Powassan virus
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Epidemiology
- found in the warm climate across Eurasia
- also exists in North America
- Northeastern & North central U.S.
- also exists in North America
- transmitted by ticks of the Genus Ixodes & Dermacentor ticks
- transmitted by Ixodes scapularis tick[2]
- maintained in a rodent reservoir[2]
- ~60 cases in the United States reports 2005-2015[2]
- 5 cases in northern New England & 13 cases in Massachusetts were reported from 2013-2016[2]
Pathology
- rare cause of viral encephalitis
- cerebral edema
- involvement of the basal ganglia & thalamus are common
Clinical manifestations
Laboratory
- Powassan virus serology*
- Powassan virus RNA
- plaque reduction neutralization test (confimatory)
* detection of the virus in blood or CSF with PCR is generally feasible only during the prodromal phase, thus diagnosis usually relies on serology[2]
* IgM serology 1st line, bur false positives due to cross-reactivity with other flaviviruses[2]
Complications
- long-term neurologic problems may occur[2]
Management
- intravenous fluids
- respiratory support as needed
- glucocorticoids as needed to reduce cerebral edema
- prevention:
- insect repellant (repells ticks)
- inspect for ticks after travelling through bushy &/or wooded areas
More general terms
References
- ↑ Wikipedia: Powassan virus https://en.wikipedia.org/wiki/Powassan_virus
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Rothaus C A Woman with Fever, Headache, and Progressive Encephalopathy NEJM Resident 360. Jan 23, 2019 https://resident360.nejm.org/content_items/a-woman-with-fever-headache-and-progressive-encephalopathy
- ↑ Centers for Disease Control & Prevention (CDC) Powassan Virus http://www.cdc.gov/powassan/