In August, a Fairbanks resident visited her doctor’s office with a mysterious gray lesion on her left upper arm, along with shoulder pain, fatigue and a fever.
According to a report issued by the state Wednesday, this woman was later diagnosed with the second-ever known case of a new species of a double-stranded DNA virus called “Alaskapox," which comes from the same genus as smallpox.
While very little is known about Alaskapox at this point, it is encouraging to see that the only two known cases were relatively mild, meaning they did not involve hospitalizations or aggressive medical treatment, according to Eric Mooring. Mooring is a lieutenant in the U.S. Public Health Service Commissioned Corps who works for the federal Centers for Disease Control and Prevention as a disease detective in Alaska, and is the lead epidemiology investigator on this case.
Evidence of human-to-human transmission is nonexistent, which is also a good sign, Mooring said.
The discovery of a new viral disease in humans is relatively rare: Alaskapox is only the third orthopoxvirus that has been discovered in the last decade, Mooring said.
He doesn’t think the discovery is a cause for alarm, just caution.
“People should be aware but not scared by this,” he said.
The first and only other case of Alaskapox was identified in 2015, when a different Fairbanks-area resident developed a similar lesion on her right shoulder that was surrounded by a rash and accompanied by fatigue and fever.
Her doctor at the time suspected a viral infection, and the lesion went away after six months.
How exactly Alaskapox was contracted by either patient, whether the infection poses a real health risk and where it originated remain a bit of a mystery. No link has been identified between the two cases, which occurred five years apart.
Illustrations from an article titled ’Novel Orthopoxvirus Infection in an Alaska Resident ’. The disease is being called Alaskapox. There are two known cases. (Creative Commons image)
“There’s a lot of uncertainty about how this happened,” Mooring said. “Our leading hypothesis is that animals have some role to play, but it’s still in the realm of hypothesis because we don’t have direct evidence, which is what we’re working on right now.”
There are other clues that inform that hypothesis.
“Both cases occurred during mid- to late summer in residents of forested areas near Fairbanks,” the report said. “While the similar time of year may be purely coincidental, it may also reflect the fact that small mammal populations are likely at or near their peak population size in late summer and that humans in Interior Alaska spend more time outdoors during the summer than other times of year.”
Although the infected patient in the earlier case from 2015 apparently had contact with “small mammals and their droppings,” no evidence of the infection was found in samples from a “taxonomically narrow sample” of 12 small mammals trapped on her property.
Still, Mooring encouraged Alaskans to not handle wild animals, to avoid areas with animal droppings and to wash their hands regularly.
In the most recent case, the patient had visited Southcentral Alaska about three weeks before the lesion appeared.
She reported that none of her family members or co-workers had recently traveled outside the country, and the only other person she lived with at the time reported no recent history of any illnesses or skin lesions.
Her two cats reportedly captured and killed small mammals, but she said she’d never touched any of them. She’d also gone raspberry picking within two weeks of developing symptoms, but she said she hadn’t interacted with any small mammals during that trip.
And as far as she was aware, no one she’d been in contact with had reported similar symptoms to hers, she told Mooring and others investigating the epidemiology of the cases.
Her shoulder pain lasted about two weeks, and her lesion had healed a month later.
Mooring said it is “definitely possible” that there’s more than just two cases of Alaskapox out there. But it is impossible to know for sure because the symptoms of Alaskapox could easily be confused with other viruses, and many people with mild symptoms are not likely to seek medical care.
“It’s also definitely possible that this virus has been around for a long, long time and is only just now being discovered," he said.
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