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Published Date: 2019-06-10 11:29:50
Subject: PRO/AH/EDR> Powassan virus encephalitis - USA: (NJ)
Archive Number: 20190610.6511838
POWASSAN VIRUS ENCEPHALITIS - USA: (NEW JERSEY)
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Date: Sat 8 Jun 2019
Source: New Jersey 101.5 [edited]
https://nj1015.com/nj-man-dies-with-rare-scary-tick-disease-another-seriously-ill/


The potentially deadly Powassan tick-borne virus has been confirmed in 2 Sussex county residents, one of whom died last month [May 2019], state health officials confirmed [Sat 8 Jun 2019].

The Powassan virus is spread by the deer tick [_Ixodes scapularis_]. The illness is rarer than Lyme disease, which is also spread by the tick, but 10% of people who contract the [Powassan virus] illness die from it.

A Department of Health official on [Sat 8 Jun 2019] said that the department had not determined the cause of death for the patient who died last month [May 2019] but said that lab results this week [week of 3 Jun 2019] confirmed that he had the virus.

A 2nd victim continues to recover at home.

Symptoms of the virus include brain swelling, meningitis, fever, headache, vomiting, weakness, confusion, loss of coordination, trouble speaking, and memory loss. Symptoms can appear a week to a month after a tick bite, although some people show no symptoms and do not require treatment.

There is no vaccine or cure for the disease. Treatment includes hospitalization, support for breathing, and intravenous fluids.

Prevention involves the same precautions that should be taken to avoid Lyme disease: avoid wooded areas with tall grasses, use insect repellent while outdoors, and check for ticks after being outdoors.

Powassan [virus] -- first discovered in Powassan, Ontario, in 1958 -- has been confirmed in recent years in New Jersey, with one case each in 2013, 2014, and 2015, and 4 cases in 2017, the most recent year for which data is available. The cases were reported in Sussex, Warren, Morris, and Essex counties.

Between 2008 and 2017, there were 125 confirmed cases in the entire country and 9 deaths.

A person who said they were close to the man who died last month [May 2019] posted on Facebook that the man was bitten in the arm by a tick while gardening and fell ill about 2 weeks later. The Facebook post said that there was no bull's-eye mark around the bite -- a known tell-tale sign for Lyme infection. About a day before he was hospitalized, the man reported feeling like he was coming down with a cold and had a high fever.

State health department's tip sheet for preventing Powassan [virus infection]:
- avoid contact with ticks by avoiding wooded areas with high grass;
- when hiking, stay on the center of the trail;
- picnic in areas away from wooded and bushy areas;
- keep children on playground equipment and away from tall grass and shrubs;
- when outdoors, apply insect repellents;
- wear light-colored clothes so it is easy to see and remove ticks;
- wear long-sleeve shirts and pants;
- tuck long pants into socks so ticks cannot crawl under pants;
- do tick checks every couple hours while outdoors and before coming indoors;
- if you see a tick during tick checks, remove it right away;
- keep grass mowed short;
- keep children's toys, playground equipment, pools, and lawn furniture at least 15 feet [4.6 m] from wooded areas;
- create a woodchip or mulch border between your yard and wooded areas;
- keep areas under bird feeders and pet dishes clean, so they do not attract animals that may carry ticks;
- keep trash in closed containers or areas so it does not attract animals that may carry ticks.

[Byline: Sergio Bichao]

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[Powassan virus is endemic in New Jersey, and cases occur there sporadically. The tick vector is the deer tick, _Ixodes scapularis_. Humans become infected with POWV during spillover transmission from the natural transmission cycles. In humans, POWV can be a causative agent of a severe neuroinvasive illness, with 50% of survivors displaying long-term neurological sequelae. Individuals living or visiting areas where the deer tick occurs, should follow the above recommendations to avoid tick bites. If a tick is found feeding, it should be removed with forceps or tweezers grasping the tick at skin level and then gentle, constant force applied. The tick should never be removed by grasping it with thumb and forefinger, as squeezing the tick may cause inoculation of contents containing the pathogenic agent into the feeding site.

POWV was recognized as a human pathogen in 1958, when a young boy died of severe encephalitis in Powassan, Ontario, Canada. In that case, POWV was isolated from the brain autopsy. There are 2 distinct genetic lineages now recognized: POWV (lineage I) and deer tick virus (lineage II). Since the index case in 1958, over 100 human cases of POWV have been reported, with an apparent rise in disease incidence in the past 16 years. This recent increase in cases may represent a true emergence of POWV in regions where the tick vector species are prevalent, or it could represent an increase in POWV surveillance and diagnosis. - Mod.TY

HealthMap/ProMED-mail map of New Jersey, United States: http://healthmap.org/promed/p/44388
New Jersey county map: https://www.mapsofworld.com/usa/states/new-jersey/newjersey-county-map.html]

See Also

2018
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Powassan virus encephalitis - USA (05): (NY) 20181008.6077846
Powassan virus encephalitis - USA (04): (NY) 20180816.5970679
Powassan virus encephalitis - USA (03): (RI) 2016 20180627.5880172
Powassan virus encephalitis - USA (02): (NY) 20180615.5858753
Powassan virus encephalitis - USA 20180612.5852812
2017
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Powassan virus encephalitis - USA (09): USA (NY) 20171021.5395473
Powassan virus encephalitis - USA (08): USA (NY) 20170727.5207785
Powassan virus encephalitis - USA (07): USA (NY) 20170721.5193574
Powassan virus encephalitis - USA (06): (NY) 20170714.5173571
Powassan virus encephalitis - USA (04): (ME) 20170601.5077456
Powassan virus encephalitis - USA (03): (NH) Alert 20170515.5037030
Powassan virus encephalitis - USA (02): (ME) 20170429.5003798
Powassan virus encephalitis - USA: (CT) 20170420.4983987
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