New Reports of "the Next Tick-Borne Plague", Powassan Virus, are Getting Attention

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A recent report about the detection of Powassan virus, described as "even worse than Lyme disease!", in southern Connecticut ticks has gotten a lot of attention.  The report from the CT ag station by Anderson and Armstrong was not so surprising, though: Powassan has been detected in New England for many years.  In fact, they reported it in 2012 as well.  Another report by Nofchissey et al. showed that it has been infecting deer in Connecticut, New Hampshire, and Maine as far back as 1979.  This Morbidity and Mortality Weekly Report review indicated human Powassan cases were reported in New Hampshire, Maine, and Massachusetts in 2013 (2014 numbers not yet published).  So we see that Powassan has been "with us" for quite some time.  Does this mean that I feel that this story is overblown?  No, not at all.  I am grateful to see the attention being paid to tickborne encephalitides, because frankly they are scary.  Powassan and its nasty friends can cause encephalitis, or an inflammation of the brain.  This is a terrible pathological state to be in.  The mortality/fatality rate for encephalitis is quite high, but something that is not discussed as much is the morbidity, or rate of long-term health problems in survivors.  It turns out that surviving encephalitis, in some instances, is no gift.  Fortunately, the majority of persons infected with Powassan will have no symptoms of any kind, or will simply feel a bit under the weather for a few days.  We may hear about a spike in cases this summer, but I suspect that will be due in part to the report from the ag station.  As happened in Minnesota, exemplified by this letter to the editor of Emerging Infectious Diseases, surveillance went up, diagnosis was attempted more often, and thus it was found more frequently.  The attention this brings is a good thing in another way: the intervention here is tick and insect protection.  By more people undertaking it, there will be intrinsic protection against Lyme disease, Eastern equine encephalitis, west Nile virus, ehrlichiosis, rickettsiosis, La Crosse virus, and many others.  I'll count that as a success!