Fatal Powassan virus encephalitis in patients with chronic lymphocytic leukemia

Johnson, Isla McKerrow; Scheckel, Caleb; Enzler, Mark J.; Fugate, Jennifer E.; Call, Timothy G.

doi:10.1038/s41408-022-00737-y

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…Upon screening, 4765 were excluded based on title and abstract review. After the full-text screening of 155 studies, 101 studies 15 – 115 were deemed appropriate for inclusion in this Review. The main characteristics of the included studies such as demographic data (age and gender), study design, publication year, study location, time of infection, incubation period, and time from onset of symptoms to diagnosis are presented in Tables 1 and 2 , respectively.…”

Section: Resultsmentioning

confidence: 99%

A comprehensive neurological perspective on tick-borne flaviviruses, with emphasis on Powassan virus

Fareed,

Rohail,

Zameer

et al. 2024

Therapeutic Advances in Infection

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Powassan virus (POWV), a tick-borne flavivirus transmitted primarily by Ixodes ticks, poses a significant threat as it can lead to severe neuroinvasive illness. This review delves into the nuanced clinical presentation of Powassan infection, a challenge in diagnosis exacerbated by the absence of an available vaccine. Over the past decade, the prevalence of POWV has surged in North America, necessitating a thorough examination of its neurological manifestations alongside tick-borne encephalitis virus (TBEV). A comprehensive literature search conducted up to January 2024 revealed 135 cases of neurological symptoms associated with either Powassan or TBEV infection. Notably, severe occipital headache emerged as the most prevalent symptom (22.75%), followed by meningoencephalitis (10.34%), seizures (8.27%), and flaccid paresis (6.8%). Additional manifestations included poor balance, wide gait, dysarthria, facial nerve palsy, seizure, slurred speech, and absent deep tendon reflexes. Tragically, nine cases resulted in fatal outcomes attributed to POWV infection. This analysis highlights the intricate spectrum of neurological symptoms associated with Powassan infection and underscores the necessity for heightened awareness among medical practitioners, particularly in regions with a higher prevalence of the virus. The complexity of symptoms emphasizes the need for further research to unravel the factors contributing to this diversity. Additionally, exploring potential treatment avenues and vaccine development is crucial in addressing the rising threat posed by POWV, ultimately enhancing our ability to manage and prevent severe neurological outcomes.

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Section: Resultsmentioning

confidence: 99%

A comprehensive neurological perspective on tick-borne flaviviruses, with emphasis on Powassan virus

Fareed,

Rohail,

Zameer

et al. 2024

Therapeutic Advances in Infection

View full text Add to dashboard Cite

show abstract

“…Symptoms can include dizziness, headaches, fatigue, coordination, memory issues, muscle weakness, and paralysis [147][148][149][150]. The reported 50% is likely an overestimation, as serological surveys have indicated that POWV infection, much like TBEV, can be resolved asymptomatically for a proportion of hosts [41,151,152]. Much like TBEV, the cause of long-term neurological involvement for POWV remains unclear.…”

Section: Powvmentioning

confidence: 99%

T Cells in Tick-Borne Flavivirus Encephalitis: A Review of Current Paradigms in Protection and Disease Pathology

Stone

Pinto

2023

Viruses

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The family Flaviviridae is comprised of a diverse group of arthropod-borne viruses that are the etiological agents of globally relevant diseases in humans. Among these, infection with several of these flaviviruses—including West Nile virus (WNV), Zika virus (ZIKV), Japanese encephalitis virus (JEV), tick-borne encephalitis virus (TBEV), and Powassan virus (POWV)—can result in neuroinvasive disease presenting as meningitis or encephalitis. Factors contributing to the development and resolution of tick-borne flavivirus (TBEV, POWV) infection and neuropathology remain unclear, though many recently undertaken studies have described the virus–host interactions underlying encephalitic disease. With access to neural tissues despite the selectively permeable blood–brain barrier, T cells have emerged as one notable contributor to neuroinflammation. The goal of this review is to summarize the recent advances in tick-borne flavivirus immunology—particularly with respect to T cells—as it pertains to the development of encephalitis. We found that although T cell responses are rarely evaluated in a clinical setting, they are integral in conjunction with antibody responses to restricting the entry of TBFV into the CNS. The extent and means by which they can drive immune pathology, however, merits further study. Understanding the role of the T cell compartment in tick-borne flavivirus encephalitis is instrumental for improving vaccine safety and efficacy, and has implications for treatments and interventions for human disease.

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Cerebrospinal fluid metagenomics has greatest added value as a test for Powassan virus among patients in New England with suspected central nervous system infection

Klontz,

Solomon,

Turbett

et al. 2024

Diagnostic Microbiology and Infectious Disease

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Fatal Powassan virus encephalitis in patients with chronic lymphocytic leukemia

Cited by 4 publications

References 14 publications

A comprehensive neurological perspective on tick-borne flaviviruses, with emphasis on Powassan virus

A comprehensive neurological perspective on tick-borne flaviviruses, with emphasis on Powassan virus

T Cells in Tick-Borne Flavivirus Encephalitis: A Review of Current Paradigms in Protection and Disease Pathology

Cerebrospinal fluid metagenomics has greatest added value as a test for Powassan virus among patients in New England with suspected central nervous system infection

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