Alaskapox virus in Child
Only 4 cases of Alaskapox have been reported (in both adults and children): 1 in 2015, 1 in 2020, and 2 in 2021. All cases occurred during mid-to-late summer in forested areas near Fairbanks, Alaska. Each case was self-limited. All cases began with the appearance of a small superficial skin ulcer. Associated symptoms and signs included surrounding erythema, induration, pain, lymphangitis, and painful adenopathy. Additional symptoms included fatigue, malaise, and subjective fever.
Serologic and viral polymerase chain reaction (PCR) testing of trapped animals from Interior Alaska has revealed past and current infection in various species of small mammals, including the northern red-backed vole, shrews, and squirrels.
There is currently no evidence of human-to-human transmission.
B08.09 – Other orthopoxvirus infections
414015000 – Disease caused by Orthopoxvirus
Differential Diagnosis & Pitfalls
- Mpox – Presents with a febrile prodrome before the onset of lesions. Characterized as a centrifugally disseminated rash with lesions also often present on the palms and soles.
- Cowpox – Presents with fever with the onset of lesions. Lesions are often localized on the hands, face, and neck due to contact transmission.
- Rickettsialpox – Presents with a triad of fever, vesicular rash, and eschar.
- Tanapox – Endemic to equatorial Africa and presents with fever, lethargy, headache, backache, and 1-3 pox lesions.
- Herpes gladiatorum – Presents as vesicles that classically occur in crops.
- Vaccinia vaccination – The transfer of smallpox vaccine from the vaccination site to the skin and mucosa due to the tendency to scratch the itchy vaccination site.
- Orf – Endemic to Europe; lesions occur from contact with livestock.
- Spider bite
- Smallpox – This has been eradicated but remains a bioterrorism threat. Presents with a febrile prodrome before the onset of lesions. Characterized as a centrifugally disseminated rash with lesions also often present on the palms and soles.