(NewsNation) — A recent case of Alaskapox resulting in the death of a man on the Kenai Peninsula has sparked concerns among health officials about the spread and severity of the virus outside of its known epicenter.

The victim, who the Alaska Department of Health said in a bulletin was an elderly man with a history of immunosuppression due to cancer treatment, initially noticed a tender red papule in his right armpit in mid-September. Over the following weeks, he sought medical attention multiple times as the lesion worsened, leading to hospitalization in November due to an extensive infection that affected his arm’s mobility.

The source of the infection remains unclear, although scratches from a stray cat the patient cared for are being investigated as a possible route of transmission.

Further diagnostic tests revealed the presence of AKPV, a particularly concerning finding as it marks the first fatal case outside the Fairbanks area. The patient’s compromised immune system likely contributed to the severity of the illness.

Despite efforts to treat the infection with antiviral medication and immunoglobulin therapy, the patient’s condition deteriorated, leading to his death in late January.

What is Alaskapox, and what species can get it?

The Alaskapox virus, a type of orthopoxvirus, was first discovered in 2015 near Fairbanks and was thought to be limited to that area until now. Orthopoxviruses are DNA viruses that can infect various mammals, including humans.

Previous reports of infection were considered relatively mild, with symptoms usually being a localized rash and swollen lymph nodes, the Anchorage Daily News reported. None of these people needed treatment. However, state epidemiology chief Dr. Joe McLaughlin noted in the newspaper that the previously-infected individuals had “healthy” immune systems. 

What species can get Alaskapox?

Current evidence indicates that Alaskapox primarily affects small mammals — specifically, red-backed voles and shrews. It could be more widespread, though, the Alaska Department of Health said, as there could have been more infections in humans or small animals that went undiagnosed.

As of February 2024, Alaska officials have not documented human-to-human transmission of the disease.

 “We are not sure exactly how the virus spreads from animals to people but contact with small mammals and potentially domestic pets who come into contact small wild mammals could play a role,” the Alaska Department of Health said.

Certain orthopoxviruses, though, are transmitted through direct contact with skin lesions, so experts recommend those with lesions that could be caused by Alaskapox keep a bandage on the affected area. 

What are the symptoms of Alaskapox?

Skin lesions, swollen lymph nodes and joint or muscle pains were some of the symptoms people have noticed. 

Health care providers can help assess whether one’s symptoms are Alaskapox, or from something else. 

Health Officials’ Response

Alaska’s Section of Epidemiology is collaborating with the University of Alaska Museum and the Centers for Disease Control and Prevention to test small mammals for AKPV outside the Fairbanks region.

As more attention is paid to Alaskapox, case counts could rise as more people recognize symptoms and get tested. 

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