributed to the severity of his illness.

Testing animals outside of Interior Alaska

State officials added that the first detection outside of Interior Alaska suggests Alaskapox is more widespread among the state’s small mammals than previously thought, which should raise awareness clinicians. Epidemiologists and their health partners, including the CDC, are testing small mammals outside of Interior Alaska to assess prevalence in animals.

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