• Embed Doc
  • Copy Link
  • Readcast
  • Collections
  • CommentGo Back
Download
 
Pathogens & People: A tick virus with a dangerous bite
By EDWARD McSWEEGAN, For The Capital
Published 04/05/09
Across much of Europe and Russia, various tick species regularly transmita serious infection called tick-borne encephalitis. It is a viral infection withlong-term neurological complications and a mortality rate of about 20percent. Fortunately, there are very effective vaccines against thissummertime menace. Here in the U.S., the situation is a more complicated,"good news-bad news" kind of story.The good news is that most of the tick-borne infections in the U.S. arebacterial (such as Lyme and Rocky Mountain spotted fever) or parasitic(such as Babesia), and easily treated with common antibiotics and anti-malarial drugs. But there is also an obscure tick-borne virus calledPowassan that may occasionally cause encephalitis. The bad news aboutPowassan is that it's probably under-diagnosed in the U.S., it can causesignificant morbidity and mortality, and there is no preventive vaccine oreffective treatment for it.Powassan virus is a flavivirus similar to the viruses that cause Japaneseencephalitis, West Nile, and St. Louis encephalitis. It was first discovered ina fatal encephalitis case in Powassan, Ottawa, in 1958. Since then, about40 cases have been described in Canada and the northeastern U.S.Between 1999 and 2005, nine cases were identified in Maine, New York,Michigan, Vermont and Wisconsin. The latest national tally in Morbidity andMortality Weekly Reports listed six cases in upstate New York and one inWisconsin during 2007.Four different tick species are known to transmit the virus, and 38 mammalspecies have been identified as possible sources of the virus. Groundhogsseem to be major sources of both Powassan virus and the tick thattransmits the virus,
Ixodes cookei 
.
 
Powassan virus may cause little overt illness unless it invades the centralnervous system. Once there, it can cause headache, fever, nausea, a stiffneck, meningitis, and of course, encephalitis. Tremors, mental confusion,seizures, coma and death also may occur. The fatality rate is 10 to 15percent.Complete recovery following infection may be prolonged or impossible.Persistent and debilitating symptoms can include headaches, muscleweakness, cognitive and memory difficulties, and other neurologic defects.A recent review of nine cases found the average length of hospitalizationwas 18.6 days. Six of those nine patients had to undergo "prolongedinpatient rehabilitation" due to "impaired ability to perform (the) activities ofdaily living."Treatment tends to be aimed at relieving the symptoms of infection. Fluids,ventilators to aid breathing, and steroids to reduce brain swelling arecommonly used. These infections probably are made worse by the delay indiagnosis. There are no commercial tests for Powassan virus, so testingoften is done at special laboratories run by the Centers for Disease Control.The lack of specific and readily available diagnostic tests also means manycases are probably missed and the actual number of cases in the U.S. isunderestimated. Some of the recently reported cases, for example, wereidentified only after initial tests turned up negative for West Nile virus.A dangerous virus that is carried by four different ticks, circulates amongthree dozen animal species and is hard to diagnose presents realchallenges to developing effective prevention and treatment measures. Thesituation is made even more difficult by the finding in 1997 of a relatedPowassan virus called the "deer tick virus." Laboratory studies suggest thedeer tick virus is less infectious than the classic Powassan virus, but theconsequences of human infection are still unknown. It may cause a mildinfection or - like its Powassan cousin - cause a life-threatening
of 00

Leave a Comment

You must be to leave a comment.
Submit
Characters: ...
You must be to leave a comment.
Submit
Characters: ...