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The Connecticut Department of Public Health announced the state’s first reported Powassan virus infection of the year this past Wednesday. Powassan virus is a rare disease spread by the same tick that causes Lyme disease, according to a recent press release.
“The identification of a Connecticut resident with Powassan virus associated illness emphasizes the need to take actions to prevent tick bites from now through the late fall,” said Dr. Manisha Juthani, who is the commissioner of the Connecticut Department of Health.
“Using insect repellent, avoiding areas where ticks are likely, and checking carefully for ticks after being outside can reduce the chance of you or your children being infected with this virus.”
Powassan virus, first discovered in Powassan, Ontario in 1958, is usually spread through the bite of an infected black-legged or deer tick, officially known as Ixodes scapularis, and can be transmitted in as little as 15 minutes after a tick bite, but it can take a week up to one month to develop symptoms, per the release.
This is in contrast to Lyme disease, the most common tick-borne disease in the United States, which is caused by a bacteria known as Borrelia burgdorferi and usually transmitted after 36-48 hours after the bite of usually the black-legged tick, according to the Centers for Disease Control and Prevention (CDC).
Human infections secondary to the Powassan virus infections have been recognized in the United States, Canada, and Russia, with the cases mostly from northeastern states and the Great Lakes region in late spring, early summer and mid-fall when ticks are most active, per the CDC.
Between 2011-20, in addition to Connecticut, the following states have reported cases to the CDC: Indiana, Maine, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Pennsylvania, Rhode Island and Wisconsin.
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Powassan cases are rare, with 20 reported in 2020 to the CDC, but the reported cases are increasing, whereas usually 30,00 cases of Lyme disease are reported to the CDC each year, but the true number is likely closer to 476,000 each year because of underreporting, per the agency.
People who work outdoors and engage in recreational activities in endemic areas for the virus are at increased risk of the infection.
The Connecticut patient who contracted Powassan virus is a male patient in his 50s who started to feel sick during the fourth week of March after a tick bite. He was later hospitalized with a central nervous system disease with laboratory confirmed evidence by the CDC of antibodies to the virus, but is now discharged and recovering at home, according to the health department’s release.
Most people infected with Powassan virus will develop mild flu-like symptoms or no symptoms at all, but some will experience severe illness affecting the central nervous system, which consists of the spinal cord and brain, per the health department.
Early symptoms of severe disease include headache, vomiting, fever and weakness that rapidly progresses to confusion, loss of coordination, difficulty speaking, or seizures. Treatment is supportive care, which means there is no specific medication directed against the disease, but instead targeted to symptoms.
Approximately one out of 10 cases of severe illness are fatal, with an estimated half of survivors experiencing long-term complications.
There were 12 cases of Powassan virus from 2017 to 2021 reported in Connecticut, including three in 2021 and two out the 12 that were fatal, the release said.
Connecticut is a state well-known for tick-bites, with the CDC categorizing it a high-incidence region for Lyme disease, as of 2019.
Lyme disease was first described in Lyme, Connecticut in 1975 by a researcher, Dr. William Burgdorfer, who connected puzzling symptoms of rheumatoid arthritis-like symptoms with the bite of deer ticks, according to the National Institute of Health (NIH).
He discovered that a spiral shaped bacterium, known as a spirochete, carried by the ticks caused the condition now known as Lyme disease. The spirochete was named Borrelia burgdorferi in 1982 in his honor, per the NIH.
An early symptom of Lyme disease is a hallmark rash that looks like a “bulls-eye,” known as erythema migrans, but later can progress to joint pain and neurological issues, according to Mayo Clinic.
Blacklegged ticks not only can carry Lyme disease and Powassan virus, but also other tick-borne diseases like anaplasmosis and babesiosis, so it’s possible to get infected with more than one infection at the same time, called a co-infection, per the CDC.
Some tips to prevent tick bites include: avoiding grassy, brushy, or wooded areas, using CDC-recommended mosquito repellents, checking for ticks immediately after an outdoor activity and showering within two hours of coming indoors, per the release.