Changing epidemiology of Powassan encephalitis in North America suggests the emergence of the deer tick virus subtype

Khoury, Marc Y Ei; Camargo, José F.; Wormser, Gary P.

doi:10.1586/14787210.2013.837805

Cited by 15 publications

(15 citation statements)

References 15 publications

(28 reference statements)

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“…Typical POWV infections have a 7to 34-day incubation period followed by a prodrome phase with nonspecific flu-like symptoms, such as fever, chills, malaise, generalized weakness, sore throat, headache, myalgia, lethargy, somnolence, dizziness, and gastrointestinal symptoms (nausea and vomiting), in the majority of patients. Headache and fever up to a temperature of 38.5°C to 41°C are reported by all patients (4,145,157). A fine erythematous morbilliform rash was observed in some cases (138,(223)(224)(225).…”

Section: Clinical Disease and Diagnosismentioning

confidence: 94%

“…From the late 1950s to the mid-2000s, around 40 to 45 human POWV illnesses were documented in North America, with the majority of cases being reported in the United States, and at least 16 cases were reported in the Russian literature, encompassing a 10-year study period in the 1980s (132,137,(145)(146)(147). The low POWV detection rate in this period (ϳ1 to 1.5 cases per year) was followed by a marked increase in reporting of POWV illnesses during the subsequent decade in the United States (4).…”

Section: Epidemiologymentioning

confidence: 99%

“…Apnea, dysarthria, psychosis, and spasticity were recorded as short-term sequelae. Long-term sequelae include prolonged headache, cognitive deficit, significant limitation in activities of daily living, bed-bound state, spastic hemiplegia and quadriplegia, hemiparesis, mental retardation, aphasia, hearing impairment, muscle weakness, imbalance, ventilator dependence, ophthalmoplegia, and memory dysfunction (Table 3) (4,145,147,178).…”

Section: Clinical Disease and Diagnosismentioning

confidence: 99%

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Tick-Borne Flaviviruses, with a Focus on Powassan Virus

2018

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SUMMARYThe tick-borne pathogen Powassan virus is a rare cause of encephalitis in North America and the Russian Far East. The number of documented cases described since the discovery of Powassan virus in 1958 may be <150, although detection of cases has increased over the past decade. In the United States, the incidence of Powassan virus infections expanded from the estimated 1 case per year prior to 2005 to 10 cases per year during the subsequent decade. The increased detection rate may be associated with several factors, including enhanced surveillance, the availability of improved laboratory diagnostic methods, the expansion of the vector population, and, perhaps, altered human activities that lead to more exposure. Nonetheless, it remains unclear whether Powassan virus is indeed an emerging threat or if enzootic cycles in nature remain more-or-less stable with periodic fluctuations of host and vector population sizes. Despite the low disease incidence, the approximately 10% to 15% case fatality rate of neuroinvasive Powassan virus infection and the temporary or prolonged sequelae in >50% of survivors make Powassan virus a medical concern requiring the attention of public health authorities and clinicians. The medical importance of Powassan virus justifies more research on developing specific and effective treatments and prevention and control measures.

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Section: Clinical Disease and Diagnosismentioning

confidence: 94%

Section: Epidemiologymentioning

confidence: 99%

Section: Clinical Disease and Diagnosismentioning

confidence: 99%

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Tick-Borne Flaviviruses, with a Focus on Powassan Virus

2018

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“…Others, such as West Nile virus, Zika virus and again, CHIK virus, are emerging or reemerging, and may cause sporadic outbreaks in regions in which they were not previously detected (Lanciotti et al, 1999; Lanciotti et al, 2007; Lanciotti et al, 2008; Solomon, Winter, 2004). Other arboviruses, such as Powassan (POW), have low or unknown incidence, and may be detected due to emergence or increased surveillance (Ei Khoury et al, 2013). …”

Section: Introductionmentioning

confidence: 99%

Development of an algorithm for production of inactivated arbovirus antigens in cell culture

Goodman

Russell

Velez

et al. 2014

Journal of Virological Methods

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Arboviruses are medically important pathogens that cause human disease ranging from a mild fever to encephalitis. Laboratory diagnosis is essential to differentiate arbovirus infections from other pathogens with similar clinical manifestations. The Arboviral Diseases Branch (ADB) reference laboratory at the CDC Division of Vector-Borne Diseases (DVBD) produces reference antigens used in serological assays such as the virus-specific immunoglobulin M antibody-capture enzyme-linked immunosorbent assay (MAC-ELISA). Antigen production in cell culture has largely replaced the use of suckling mice; however, the methods are not directly transferable. The development of a cell culture antigen production algorithm for nine arboviruses from the three main arbovirus families, Flaviviridae, Togaviridae, and Bunyaviridae, is described here. Virus cell culture growth and harvest conditions were optimized, inactivation methods were evaluated, and concentration procedures were compared for each virus. Antigen performance was evaluated by the MAC-ELISA at each step of the procedure. The antigen production algorithm is a framework for standardization of methodology and quality control; however, a single antigen production protocol was not applicable to all arboviruses and needed to be optimized for each virus.

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“…Vectors of DTV and POW‐L1, I. scapularis and I. cookei, have been most frequently sampled in epidemiological studies and reported to be carrying the virus, respectively; however, POWV has occasionally been isolated from other ticks I. marxi, I. spinipalpus and D. andersoni , which have been studied to a lesser extent (Keirans & Clifford, ; McLean, Devos, et al, ). Experiments on POWV transmission efficiency demonstrated I. scapularis is a competent vector of DTV and D. andersoni is a competent vector of POW‐L1 (Chernesky & McLean, ; Costero & Grayson, ; Ebel & Kramer, ; El Khoury, Camargo, & Wormser ). Ixodes pacificus is likely a very inefficient vector of POW‐L1 as this species rarely became infected after feeding on viremic mammals (Chernesky, ).…”

Section: Discussionmentioning

confidence: 99%