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Alaskapox: What To Know About Rare Virus After 1st Reported Human Death

Alaskapox, a virus first identified in 2015, has recently claimed the life of an elderly Alaskan man, marking the first known human fatality linked with this pathogen, according to officials.

The man, from the Kenai Peninsula (just south of Anchorage), was hospitalized in November due to a worsening infection that impacted the range of motion in his arm, Alaskan public health officials stated on Feb. 9. He then tested positive for Alaskapox (also known as AKPV) and died in January.

The man was undergoing cancer treatment and had a suppressed immune system because of the drugs, which may have contributed to the severity of his illness, officials said. He was described as elderly but an age wasn't given.

3:52Addressing zoonotic diseases in Ontario

"With Alaskapox, it was first described in 2015 as new, and since then there have been seven reported cases," infectious diseases specialist Dr. Isaac Bogoch told Global News. "Most of the cases were around the Fairbanks, Alaska region, but it's likely much more widespread. This is probably going to be one of those things where the more you look for it, the more you're going to find it."

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Alaskapox, part of the orthopoxvirus family, is known to afflict both animals and humans with disease. This virus family also includes illnesses like smallpox and mpox, Bogoch said.

"These viruses occur all over the world and they typically live in rodent populations," Bogoch said. "Once in a while, they can move from the rodent population either to other non-human animals or from rodent populations to humans, or from rodent populations to non-human animals to humans."

Where did Alaskapox originate?

Alaskapox was first identified in an adult living near Fairbanks, Alaska, in 2015, according to health officials.

To date, there have been seven reported Alaskapox infections. And until the recent fatal case, all infections occurred in residents of the Fairbanks area and involved a localized rash and the swelling of lymph nodes, health officials stated.

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Testing was done on small mammals in the area, and officials identified Alaskapox infection in four distinct species, with red-backed voles emerging as a significant presence among them.

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There also has been evidence suggesting that prior AKPV infection has also been documented in at least one domestic pet linked to a patient, officials added.

What happens when you get infected?

Symptoms of Alaskapox and other viruses in this family can include a rash, swollen lymph nodes and joint or muscle pain.

Dr. Zain Chagla, infectious disease physician and associate professor at McMaster University in Hamilton, Ont., noted that in the seven cases in Alaska, the lesions resemble pox-like sores akin to those observed in smallpox and mpox. These lesions typically start as blisters, which then rupture and ulcerate, forming large scabs before eventually healing, he said.

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In the latest case, he explained that due to the man's immunocompromised state, the development of widespread lesions proved fatal despite efforts to treat the infection.

"It is now described for the first time that it leads to serious complications in very immunocompromised individuals," he said.

How does it spread?

It's unclear how AKPV is transmitted but researchers say it may be zoonotic, meaning it can jump from animals to humans.

In the most recent case, health officials reported that the elderly man lived alone in a forested area and had not travelled recently. However, he mentioned caring for a stray cat that often hunted small mammals and scratched him frequently. While the patient had no other recent contact with small mammals, he did report gardening in his backyard until September 2023.

The stray cat underwent testing and the results were submitted to the U.S. Centers for Disease Control and Prevention (CDC). But all tests returned negative results.

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"The first six individuals, and even a little bit of the seventh individual, had some exposure to small animals in the environment. Some of them through direct hunting, some of them through their pets that hunted other animals," Chagla said.

"And so potentially there may be a mechanism to spread that way through, dead and decaying animal matter where people may come into contact with and then contract it through the skin."

Chagla noted that in a few of the Alaskapox cases, some family members showed evidence of exposure to the viruses, suggesting that certain populations may experience minimal symptoms or none at all.

'Expansion of zoonotic infections'

While Bogoch emphasized that Alaskapox currently doesn't present a major threat to large populations, he cautioned this still highlights the broader concern of zoonotic diseases crossing into human populations.

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"Are they on the rise? Yes, we're seeing the expansion of zoonotic infections. We're also discussing it a lot more since COVID-19 because it's front and center on many people's minds. But this has been an issue that's been brewing for decades," he said.

"We have to take these seriously. We have a lot of interactions between humans and animals and some of these can cause epidemics, some of these infections have pandemic potential."

For example, Bogoch referenced H1N1, which triggered a worldwide pandemic in 2009, underscoring the capacity of zoonotic infections to swiftly propagate and affect widespread human populations.

2:29Animal experts say stopping future outbreak starts with origins

H1N1, also known as the swine flu, originated from pigs and spread to humans. The virus spread rapidly, and is estimated to have infected between 700 million and 1.4 billion people worldwide during its first year of circulation, resulting in approximately 151,700 to 575,400 deaths, according to the CDC.

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Bogoch believes that whether it's mpox, swine flu, avian flu, or Alaskapox, the phenomenon of viruses spilling over to humans will persist.

"A lot of this is related to urbanization, destruction of habitat, humans coming into contact with non-human animals either through hunting or wildlife trade, pets or farming and agriculture," he warned.

And since zoonotic infections have no borders, Bogoch said "there will very likely be more cases of this in the future."

