Academician Pokrovsky spoke about possible ways of spreading the Alaskan smallpox virus

The first death of a patient infected with a relatively new virus—Alaskan smallpox, or Alaskapox—has been reported on the American peninsula. A man who became infected last year (presumably from a stray cat) was hospitalized in November and died at the end of January 2024. So far, 7 cases of infection with alascapox have been reported in the world. The famous epidemiologist and infectious disease specialist, epidemiologist, professor, academician of the Russian Academy of Sciences Vadim Pokrovsky told MK how dangerous the virus is.

Alaskapox, like smallpox, belongs to the poxvirus family. It was first discovered in Alaska back in 2015. And in 2019, having deciphered the genome, they gave it the name Alaskapox. There are currently seven known cases, six of which are in the Fairbanks North Star area and one in the Kenai Peninsula area. Until the last case, the disease in those infected was mild – in the form of small lesions on the skin that heal within a few weeks or months. Sometimes patients are also worried about joint or muscle pain, fever, and swollen lymph nodes. Most likely, the virus is transmitted to humans from small animals, red-backed voles and shrews, but it is not entirely clear how. Cats and dogs can be an intermediate link. No cases of person-to-person transmission have been reported.

According to the Alaska Department of Health, this is the first time a case of severe Alaskapox infection has been reported, resulting in hospitalization and death. However, one should take into account the fact that this happened to an elderly patient who had a weakened immune system due to cancer. In the fall, a Kenai Peninsula resident discovered a painful red papule on his body. A course of antibiotics did not help – his condition worsened, and in November he was hospitalized. During his stay in the hospital, he developed a severe rash in the form of pockmarks, and the wounds did not heal well. In addition, he lost his appetite, then developed acute kidney failure and breathing problems. It was not possible to save him.

It is believed that the man could have been infected by a stray cat that scratched him several times. And although the exact route of transmission of this infection has not been established, academician Vadim Pokrovsky says that viruses related to the smallpox virus are found in many mammals, including rodents:

– Researchers constantly monitor such cases in order to detect dangerous pathogens in time. In this situation, most likely, there is no need to talk about the fact that the disease is truly dangerous in epidemic terms. The death was registered in a patient with impaired immunity, and it cannot be said that the direct culprit was the virus. However, it is necessary to conduct constant monitoring of Alaskapox, which is what specialists are doing.

– Are there other dangerous representatives of this group of viruses?

“More recently, we witnessed that another pathogen from this group, monkeypox, did cause an outbreak of the disease, and there were deaths, although in patients with HIV infection, that is, with reduced immunity. Unfortunately, our contacts with nature are very large – we are invading previously undeveloped territories, and economic activity is actively developing in Alaska, so we need to monitor and take action if the situation gets out of control. Although, of course, we are not talking about total vaccination yet.

– Will the smallpox vaccine help against Alaskan smallpox?

– Yes, all smallpox vaccines will be effective. This vaccine, in principle, is not against human smallpox, but against cowpox, but all orthopoxviruses are related, so immunization against one of them will protect against others. Although, of course, this issue requires careful study and comparison of pathogen antigens, and such work is being carried out in all countries. So far, not much is known about Alaskapox: there were only a few cases of infection, and they were not very severe, so they were not particularly recorded. But the first death has epidemiologists watching him more closely. Of course, a lot depends on the immunity of a particular person, but vigilance is necessary, therefore epidemiological services, including ours, are closely monitoring not only this situation, but also all pathogens that can be transmitted from animals.

– Could the emergence of a new smallpox virus be somehow related to climatic conditions?

– These pathogens are associated with certain species of animals, so it is necessary to monitor the migration of animals that are hosts of viruses or their carriers. Due to climate change, animals begin to move from more northern territories, and some, on the contrary, move away from warming to colder regions.

– Could the appearance of Alaskapox in Alaska be somehow related to glaciers?

“He was undoubtedly there for a long time, he just wasn’t identified.” For example, previously, hardly anyone would have paid attention to diagnosing viruses in Indians. However, in recent years the capabilities of the laboratory service have greatly improved, and it is now possible to identify and investigate what was previously impossible. Therefore, new pathogens are now being isolated in large quantities. Not all of them are dangerous, but they need to be monitored to minimize the risk of spreading infections.