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Powassan Virus Infections: A Systematic Review of Published Cases.

Loukas Kakoullis1,2, Victor Renault Vaz1,2, Divmehar Kaur1,2

  • 1Department of Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA.

Tropical Medicine and Infectious Disease
|December 22, 2023
PubMed
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Powassan virus, a tick-borne arbovirus, causes significant neurotropic disease. This review highlights its severe complications, including paralysis and cognitive deficits, with notable mortality rates in adults.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Public Health

Background:

  • Powassan virus is an emerging neurotropic arbovirus transmitted by the *Ixodes scapularis* tick.
  • It poses a significant threat due to its potential for severe neurological complications.

Purpose of the Study:

  • To systematically review and aggregate data on the clinical manifestations, diagnostic findings, and complications of Powassan virus infections.
  • To understand the disease burden and identify risk factors associated with Powassan virus infection.

Main Methods:

  • A comprehensive literature search was conducted on PubMed using the term "Powassan" up to August 2023.
  • PRISMA guidelines were followed to identify and include relevant published case studies of Powassan virus infections.
Keywords:
climate changeemerging infectious diseaseexpanding habitattick-borne infection

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Main Results:

  • The review included 45 studies detailing 84 cases (70 adults, 14 pediatric) primarily from the USA and Canada.
  • High rates of complications were observed, including paralysis (42.6-44.1%), cognitive deficits (25-33.3%), and significant mortality (7.1% in pediatric, 19.1% in adult cases).
  • Mortality correlated with age, paralysis, and respiratory distress, while neurological deficits were linked to ataxia, paralysis, speech disorders, and cranial nerve involvement.

Conclusions:

  • Powassan virus infections are associated with substantial morbidity and mortality.
  • The virus should be suspected in encephalitis cases, especially with a history of tick exposure.
  • Early recognition and diagnosis are crucial for managing severe outcomes.