— with files from the Associated Press

© 2024 Global News, a division of Corus Entertainment Inc.

Allowing Dogs To Lick Your Face Could Be Unhealthy, Even Fatal

Any dog owners reading this will know the joy of getting home and being greeted with utter delight by their pet – tail wagging wildly before enthusiastic but face-drenching licks. While some owners will push their pooches away playfully to discourage face licking, others positively revel in their dog's affection and may even offer up pursed lips for a canine kiss.It's a heartwarming scene. But think of what that doggy companion has been licking throughout the day. Their food and water, their paws, their toys and chews – and maybe their bottom and genitals. Do those cute kisses seem a little less appealing now? Not matter what pets have licked, many owners are so taken with their dogs that they're willing to overlook the potential hygiene issues.And licking is important for dogs. It's an instinctive canine behaviour. When dogs repeatedly lick their mouths, it can be a subtle sign of stress or fear, especially when combined with ears back and a tense expression. In fact, observing lip licking frequency is a way to gauge dogs' welfare during training sessions and when kept in kennels.Dogs also use lip licking as a behavioural response to humans' emotional states. Evidence suggests that dogs are empathetic. They can recognise emotions in both humans and other dogs using visual and audio cues. A study showed that dogs lick their lips more frequently when looking at angry human faces.For dogs, then, lip licking is a natural instinct – and that applies to relationships with their humans, too. For anyone living with a dog, being licked is a common event, and many dogs will try to lick the faces and mouths of their humans. Almost half of canine owners report being licked on their face by their dog. But, given the penchant that many dogs have for consuming items owners might not find appetising (quick poo snack, anyone?) is it hygienic, or even safe, to let your dog lick your face?What hides withinOwners usually love their dogs, and dogs' companionship and affection can do wonders for their owners' wellbeing and mental health. But there's no doubt that, for some humans, canine saliva might do more harm than good.For people who are immunocompromised, have open wounds, or a dog who likes to supplement their meals with a spot of coprophagia (poop eating), then it's best to avoid those face licks.Dogs' mouths can harbour a range of microorganisms that are usually low risk for humans. However, in rare cases, zoonoses (infectious diseases passed on between species) can be transmitted from dogs to humans by bites, licks and scratches.Most of the time, humans who come into contact with dog saliva do not become ill. In fact, many people manage to live alongside their pets, licks and all, without encountering any health issues.However, there are rare cases where people have become seriously ill following contact with dog saliva. For example, Capnocytophaga canimorsus, a bacteria found in the mouths of up to three quarters of otherwise healthy dogs and cats, has caused life-threatening sepsis.Other microbes such as Pasteurella multocida can be spread by contact with dog saliva, potentially resulting in serious outcomes including meningitis.People considered to be at high risk from zoonotic infections are the immunocompromised, very young children, older adults and pregnant women.If you fall into one of these groups, then it's in your interest to dodge dog licks. Additional measures should also be implemented for at risk dog owners. Keep surfaces clean, minimise contamination of household items and maintain scrupulous household hygiene at all times, especially after contact with animals.Antibiotic resistance is recognised as a major global health challenge. Canine saliva can be a potential source of bacteria carrying antibiotic resistant genes. These bacteria are capable of colonising humans after exposure to dog saliva.However, in 2023 a German study of 2,800 hospital patients and their companion animals verified "that the sharing of multidrug-resistant organisms between companion animals and their owners is possible", but the study only identified a handful of cases. The researches therefore concluded that "cat or dog ownership isn't an important risk factor for multidrug-resistant organism colonisation in hospital patients." It is possible, then, that being licked by your dog could contribute to the spread of antibiotic resistance – but it isn't likely.Doctor dogDespite potential threats to health, can dog licks be beneficial? Records suggest that in the past, animal saliva has been used for wound healing, with some dogs specially trained to lick open wounds. However, there is no research to suggest that allowing animal companions to lick wounds will help them to heal. Allowing animals to lick open wounds, in fact, could put an owner at increased risk of infection.The relationship between humans and their dogs can confer other potentially healing benefits. Animal-assisted therapy helps people with a range of issues, such as anxiety, eating disorders and trauma. Cuddling and stroking dogs, for example, can help patients to feel calmer and lower blood pressure and heart rate.Dog owners tend to benefit from their pets through increased physical activity and social connections, as well as companionship and improved mental health. Licking, however, is not essential to the close bond between human and canine.Within reason, for most people, letting your dog lick you is probably safe. With good management, healthcare (for you and your dog) and excellent hygiene, the risks of an occasional lick are likely to be minimal. But it's a good idea to enforce the "not on the mouth" rule, for everyone's safety. (The Conversation)

Decoding Disease X: What Is The Unknown Pathogen Threatening The World?

- Disease X is 'likely to be a respiratory virus,' according to Amesh Adalja, senior scholar at Johns Hopkins Center for Health Studies

- 'It could be one of the other viruses that infect humans or evolves new characteristics or qualities to be able to spread, or a human virus could be combined with an animal virus,' says Adalja

- Pneumonias and upper respiratory infections are going to be the types of syndrome clusters likely to be seen, Adalja tells Anadolu    

ISTANBUL 

It was in 2018 when Dr. Amesh Adalja, an infectious disease specialist in the US, started thinking about and working on Disease X, realizing that pandemic preparedness was "stultified" and that people were mostly focusing on influenza. 

