A rare viral disease has emerged in an outbreak in Alaska’s largest city that appears to be spreading, state health officials report.
There are now four new cases in Anchorage of mpox, a viral disease formerly called monkeypox that is transmitted through close contact and can be fatal.
None of the patients reported traveling out of state in the month before infection.
This is the highest number of annual mpox cases in Alaska since 2022, when five cases were diagnosed in the state amid a global outbreak. Between 2023 and 2025, there have only been two cases in Alaska.
Three of Anchorage’s cases emerged in October and were reported in late October through an alert from the state Department of Health intended to raise awareness among the public and health care providers. The fourth case was reported to state officials Thursday, said Dr. Joe McLaughlin, Alaska state epidemiologist.
The four Anchorage cases involve men who reported no travel outside of Alaska in the past 30 days, Mclaughlin said. This contrasts with previous cases in Alaska, all of which involved people who had recently traveled. Until now, travel has been implicated in the spread of mpox in Alaska.
Authorities are currently trying to trace the source of the infection, said McLaughlin and Dr. Randi Rollins, an epidemiologist with the U.S. Centers for Disease Control and Prevention working with the Alaska Department of Health.
The lack of out-of-state travel “does not necessarily establish that the monkeypox virus is circulating here in Alaska,” Rollins said. “They may have been in contact with someone who traveled to Alaska, and they could be the end of that transmission line at this point. We don’t know.”
Mpox is characterized by lesions that appear on various parts of the body.
It usually takes three to 17 days after infection for symptoms to appear, Rollins said, and in the first phase, symptoms resemble those of the flu: “fever, chills, fatigue, headache, muscle aches and even swollen lymph nodes.” The lesions develop in the second phase, with bumps that are firm to the touch or sometimes tender, she said.
Some people ignore early symptoms and show no signs of infection until the rash phase develops, she said.
The illness lasts a few weeks and patients are considered cured when all lesions have disappeared. Until that final lesion is completely healed, “the person is still contagious and can transmit monkeypox, and that can usually take two to four weeks,” she said.
McLaughlin said Alaska patients are isolating and recovering. Two of the reported cases involved male partners, but it is unclear whether there are additional connections between the patients, he said.
Nationwide increase in cases
The new mpox outbreak in Anchorage fits a national pattern. After a lull following the 2022-23 global outbreak, cases are on the rise again in the United States. A surge in infections began in March, the CDC reported.
The virus currently circulating is genetically different from the variety causing the 2022 global outbreak, called clade II.
The virus currently circulating is called clade I. In central Africa, the clade I variant was more deadly than the clade II variant. But the current clade I virus variant does not appear particularly deadly, according to health officials.
Spread of the virus occurs through close contact, including but not limited to sexual contact.
Alaska health officials encourage anyone considered at risk of infection to get vaccinated.
The JYNNEOS vaccine, approved by the Food and Drug Administration in 2019, protects against both mpox clades, as well as smallpox, a disease that historically killed much of the world’s population but is now considered eradicated.
The vaccine, which is administered in two doses, is available through the Anchorage Department of Health and other health providers.
It is recommended for certain groups of people considered to be at higher risk of infection. These include men who have sex with men, anyone who has been exposed to another person suspected of having mpox, people who travel to areas of the world with outbreaks of mpox, and medical workers, such as those employed in laboratories or health care settings, whose work puts them at risk of exposure to this and other pathogens.
The vaccine is effective even for people already infected with the virus, reducing risks even for those who might develop the disease, Rollins said.
For anyone who has been exposed, “it is recommended to get vaccinated within four days of exposure,” she said. While this window of time is ideal, “you can extend it to about 14 days and still see effectiveness in reducing disease severity,” she said.
State vaccination records show that since 2022, 851 people in Alaska have received a first dose of the JYNNEOS vaccine and 604 have received a second dose, Rollins said.
New Boreal Smallpox Cases Reported
While health care providers are advised to monitor the resurgence of mpox, there are reports of a rarer type of smallpox: boreal pox.
Two cases of boreal pox, formerly known as Alaskapox, have been diagnosed this year, Rollins and McLaughlin said.
This brings the total number of diagnosed cases of Boreal smallpox worldwide to nine.
The disease, linked to mpox, smallpox and other poxes, was first identified in 2015 in Fairbanks. The first six cases were detected in Fairbanks and were considered mild. Like other smallpoxes, they were characterized by skin lesions and flu-like symptoms.
However, in January 2024, a Kenai Peninsula man died from boreal pox after being infected with what scientists discovered was a genetically different strain of the virus. The patient was in his sixties and his immune system was weakened by cancer treatment.
This year’s two cases of boreal smallpox, like previous cases in the Fairbanks area, were mild, Rollins said.
“This is the lesion that caught the attention of both patients, and they sought treatment for this lesion,” she said. “One patient suffered from respiratory illnesses, fever, muscle and joint pain.”
Scientists say boreal pox circulates among small mammals. So far, red-backed voles, which are abundant across most of Alaska, have been identified as a major source. Case investigations so far have focused on pets that appear to have encountered voles or other infected small mammals.
Unlike mpox, there is no vaccine against boreal pox. But some scientists are working to develop one, and others are studying the effectiveness of certain antiviral drugs in treating infections.
Originally published by Alaska Beaconan independent, nonpartisan news organization that covers Alaska state government.
Gn Health
