(Image via forbes.com)

Staff Writer: Maya Arruda

Email: marruda7@umassd.edu

Society has just begun to recover from the COVID-19 pandemic. We have all, painfully, learnt about the real-world implications of pathogenic viruses; however, in 2024, there is a new threat in our own backyard. 

Alaskapox, caused by the Alaskapox virus, is a smallpox-esque affliction that can cause skin lesions, muscle pain, and swollen lymph nodes. It’s been around since 2015 in the frigid state of Alaska, hence the name. There have been seven reported cases of Alaskapox in humans after its emergence in 2015, though it is more than likely that there were unreported cases. 

Primarily infecting small mammals, Alaskapox has slid under the radar until an Alaska resident died due to Alaskapox infection in late January. This unnamed elderly man had a prior medical history of drug-induced immunosuppression and cancer treatment, according to the Alaska State’s Department of Health epidemiology bulletin, which contributed to the severity of his Alaskapox case. 

Based on this individual’s lifestyle, it was possible he contracted the virus from the claws of a stray cat he took care of.

The man reported skin lesion symptoms in mid-September of 2023 and was hospitalized on November 17th, 2023, due to extensive virus-induced muscle pain and immobility. After one week of treatment, he showed signs of improvement; however, his health had a sharp downturn, showing malnutrition, acute renal failure, and acute respiratory failure. 

The Alaskapox virus (AKPV) is an orthopox virus, making it a close relative of the smallpox virus. Compared to the smallpox virus, however, the AKPV genome has fewer virulence factors, which makes it less deadly than smallpox. On the downside, AKPV has genes that allow it to have a wide host range similar to other orthopoxviruses, allowing it to be zoonotic and infect humans. 

The immune system, of course, is responsible for defending against viral infection. Under normal conditions, the innate immune response (white blood cells, macrophages, etc.) kicks in to keep infection low until the adaptive immune system (B cells and T cells) can mount a specific, targeted response against the pathogen and eliminate it. 

To loosely paraphrase my immunology professor, the innate immune system is the general force, while the adaptive immune system is the special task force. 

However, you have a problem when the immune system is not hunky dory. Drug-induced immunosuppression is, as the name suggests, a targeted method of lowering an immune response. Usually, these kinds of drugs are used to treat autoimmune diseases or for transplant recipients to keep the immune system from attacking the patient’s normal cells and tissue or from attacking the transplanted organ, respectively. 

The major drawback of immunosuppressive drug treatments is that they weaken the immune system and essentially open the patient up to more frequent and more severe infections. 

Having cancer would also have an effect on the immune system. To put it simply, the immune system has finite resources, and it costs a great amount of energy to mobilize an immune response, especially to mobilize the adaptive immune system. Moreover, some cancers can do their own suppression of the immune system through the secretion of proteins that inhibit T cells and macrophages. 

To make matters worse, immunosenescence has joined the proverbial chat. 

Immunosenescence is a natural process that happens to all people, where the adaptive immune system decides it wants to retire. The immune system has a lower response rate, meaning fewer T cells are made. This increases the likelihood of cancers and infections with age as well as disease severity. 

Combining drug-induced immunosuppression with possible cancer-induced immunosuppression and age-induced immunosenescence, like in the case of the man who died from Alaskapox, is a recipe for disastrously severe infections.  

While his death from Alaskapox is tragic, it is unlikely to occur in most people who have at least semi-functioning immune systems. In my opinion, Alaskapox will only be a threat to immunocompromised individuals. Vaccination may mitigate the threat to these individuals, though it is unlikely Alaskapox vaccinations will become as ubiquitous as those for COVID-19.