"Disease X has been something that for the last six or seven years people in my field have been really trying to develop a framework around to make the world more resilient to pandemic threats, even if they come from something that we haven't characterized yet," Adalja told Anadolu in a video interview.

A senior scholar at the Johns Hopkins Center for Health Security, Adalja's concerns were not without ground.

The World Health Organization (WHO) has recently ramped up its efforts and discussions about this unknown infectious pathogen that experts warn may trigger the next pandemic.

In January, WHO chief Tedros Adhanom Ghebreyesus expressed hope that countries will reach a pandemic agreement by this May to address this "common enemy," warning that a global health emergency was now "a matter of when, not if."

In an email to Anadolu, the WHO said a global agreement to protect against future pandemics is under discussion by its member states, and it stands ready to support the accord once agreed by all.

The WHO said it aims to strengthen cooperation, coordination, governance and investment "needed to prevent a repeat of the devastating health and socioeconomic impact caused by COVID-19, (and) make the world better prepared for (a) future pandemic."

According to the WHO, Disease X is a "placeholder term often used to refer to a potential unknown pathogen that could cause a future pandemic or health crisis, and to remind the world that we need to prepare for unknown diseases along with known threats."

In 2017, the WHO published its first list about diseases that had the potential to cause a severe epidemic, for which it says "we don't have enough or no known medical countermeasures."

The list, which urges donors, researchers and scientists to focus on specific diseases with epidemic potential, mentioned Disease X in 2018.

According to WHO's Tedros, COVID-19, which claimed more almost 7 million lives worldwide, was the first Disease X.  

Likely to be a respiratory virus

Adalja also explained that Disease X is a placeholder concept that does not have any real definition or real reference.

However, he said it is most likely to be a respiratory virus caused by a zoonotic pathogen, meaning that it could be spread from animals to humans.

It is most likely that "a pandemic pathogen is going to be a virus because of their ability to mutate," he said.

"It's also most likely to be something that spreads through the respiratory route," said Adalja.

An infection that spreads through the respiratory route can really do so prolifically and it is very difficult for interventions to stop it the way an intervention could stop something that might be spread through blood and body fluids, he explained.

Adalja pointed out that there are many respiratory viruses that circulate in animals, particularly mammals, that could develop the ability to spread efficiently in humans.

However, it might not necessarily be from an animal, he stressed.

"It could be one of the other viruses that infect humans or evolves new characteristics or qualities to be able to spread. Or a human virus could be combined with an animal virus," he added.  

Origins and emergence

The infectious disease expert pointed out that zoonotic risks are very high when it comes to the Disease X pathogen.

"We think that they would emerge in places that there's a lot of human-animal interface," he said.

However, he said there is no way of being sure, pointing to the emergence of the H1N1 virus from Mexico, a country that "was not on anybody's list of a place where a pandemic pathogen might emerge."

"It's not always going to be in hotspots in Africa and Asia where there's high levels of biodiversity," he said.

"We shouldn't be completely blinded to the fact that we could get a pandemic from North America."  

What to look out for

A likely scenario with any Disease X outbreak would be a surge in cases of pneumonias and upper respiratory infections, according to Adalja.

"When a Disease X emerges, it's likely to present in some country with a cluster of unexplained pneumonia cases, just like COVID did," he said.

That makes it important for countries to have the diagnostic capability "to understand what's causing people to be sick with pneumonia and respiratory illnesses," he said.

"Part of Disease X is going to be really being much more aggressive with diagnostic testing of things that are making people sick all over the world," said Adalja.

That is particularly important because there "could be cases of unknown pathogens that are spreading in humans that are not causing much disruption and are going unnoticed because our diagnostic paradigm is not very robust when it comes to infectious disease," he warned.

For example, prior to COVID, most people did not test to see what was making people come into hospitals with pneumonia, he explained.  

Preemptive possibilities

While Disease X may yet be a placeholder concept, the expert emphasized that there are still steps that can be taken to counter it.

"The principle with Disease X is that you can work in those viral families ahead of time, because Disease X is likely to come from maybe a half dozen or so viral families that have very prolific respiratory viruses," he explained.

Categorization of viruses and understanding how they make people sick can be done, along with understanding their transmission characteristics and what parts of that virus might be important for an immune response, he continued.

He said vaccines can be developed ahead of time and might need to be tailored to the specific pathogen that ends up emanating as a pandemic pathogen or as an infectious disease emergency.

For example, he pointed out that SARS-CoV-2, the cause of COVID-19, was a Disease X.

"It wasn't on anybody's list, it was not known to humans before 2019, and yet we were able to make a vaccine within less than a year," said Adalja.

"That vaccine was developed because people had been working on other viruses in the coronavirus family, for example … the work done on MERS (Middle East Respiratory Syndrome) allowed people to move very quickly when SARS-CoV-2 was discovered and categorized."

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